Hepatitis

What is hepatitis?

Swelling and inflammation of the liver is defined as hepatitis. Due to a diverse range of causes, hepatitis can affect people of all age groups. Viral infections are the most common cause of hepatitis. Based on the causative virus, hepatitis is classified as hepatitis A, B, C, D and E. An estimated 4.4 million people in the U.S. have chronic hepatitis, most likely hepatitis- A, B or C. Surveillance of viral hepatitis has shown that the incidence of hepatitis A and B significantly dropped between 2006 and 2010, while that of hepatitis C has remained steady.

What are the symptoms?

The symptoms of hepatitis are :

  • Jaundice due to deposition of bilirubin, yellow pigment, under the skin and whites of eye as the liver fails to clear this by-product of breakdown of red blood cells. This is often associated with an itch. Jaundice is observed in all forms of hepatitis, except hepatitis C.
  • Dark urine resulting from elimination of bilirubin in urine.
  • Clay-colored or pale stools which lack the pigment, stercobilin, produced by the liver from bilirubin.
  • Abdominal pain, nausea and vomiting due to impaired metabolism of fats.
  • Low grade fever.
  • Fatigue.
  • Anorexia or loss of appetite and weight loss.
  • Perturbed menstrual cycle in women

Untreated hepatitis can progress to scarring of the liver (cirrhosis), liver failure and hepatic cancer.

What causes hepatitis?

  • Hepatitis A is usually a food-borne or water-borne disease. It could also spread by contact with fecal matter containing the virus. Other major source for all forms of viral hepatitis is contact with infected body fluids such as blood, semen, saliva and vaginal secretions. This could happen in the following situations:
    – Blood transfusions during surgeries, especially before 1992, when the blood tests for screening hepatitis were not as improved as they are today.
    – Sharing of needles, particularly amongst victims of drug abuse.
    – Sexual intercourse.
    – Childbirth.

Digestion of alcohol produces chemicals such as acetaldehyde which trigger hepatic inflammation in chronic alcoholics. Overdose of the drug acetaminophen may also cause hepatitis.

For reasons unknown, the immune system may mount a defensive response against the liver and cause autoimmune hepatitis. It is usually present along with thyroiditis, ulcerative colitis and rheumatoid fever.

How is hepatitis treated?

Diagnosis of viral hepatitis involves blood tests to detect the presence of the viral DNA, determine the type (A, B or C) and the load (quantity) of virus and circulating antibodies. Additionally, biopsies of the liver may be taken to assess the severity of damage.

Hepatitis A and acute hepatitis B or C infections clear on their own. In cases of chronic hepatitis B or C, with significant (but not complete) liver damage, the doctor prescribes anti-viral medications such as interferons and reverse transcriptase inhibitors (adefovir, entecavir).

Additional drugs include corticosteroids or pentoxyfilline to control inflammation and anti-emetics to prevent vomiting. Patients with alcoholic hepatitis must abstain from alcohol consumption and manage their diet to prevent the weakened liver from further damage.

A liver transplantation may be the only remedy for serious hepatic damage.

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