HEPATITIS

Hepatitis
ARTICLE PUBLISHED BY MEDIPHARMAC MEDICAL CENTER
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Overview Types Causes Sym
What Is Hepatitis?
Hepatitis refers to an inflammatory condition of the
liver. It’s commonly caused by a viral infection, but
there are other possible causes of hepatitis. These
include autoimmune hepatitis and hepatitis that occurs
as a secondary result of medications, drugs, toxins, and
alcohol. Autoimmune hepatitis is a disease that occurs
when your body makes antibodies against your liver
tissue.
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The liver is located on the right upper quadrant of your
abdomen. It performs many critical functions that
affect metabolism throughout your body, including:
bile production that’s essential to digestion
filtering of toxins from the body
excretion of bilirubin, cholesterol, hormones, and
drugs
metabolism of carbohydrates, fats, and proteins
activation of enzymes, which are specialized
proteins essential to metabolic functions
storage of glycogen, minerals, and vitamins (A, D,
E, and K)
synthesis of plasma proteins, such as albumin
synthesis of clotting factors
According to the Centers for Disease Control and
Prevention (CDC) , there are 4.4 million Americans
currently living with chronic hepatitis. Many more
people don’t even know that they have it.
Viral infections of the liver that are classified as
hepatitis include hepatitis A, B, C, D, and E. Hepatitis A
is a milder version of the disease, and hepatitis C and
D are more severe. Treatment options vary depending
on what form of hepatitis you have and what caused
the infection. You can prevent some forms of hepatitis
through immunizations or lifestyle precautions.
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The 5 Types of Viral Hepatitis
Hepatitis A
This type derives from an infection
with the hepatitis A virus (HAV).
This type of hepatitis is most
commonly transmitted by
consuming food or water
contaminated by feces from a
person infected with hepatitis A.
Hepatitis B
This type derives from an infection with the hepatitis B
virus (HBV). This type is transmitted through puncture
wounds or contact with infectious body fluids, such as
blood, saliva, or semen. Injection drug use, having sex
with an infected partner, or sharing razors with an
infected person increase your risk of getting hepatitis B.
It’s estimated by the CDC that 1.25 million people in
the United States have chronic hepatitis B and 350
million people worldwide live with this chronic disease.
Hepatitis C
This type comes from the hepatitis C virus (HCV).
Hepatitis C is transmitted through direct contact with
infected body fluids, typically through injection drug use
and sexual contact. HCV is among the most common
blood-borne viral infections in the United States.
Approximately 2.7 million Americans are currently living
with a chronic form of this infection.
Hepatitis D
This is also called delta hepatitis. Hepatitis D is a
serious liver disease caused by the hepatitis D virus
(HDV). HDV is contracted through puncture wounds or
contact with infected blood. Hepatitis D is a rare form
of hepatitis that occurs in conjunction with hepatitis B
infection. It’s very uncommon in the United States.
Hepatitis E
Hepatitis E is a waterborne disease caused by the
hepatitis E virus (HEV). Hepatitis E is mainly found in
areas with poor sanitation and is typically caused by
ingesting fecal matter. This disease is uncommon in the
United States. However, cases of hepatitis E have been
reported in the Middle East, Asia, Central America, and
Africa, reports the CDC .
Hepatitis A and E are normally contracted from eating
contaminated food or drinking contaminated water.
Hepatitis B, C, and D are contracted through
contaminated blood. These forms of hepatitis can be
either acute or chronic. Types B and C usually become
chronic.
Causes of Nonviral Hepatitis
Alcohol
Hepatitis can be caused by liver
damage from excessive alcohol
consumption. This is sometimes
referred to as alcoholic hepatitis.
The alcohol causes the liver to
swell and become inflamed. Other
toxic causes include overuse of medication or exposure
to poisons.
Autoimmune Disease
The immune system may mistake the liver as a harmful
object and begin to attack it, hindering liver function.
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Common Symptoms of Hepatitis
If you have forms of hepatitis that
are usually chronic (hepatitis B and
C), you may not have symptoms in
the beginning. Symptoms may not
occur until liver damage occurs.
Signs and symptoms of acute
hepatitis appear quickly. They
include:
fatigue
flu-like symptoms
dark urine
pale stool
abdominal pain
loss of appetite
unexplained weight loss
yellow skin and eyes, which may be signs of
jaundice
Since chronic hepatitis develops slowly, these signs and
symptoms may be too subtle to notice.
How Is Hepatitis Diagnosed?
Physical Exam
During a physical examination, your
doctor may press down gently on
your abdomen to see if there’s pain
or tenderness. Your doctor may
also feel to see if your liver is
enlarged. If your skin or eyes are
yellow, your doctor will note this during the exam.
Liver Biopsy
A liver biopsy is an invasive procedure that involves the
doctor taking a sample of tissue from your liver. This is
a closed procedure. In other words, it can be done
through the skin with a needle and doesn’t require
surgery. This test allows your doctor to determine if an
infection or inflammation is present or if liver damage
has occurred.
Liver Function Tests
Liver function tests use blood samples to determine
how efficiently the liver works. These tests check how
the liver clears blood waste, protein, and enzymes. High
liver enzyme levels may indicate that the liver is
stressed or damaged.
Ultrasound
An abdominal ultrasound uses ultrasound waves to
create an image of the organs within the abdomen.
This test will reveal fluid in the abdomen, an enlarged
liver, or liver damage.
Blood Tests
Blood tests used to detect the presence of hepatitis
virus antibodies and antigen in the blood will indicate or
confirm which virus is the cause of the hepatitis.
Viral Antibody Testing
Further viral antibody testing may be needed to
determine if a specific type of the hepatitis virus is
present.
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How Is Hepatitis Treated?
Treatment options are determined
by which type of hepatitis you have
and whether the infection is acute
or chronic.
Hepatitis A
Hepatitis A isn’t usually treated.
Bed rest may be recommended if symptoms cause a
great deal of discomfort. If you experience vomiting or
diarrhea, you will be put on a special diet created by
your doctor to prevent malnutrition or dehydration.
Vaccination can also prevent hepatitis A infections by
helping your body produce the antibodies that fight this
type of infection. Most children receive the vaccination
between ages 12 and 18 months. Vaccination is also
available for adults.
Hepatitis B
Acute hepatitis B doesn’t require specific treatment.
Chronic hepatitis B is treated with antiviral
medications. This form of treatment can be costly
because it must be followed for several months or
years. Treatment for chronic hepatitis B also requires
regular medical evaluations and monitoring to
determine if the virus is progressing. The CDC
recommends hepatitis B vaccinations for all newborns.
The vaccine is also recommended for all healthcare and
medical personnel.
Hepatitis C
Antiviral medications are used to treat both acute and
chronic forms of hepatitis C. People who develop
chronic hepatitis C are typically treated with a
combination of antiviral drug therapies. They may also
need further testing to determine the best form of
treatment. People who develop cirrhosis (scarring of the
liver) or liver disease as a result of chronic hepatitis C
may be candidates for a liver transplant.
Hepatitis D
Hepatitis D is treated with a medication called alpha
interferon. According to the Public Health Agency of
Canada, between 60 to 97 percent of people develop
hepatitis D again even after treatment.
Hepatitis E
There are currently no specific medical therapies to
treat hepatitis E. Because the infection is often acute, it
typically resolves on its own. People with this type of
infection are often advised to get adequate rest, drink
plenty of fluids, get enough nutrients, and avoid alcohol.
Tips to Prevent Hepatitis
Hygiene
Practicing good hygiene is one key
way to avoid contracting hepatitis.
If you’re traveling to a developing
country, you should avoid:
drinking local water
ice
seafood
raw fruit and vegetables
Hepatitis contracted through contaminated blood can
be prevented by:
not sharing drug needles
not sharing razors
not using someone else’s toothbrush
not touching spilled blood
Vaccines
The utilization of vaccines is a second key to
preventing hepatitis. Vaccinations are available to
prevent the development of hepatitis A and B. Experts
are currently developing vaccines against hepatitis C,
D, and E.
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Complications of Hepatitis
Chronic hepatitis B or C can often
lead to more serious health
problems. Because the virus
primarily affects the liver, people
with chronic hepatitis B or C are at
risk for:
chronic liver disease
cirrhosis (scarring of the
liver)
cancer of the liver (in rare
cases)
When the liver stops functioning normally, liver failure
can occur. Complications of liver failure include:
bleeding disorders
a buildup of fluid in the abdomen
increased blood pressure in portal veins that
enter the liver
kidney failure
hepatic encephalopathy, which can involve
fatigue, memory loss, and diminished mental
abilities due to the build up of toxins that affect
the brain (especially ammonia)
hepatocellular carcinoma, which is a form of liver
cancer
People with chronic hepatitis C are encouraged to avoid
alcohol because it can accelerate liver disease and
failure. Certain supplements, prescription, and over-the-
counter medications can also affect liver function. If
you have chronic hepatitis C, check with your doctor
before taking any new medications.