Hepatitis

What is hepatitis?

Hepatitis is an inflammation of the liver. It may be caused by viral infection, alcohol consumption, several health conditions, or even some medications.

What is the cause of hepatitis?

Hepatitis refers to an inflammatory condition of the liver. It is commonly the result of 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.

Viral hepatitis

The five main viral classifications of hepatitis are hepatitis A, B, C, D, and E. A different virus is responsible for each type of viral hepatitis. The World Health Organization (WHO) estimates that 354 million people currently live with chronic hepatitis B and C globally.

The sources of the viruses are outlined below.

• Hepatitis A: exposure to HAV in food or water
• Hepatitis B: contact with HBV in body fluids, such as blood, vaginal secretions, or semen
• Hepatitis C: contact with HCV in body fluids, such as blood, vaginal secretions, or semen
• Hepatitis D: contact with blood containing HDV
• Hepatitis E: exposure to HEV in food or water

What are the causes of non-infectious hepatitis?

Although hepatitis is most commonly the result of an infection, other factors can cause the condition.

Alcohol and other toxins

Excess alcohol consumption can cause liver damage and inflammation. This may also be referred to as alcoholic hepatitis. The alcohol directly injures the cells of your liver. Over time, it can cause permanent damage and lead to thickening or scarring of liver tissue (cirrhosis) and liver failure. Other toxic causes of hepatitis include misuse of medications (herbal medication inclusive) and exposure to toxins.

Autoimmune system response

In some cases, the immune system mistakes the liver as harmful and attacks it. This causes ongoing inflammation that can range from mild to severe, often hindering liver function. It’s three times more common in women than in men.

What are the common symptoms of hepatitis?

If you are living with a chronic form of hepatitis, like hepatitis B and C, you may not show symptoms until the damage affects liver function. By contrast, people with acute hepatitis may present with symptoms shortly after contracting a hepatitis virus.

Common symptoms of infectious hepatitis 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

How is hepatitis diagnosed?

It is crucial to understand what is causing hepatitis in order to treat it correctly. Doctors will progress through a series of tests to accurately diagnose your condition.

History and physical exam

To diagnose all forms of hepatitis, your doctor will first take your history to determine any risk factors you may have.

Liver function tests

Liver function tests use blood samples to determine how efficiently your liver works.

Other blood tests

If your liver function tests are abnormal, your doctor will likely order other blood tests to detect the source of the problem. These tests can determine if you have infectious hepatitis by checking for the presence of hepatitis viruses or antibodies your body produces to combat them. Doctors may also use blood tests to check for any signs of autoimmune hepatitis.

Liver biopsy

When diagnosing hepatitis, doctors will also assess your liver for potential damage. A liver biopsy is a procedure that involves taking a sample of tissue from your liver. This test allows your doctor to determine how infection or inflammation has affected your liver.

Ultrasound

An abdominal ultrasound uses ultrasound waves to create an image of the organs within your abdomen. This test allows your doctor to take a close look at your liver and nearby organs. It can reveal:

• Fluid in your abdomen
• Liver damage or enlargement
• Liver tumors
• Abnormalities of your gallbladder

Sometimes the pancreas shows up on ultrasound images as well. This can be a useful test in determining the cause of your abnormal liver function.

How is hepatitis treated?

Treatment options will vary by the type of hepatitis you have and whether the infection is acute or chronic.

Hepatitis A

Hepatitis A is a short-term illness and may not require treatment. However, if symptoms cause a great deal of discomfort, bed rest may be necessary. In addition, if you experience vomiting or diarrhea, your doctor may recommend a dietary program to maintain your hydration and nutrition.

Hepatitis B

There is no specific treatment program for acute hepatitis B. However, if you have chronic hepatitis B, you will require antiviral medications. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment.

Hepatitis C

Antiviral medications can treat both acute and chronic forms of hepatitis C. Typically, people who develop chronic hepatitis C will use a combination of antiviral drug therapies. They may also need further testing to determine the best form of treatment. People who develop cirrhosis or liver disease due to chronic hepatitis C may be candidates for a liver transplant.

Hepatitis D

The WHO lists pegylated interferon alpha as a treatment for hepatitis D. However, this medication can have severe side effects. As a result, it’s not recommended for people with cirrhosis liver damage, those with psychiatric conditions, and people with autoimmune diseases.

Hepatitis E

Currently, no specific medical therapies are available to treat hepatitis E. Because the infection is often acute, it typically resolves on its own.

Autoimmune hepatitis

Corticosteroids, like prednisone or budesonide, are extremely important in the early treatment of autoimmune hepatitis. They’re effective in about 80 percent of people with this condition. Azathioprine (Imuran), a drug that suppresses the immune system, may also be a part of treatment programs. People may use this with or without steroids.

What are the tips to prevent hepatitis?

There are vaccines that can help protect against many hepatitis viruses. Minimizing your risk of exposure to substances containing these viruses can also be an important preventive measure.

Vaccines

A vaccine for hepatitis A is available and can help prevent the contraction of HAV. The GHS recommends hepatitis B vaccinations for all newborns. Doctors typically administer the series of three vaccines over the first 6 months of childhood. The GHS also recommends the vaccine for all healthcare and medical personnel. Vaccination against hepatitis B can also prevent hepatitis D. There are currently no vaccines for hepatitis C or E.

Reducing exposure

Hepatitis viruses can transmit from person to person through contact with bodily fluids, water, and foods containing infectious agents. Minimizing your risk of contact with these substances can help to prevent contracting hepatitis viruses. Practicing effective hygiene is one way to avoid contracting hepatitis A and E. The viruses that cause these conditions can be present in water. The hepatitis B, C, and D viruses can transmit through contact with bodily fluids containing these infectious agents.

You can reduce your risk of coming into contact with fluids containing these viruses by:

• Not sharing needles
• Not sharing razors
• Not using someone else’s toothbrush
• Not touching spilled blood

Hepatitis B and C can carry through sexual intercourse and sexual contact. Using barrier methods, such as condoms and dental dams, during sexual activity can help decrease the risk of infection.

What are the complications of hepatitis?

Chronic hepatitis B or C can lead to more severe health problems. Because the virus affects the liver, people with chronic hepatitis B or C are at risk of:

• Chronic liver disease
• Cirrhosis
• Liver cancer

When your liver stops functioning normally, liver failure can occur. Complications of liver failure include:

• Bleeding disorders
• A buildup of fluid in your abdomen, known as ascites
• Increased blood pressure in portal veins that enter your liver, known as portal hypertension
• Kidney failure
• Hepatic encephalopathy, which can involve fatigue, memory loss, and diminished mental abilities
• Hepatocellular carcinoma, which is a form of liver cancer
• Death

People with chronic hepatitis B and C should avoid alcohol as it can accelerate liver disease and failure. Certain supplements and medications can also affect liver function. If you have chronic hepatitis B or C, check with your doctor before taking any new medications.