Hepatitis

There are two types of Hepatitis:

Acute hepatitis - meaning the new onset of Hepatitis
Chronic hepatitis - meaning the Hepatitis has been present for more than 6 months

What is acute hepatitis?

Acute Hepatitis is an inflammation of the liver that results in liver cell damage and destruction. Acute hepatitis is quite common: whereas one in every 4000 people develop acute hepatitis every year in developed countries, this figure may be 5 times higher in developing countries.

Causes

Common causes of acute hepatitis may include:

• Infection with a virus (viral hepatitis A, B, C, D, or E)
• Overdose of drugs (such as acetaminophen, paracetamol)
• Chemical exposure (such as dry cleaning chemicals, and some wild mushrooms)

Symptoms

Acute hepatitis usually starts with flu-like symptoms. The following are the most common symptoms of acute hepatitis. However, each individual may experience different symptoms such as, jaundice, nausea, vomiting, loss of appetite, fever, tenderness in the right upper part of the tummy (abdomen), sore muscles, joint pain and itchy red hives on skin .

The symptoms of acute hepatitis may resemble other conditions or medical problems. A physician must be contacted for timely diagnosis.

Diagnosis

In addition to a complete medical history and medical examination, diagnostic procedures for acute hepatitis may include
a) specific laboratory tests for virus detection,
b) liver function tests.

Treatment

Treatment for acute hepatitis will be determined by your physician based on the cause, severity, your underlying health and whether there is any previous history of liver disease.

In general, most people recover without treatment. Severe acute hepatitis may require hospitalization. People who have had acute viral hepatitis may become chronic carriers of the disease in case of Hepatitis B or C infection.

What is chronic hepatitis?

Some people do not recover fully from acute hepatitis and develop chronic hepatitis, as the liver continues to sustain more damage and inflammation. Hepatitis is considered chronic if symptoms persist longer than six months. Chronic hepatitis can last years.

Different forms of chronic hepatitis

1. Alcohol-induced chronic hepatitis - continued damage throughout the liver from heavy alcohol consumption.
2. Chronic active hepatitis - an aggressive inflammation and destroyer of liver cells, which may lead to cirrhosis.
3. Chronic persistent hepatitis - a milder chronic inflammation of the liver, which usually does not lead to cirrhosis.

Causes
Certain viruses and drugs may cause chronic hepatitis in some people, but not in others.

Common causes include:

1. Viral hepatitis
2. Heavy alcohol consumption
3. Autoimmune disorder (when the body attacks its own tissues)
4. Reaction to certain medications especially those given for TB.
5. Metabolic disorders (such as Hemochromatosis or Wilson's Disease)

Symptoms

Symptoms for chronic hepatitis are usually mild. Although the liver damage continues, its progression is usually slow.
Some individuals may experience no symptoms, while others may experience the following: feeling ill, poor appetite, fatigue, low fever, upper abdominal pain, jaundice, symptoms of chronic liver disease (such as enlarged spleen, spider-like blood vessels in skin and fluid retention).

The symptoms of chronic hepatitis may resemble other conditions or medical problems. A physician must be consulted for diagnosis.

Diagnosis

In addition to a complete medical history and medical examination, diagnostic procedures for chronic hepatitis may include a) laboratory tests for specific viruses, b) liver function tests or c) liver biopsy to determine severity of inflammation, scarring, cirrhosis and underlying cause.

Treatment

Specific treatment for chronic hepatitis will be determined by your liver physician based on the cause, severity, your underlying health and whether there is any previous history of liver disease.
The goal of treatment is to stop damage to the liver and alleviate symptoms.

Treatment may include one/more of the following:

Antiviral Agents - When caused by Hepatitis B or C, inflammation of the liver may be stopped with the injectable antiviral drug interferon-alpha. In addition, in Hepatitis B, oral anti-viral agents such as lamivudine or adefovir may be used, while in Hepatitis C, ribavirin can be used.

Corticosteroids - Corticosteroids may be used to treat chronic liver disease caused by an autoimmune disorder. Inflammation is suppressed, but scarring of the liver may continue.

Discontinuation of certain drugs - When chronic Hepatitis is caused by certain drugs, discontinuing those drugs usually clears up any symptoms.

Discontinuance of alcohol - While this is essential for recovery in alcohol induced chronic liver disease, it is also highly advisable in Hepatitis C and other chronic diseases of the liver.

Preventing the spread of viral hepatitis:

Proper hygiene is the key to preventing the spread of many diseases, including Hepatitis. Other preventive measures include:

Vaccinations - A Hepatitis B vaccine is routinely given to toddlers as part of their immunization schedule. A hepatitis A vaccine is available for people at risk for contracting the disease while traveling. (There are no vaccines for hepatitis C, D, or E at this time.)

Blood transfusion - Blood products are routinely screened for Hepatitis B and C, and HIV, to reduce the risk of infection from transfusion.

Antibody preparation - If a person has been exposed to Hepatitis B, an antibody preparation can be administered to help protect them from contracting the disease.

The prevention of Hepatitis B and C should be aimed at the high risk groups and situations which are a) Unsafe Blood transfusion, b) Hepatitis B or Hepatitis C in the family, c) Surgical procedures or dental manipulation, d) intravenous drug abuse, e) Unprotected sexual exposure, f) Dialysis, g) Medical or paramedical personnel.