By Health Square desk What is Hepatitis?
Hepatitis is an inflammatory disease affecting the liver. A viral infection mostly causes hepatitis, but there are also other causes associated with the disease. Some of these are
- Autoimmune hepatitis-a type in which the body starts making antibodies against its own liver cells
- Hepatitis as a secondary result of medication
- Drugs
- Toxins
- Alcohol
The liver is a very critical organ located in the upper area of the abdomen in the body. It performs prime functions that affect the metabolism of the body including
- Bile production-a digestive hormone
- Removal of toxins from the body
- Excretion of bilirubin (end-product of red blood cells breakdown), hormones, drugs, and cholesterol
- Breakdown of fats, proteins, and carbohydrates
- Synthesis of blood proteins-albumin
- Synthesis of blood clotting factors
- Storage of blood sugar glycogen, minerals, and vitamins
Types of Hepatitis
There are five types of viral hepatitis infection, including A, B, C, D, and E. A different kind of virus handles each type of hepatitis.
Hepatitis A
Hepatitis A is an acute and short-term disease. It is caused by infection with hepatitis A virus (HAV). Type A is mostly caused by consuming contaminated food and water from the faeces of a Hepatitis A infected person.
Hepatitis B
Hepatitis B transmits by contacting infectious body fluids-blood, vaginal secretions, semen of the person infected from the hepatitis B virus. Other methods of spreading the infection are
- Use of a contaminated syringe
- Having sex with the infected partner
- Sharing razors
The reuse of the contaminated things by HBV causes the transmission of disease in healthy persons. Millions of people worldwide get infected and are living with this chronic disease.
Hepatitis C
It transmits directly through contact with infected body fluids during intercourse and the use of syringes. Hepatitis C is the most common blood transmitted viral infection in the world.
Hepatitis D
This is a severe liver disease caused by Hepatitis D virus and is transmitted through direct contact with infected blood. This rare form of hepatitis occurs in conjunction with Hepatitis B. It is a medical fact that hepatitis D virus cannot multiply without the presence of Hepatitis B.
Hepatitis E
Hepatitis E is an acute form of hepatitis but can be dangerous in pregnant women. It is a waterborne disease found in poorly sanitated areas. The ingestion of water contaminated from the faecal matter of infected people is the prime cause of illness. The cases of Hepatitis E are common in third world countries.
Non-infectious Hepatitis
Alcohol and toxins
Too much alcohol consumption causes the inflammation and damage of the liver, known as alcoholic hepatitis. The excessive use of alcohol directly damages the cells of the liver. Over time, it leads to permanent damage and causes liver failure and cirrhosis (thickening and scarring of the liver). Toxins include overdose of drugs and exposure to the toxic environment.
Autoimmune Hepatitis
In this disorder, the immune system of the body mistaken the liver as a harmful object and backfires against it. The autoimmune system response causes the inflammation of the liver and often hinders the healthy liver function.
Symptoms of Hepatitis
The symptoms usually do not appear at the beginning of infection when suffering from Hepatitis B and C. The symptoms typically appear after the damage to the liver.
However, the symptoms of acute hepatitis appear early such as,
- Fatigue
- Flu-like symptoms
- Dark urine
- Yellow stool
- Abdominal pain
- Weight loss
- Loss of appetite
- Signs of jaundice
Diagnosis
Physical examination
The first test performed is a physical examination by a doctor. The doctor will look for the symptoms like
- Pale skin
- Yellow eyes
- Abdominal pain
- Abdominal tenderness
- Liver enlargement
The doctor will also take the medical, family, and social history to analyze the risk factors.
Liver Function Tests
The blood samples of the patient determine enzyme levels which show how efficiently the liver is working. Abnormal liver enzyme levels show the abnormal functioning of the liver.
Blood tests
In case of abnormal liver functioning test, the doctor will order a few more blood tests to diagnose the source of the disease. Blood tests also find for the viruses responsible for hepatitis.
Blood tests also check antibodies status, which is critical in autoimmune hepatitis.
Ultrasound
An abdominal ultrasound takes a close look at the internal organs. The doctor performs this test to reveal
- Retention of fluid in the abdomen
- Liver enlargement
- Liver tumours
- Abnormalities of gall bladder
The pancreas also showed up sometimes in the ultrasound and useful in determining the liver function.
Liver biopsy
Liver biopsy is an invasive method comprising of taking the sample from the tissues of the liver. It does not require surgery. The sample is taken by invading a needle through your skin and taking a sample of liver tissue.
A biopsy determines the level of damage done to the organ because of infection.
Treatment of Viral Hepatitis
The treatment depends on the type of viral hepatitis and the stage of infection.
Hepatitis A
It does not require treatment, and the symptom usually alleviate by bed rest. If symptoms are more discomforting like diarrhoea and vomiting, consult your doctor for a hydration plan.
Vaccination for hepatitis A is available and aims at preventing the infection. In children, the vaccination is done between the ages of 12 and 18 months.
Vaccine for adults is also available but is given usually in combination with hepatitis B vaccine.
Hepatitis B
The treatment of Hepatitis B is an antiviral medication, which can be costly and needs continuation for several months or even years in some cases. Treatment requires regular monitoring and medical evaluation to determine the response of the virus towards medicine.
Hepatitis vaccination is recommended in all newborns. Vaccination is completed in a series of three vaccines within six months of age.
The vaccine is also recommended in healthcare professionals.
Hepatitis C
Till date, there is no vaccination available for hepatitis C. A combination of antiviral medicines is used as a treatment in both acute and chronic form of hepatitis C.
In people who have cirrhosis as a hepatitis C complication, requires a liver transplant.
Hepatitis D
There is no antiviral medicines treatment plan for hepatitis D at present. Some studies claimed alpha-interferon is useful in the treatment of hepatitis D. Interferons are effective in only 25-30% people. It can be prevented by getting vaccination of hepatitis B as hepatitis D does not develop without prior infection by hepatitis B.
Hepatitis E
At present, there are no medical therapies available to treat hepatitis E. hepatitis E is an acute infection and cures on its own. Infected people should drink adequate fluid, take rest, get nutrients, and avoid alcohol.
But hepatitis can be dangerous for pregnant women and requires care and close monitoring by a specialist.
Autoimmune Hepatitis
The treatment plan in autoimmune hepatitis includes corticosteroids like prednisone and budesonide, effective in 80% of people.
Azathioprine suppresses the immune system and can be used with or without steroids.
Some Other immunosuppressing drugs like
- Mycophenolate
- Tacrolimus
- Cyclosporine can also be an alternatives to azathioprine treatment.
How to prevent Hepatitis?
Hygiene
The key way to avoid Hepatitis A and E is practising good hygiene. If you plan to travel in an affected area, avoid
- Local Water
- Ice
- Undercooked food
- Raw fruits and vegetables
Hepatitis B, C and D spread through contaminated blood, so can be avoided by
- Not sharing needles
- Avoiding blood contact
- Avoiding Sexual relation with an infected person
- Not sharing razors
Vaccination
Vaccination can help to prevent the development of Hepatitis A and B. Vaccines for other types of hepatitis are still under research, manufacturing, or trial stages.
Complications of Hepatitis
Hepatitis C and B can be a potent cause of other serious health problems. As the virus affects the liver, therefore the patients with chronic hepatitis B and C are at high risk of developing
- Chronic liver disease
- Cirrhosis
- Liver cancer
Once the healthy liver function is stopped, it leads to liver failure. Some of the complications resulting from liver failure are
- Bleeding disorders
- Ascites-building up of fluid in the abdomen
- Portal hypertension-increased blood pressure in portal veins
- Kidney failure
- Hepatic encephalopathy
- Death
People who have hepatitis should stop alcohol intake as it aggravates the complications. Medications also affect the person who has hepatitis. So, a person with hepatic problems must consult the doctor before taking any medication.