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Hepatitis

Last updated on Wednesday, February 5, 2014

Overview

Hepatitis is a general term for any inflammation of the liver, and most cases of hepatitis in the world are caused by viral infections. Infections that most commonly lead to hepatitis are brought on by the hepatitis A virus (HAV), the hepatitis B virus (HBV), and the hepatitis C virus (HCV). Hepatitis D virus (HDV) is uncommon in the US. In India and some other parts of the world, hepatitis E virus (HEV) is another common cause of hepatitis. Other factors such as substance abuse (especially alcohol abuse) and autoimmune diseases can also give rise to other types of hepatitis.

Causes and Transmission

Viral infection is the most encountered cause of hepatitis, and there are five major groups of eponymous viruses, lettered A through E. These viruses are not closely related but can all lead to viral hepatitis.

  • The hepatitis A virus (HAV) causes an acute form of hepatitis and is transmitted via the fecal-oral route. That is, HAV is found in the feces of infected individuals and can be spread by close person-to-person contact. It is most commonly contracted by consuming contaminated food or water.
  • The hepatitis B and C viruses (HBV and HCV) can both be spread when a person not immune to either comes in contact with blood or body fluids from an infected person. Major methods one can contract the viruses therefore include unprotected sex (unusual for HCV), needle sharing, and vaginal birth.
  • The hepatitis D virus (HDV) can only be contracted when an individual is infected with HBV. The two infections can occur simultaneously, or HDV can infect a chronic carrier of HBV. In conjunction with HBV infections, HDV infections can be very dangerous and has a much higher rate of mortality.
  • The hepatitis E virus (HEV) is in many ways similar to HAV. It is also transmitted via the fecal-oral route, and the infection is self-limiting and rarely serious. Occurrence in the U.S. is less common than other parts of the world.

Aside from these viruses, many agents can cause hepatitis, and these include other viruses, bacteria, protozoa, parasites, and fungi, though they contribute in only a small proportion of cases. Some of the most common noninfectious causes of hepatitis are:

  • Alcohol abuse: Since the liver plays a pivotal role in the metabolism of alcohol, binge drinking and alcoholism take a significant toll on the liver, potentially leading to hepatitis and cirrhosis.
  • Drug abuse: The liver is also involved in the detoxification and metabolism of various unnatural substances (e.g., drugs) from the body. At incorrect doses, over-the-counter drugs such as pain medication (e.g., acetaminophen, ibuprofen) and some antibiotics can damage the liver. Never mix medicines such as acetaminophen with alcohol, because this can cause life-threatening liver damage. Recreational substances also have the capacity to incur damage and lead to hepatitis.
  • Toxin exposure: Many toxins found in plants and mushrooms have a great impact on the liver, and organic chemicals can also alter liver functionality. These substances can lead to hepatitis and trigger related symptoms. If this is the case, immediate medical attention will be required.
  • Other conditions: Many other conditions such as autoimmune and metabolic diseases are also associated with liver inflammation (i.e., hepatitis). Some of these can be inherited, while others are triggered by biological and environmental factors. Speak to a physician when in doubt.

Signs and Symptoms

Hepatitis can be classified by their severity and duration as either acute or chronic hepatitis.

Most acute hepatitis cases feature these symptoms: fatigue, muscle aches, headache and fever, nausea or vomiting, loss of appetite, abdominal discomfort, and a general feeling of malaise. Dark urine, very light-colored (clay-colored) stool, and yellowing (jaundice) of the skin and eyes are often telltale signs of hepatitis. With severe hepatitis, the liver stops working properly and will be unable to remove waste. While children may not experience any symptoms at all, most individuals begin experiencing symptoms a few weeks after infection and recover within a few weeks. In rare cases, acute liver failure may occur as a result of liver damage.

On the other hand, chronic hepatitis may not give rise to any symptoms or a general feeling of weakness and malaise. Make no mistake, however, as liver damage is still taking place, even though no salient symptoms are observed. A blood test and physical examination are needed in screening for chronic hepatitis. When symptoms such as jaundice appear, massive liver damage such as cirrhosis (liver scarring) may already have occurred. Other symptoms can include weight loss, easy bruising, and swelling. Chronic hepatitis B and C can lead to liver cancer after decades of infection.

Treatments and Prevention

There aren't any specific treatments for most types of hepatitis, but patients typically recover within weeks without complications, as most types of hepatitis are self-limiting, and the body can combat the disease and heal itself in time. It is important to avoid alcohol, which can worsen liver damage. The best advice for patients is to rest and live a healthy lifestyle while they recover. A physician will usually evaluate a patient's condition on a case-by-case basis and devise a plan. There are antiviral medications that can prevent serious liver damage for particularly severe cases and for those with chronic infection with HBV, HCV, and HDV.

In terms of prevention, use common sense. You should wash your hands frequently, especially after touching contaminated surfaces (e.g., by blood), and always follow sanitary guidelines when preparing food or drinks. Another important way to prevent certain types of hepatitis is to practice safer sex, since bodily fluids can transmit HBV and HCV. Drink alcohol responsibly, and read instructions carefully before taking medications (including acetaminophen) or using any dangerous chemicals. If you are a chronic HBV or HCV patient, check with your physician about additional precautions you should take. Everyone should be vaccinated against hepatitis B and it is a good idea to be receive vaccine for hepatitis A. There is no vaccine for hepatitis C.

Tags: alcoholdrugshepatitisinfectionsliversubstancesviruses

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