Hepatitis: Inflammation of the Liver

Hepatitis: Types 

Hepatitis can be caused by viral infections, such as hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus, and hepatitis E virus. Hepatitis A, D and E are acute. Hepatitis B and C can be acute or chronic. 

Hepatitis: Causes and risk factors 

Hepatitis is most commonly caused by viral infection:

Hepatitis A 

• Infection with the hepatitis A virus: Leading to a short-term and acute disease
• Exposure to HAV in food or water

Hepatitis B 

• Contact with Hepatitis B virus 
• Exposure from bodily fluids: Blood, semen, and vaginal secretion 

Hepatitis C

• Contact with Hepatitis C virus 
• Exposure from bodily fluids: Blood, semen, and vaginal secretion

Hepatitis D

• Exposure to blood containing the hepatitis D virus
• Exposure to a chronic hepatitis B patient

Hepatitis E 

• Exposure to hepatitis E virus in food or water

Hepatitis can also be caused by: 

• Excessive alcohol consumption, leading to liver damage: Alcoholic hepatitis
• Medications 
• Exposure to toxins 
• Autoimmune system response 

Hepatitis: Signs and symptoms 

Acute:

• Flu-like symptoms 
• Fever
• Nausea and vomiting 
• Fatigue 
• Dark urine 
• Pale and clay-colored stool
• Loss of appetite 
• Abdominal pain 
• Unexplained weight loss
• Jaundice: Yellow skin
• Intense itching 
• Bleeding easily
• Bruising easily
• Fluid buildup in the abdomen (Ascites) 
• Edema in the legs 
• Confusion, slurred speech, and drowsiness 

Hepatitis: Diagnosis

Hepatitis can be diagnosed with a combination of doctor’s clinical examination and tests, including:

• Blood test: a simple blood test can detect signs of viruses in your body and determine if you are immune to the condition, or whether the infection is acute or chronic
• Liver ultrasound: it can provide images and show the amount of liver damage
• Liver biopsy: a small sample of your liver may be taken (biopsy) to check for liver damage

Hepatitis: Treatment 

Hepatitis is treated depending on the type. 

Hepatitis A 

• Hepatitis A may not require treatment because it is a short-term illness and the body will clear the virus on its own. The liver should heal within six months, with no long-term damage. 
• If symptoms cause significant discomfort, then bed rest is needed 
• Dietary program to maintain hydration and nutrition if you are vomiting or experiencing diarrhea.

Hepatitis B 

• Acute hepatitis B has no specific treatment, and some patients may not require pharmacological treatment. The following can be done to improve the situation: 
  • Rest 
  • Proper nutrition 
  • Rehydration and ensuring the patient is taking plenty of fluids
  • In severe cases, antiviral drugs may be given to prevent complications
• Chronic hepatitis B is treated using: 
  • Antiviral medication: Entecavir, tenofovir

Hepatitis C 

• Antiviral medications 
• Vaccination: There is no vaccine for hepatitis C, but the hepatitis A and B vaccine is recommended. 

Hepatitis D 

• Interferon alpha 

Hepatitis E

• There is no specific medication. The infection is often acute, and the body will clear the virus on its own. 
• Patients are advised to rest, rehydrate, avoid alcohol, and get enough nutrients.

Autoimmune hepatitis 

• Corticosteroids: Prednisone, and budesonide
• Immunosuppressors: Azathioprine, mycophenolate, tacrolimus, cyclosporin 

Hepatitis: Prevention 

Hepatitis can be prevented by:

• Taking the hepatitis vaccine: There is currently no vaccine for hepatitis C and E 
• Alcohol cessation 
• Avoiding sex with hepatitis carriers
• Practicing safe sex and using a new condom every time 
• Reducing exposure by limiting the contact of bodily fluids, water, and foods with hepatitis carriers
• Do not share needles, razors or toothbrushes
• Avoiding contact with someone else’s blood
• If you are travelling to a country with a high prevalence of hepatitis, avoid: local water or ice, raw food, undercooked seafood, raw fruits and vegetable 

Patients with hepatitis can prevent the spread by: 

• Patients with hepatitis A should avoid all sexual activity until they are cured. Patients with hepatitis B and hepatitis C should practice safe sex and use a new condom every time 
• Wash their hands after using the toilet or changing diapers 
• Do not prepare food for other people while infected
• Alcohol cessation 
• Avoid medications that cause liver damage 
• Cover wounds
• Do not donate blood, organs, or semen 
• Do not share personal care items

Hepatitis: Complications 

• Cirrhosis 
• Liver cancer
• Liver failure: which results in other complications such as 
  • Bleeding disorders 
  • Ascites
  • Portal hypertension: Increased blood pressure in the portal veins 
  • Hepatic encephalopathy
  • Kidney failure 
  • Death