What Is Hepatitis?
Hepatitis refers to an
inflammatory condition of the liver. It’s commonly caused by 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.
The liver is located
on the right upper quadrant of your abdomen. It performs many critical
functions that affect metabolism throughout your body, including:
v bile production that’s essential to digestion
v filtering of toxins from the body
v excretion of bilirubin, cholesterol, hormones,
and drugs
v metabolism of carbohydrates, fats, and proteins
v activation of enzymes, which are specialized
proteins essential to metabolic functions
v storage of glycogen, minerals, and vitamins
(A, D, E, and K)
v synthesis of plasma proteins, such as albumin
v synthesis of clotting factors
According to the Centers for Disease Control andPrevention (CDC), there are 4.4 million Americans currently living
with chronic hepatitis. Many more people don’t even know that they have it.
Viral infections of
the liver that are classified as hepatitis include hepatitis A, B, C, D, and E.
Hepatitis A is a milder version of the disease, and hepatitis C and D are more
severe. Treatment options vary depending on what form of hepatitis you have and
what caused the infection. You can prevent some forms of hepatitis through
immunizations or lifestyle precautions.
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Hepatitis A
This type derives from
an infection with the hepatitis A virus (HAV). This type of hepatitis is most
commonly transmitted by consuming food or water contaminated by feces from a
person infected with hepatitis A.
Hepatitis B
This type derives from
an infection with the hepatitis B virus (HBV). This type is transmitted through
puncture wounds or contact with infectious body fluids, such as blood, saliva,
or semen. Injection drug use, having sex with an infected partner, or sharing
razors with an infected person increase your risk of getting hepatitis B. It’s
estimated by the CDC that 1.25 million people in the United States
have chronic hepatitis B and 350 million people worldwide live with this
chronic disease.
Hepatitis C
This type comes from
the hepatitis C virus (HCV). Hepatitis C is transmitted through direct contact
with infected body fluids, typically through injection drug use and sexual
contact. HCV is among the most common blood-borne viral infections in the
United States. Approximately 2.7 million Americansare currently living
with a chronic form of this infection.
Hepatitis D
This is also called
delta hepatitis. Hepatitis D is a serious liver disease caused by the hepatitis
D virus (HDV). HDV is contracted through puncture wounds or contact with
infected blood. Hepatitis D is a rare form of hepatitis that occurs in conjunction
with hepatitis B infection. It’s very uncommon in the United States.
Hepatitis E
Hepatitis E is a
waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly
found in areas with poor sanitation and is typically caused by ingesting fecal
matter. This disease is uncommon in the United States. However, cases of
hepatitis E have been reported in the Middle East, Asia, Central America, and
Africa, reports the CDC.
Hepatitis A and E are normally contracted from eating contaminated
food or drinking contaminated water. Hepatitis B, C, and D are contracted
through contaminated blood. These forms of hepatitis can be either acute or
chronic. Types B and C usually become chronic.
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Alcohol
Hepatitis can be
caused by liver damage from excessive alcohol consumption. This is sometimes
referred to as alcoholic hepatitis. The alcohol causes the liver to swell and
become inflamed. Other toxic causes include overuse of medication or exposure
to poisons.
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Autoimmune Disease
The immune system may
mistake the liver as a harmful object and begin to attack it, hindering liver
function.
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If you have forms of
hepatitis that are usually chronic (hepatitis B and C), you may not have
symptoms in the beginning. Symptoms may not occur until liver damage occurs.
Signs and symptoms of
acute hepatitis appear quickly. They include:
1.
fatigue
2.
flu-like symptoms
3.
dark urine
4.
pale stool
5.
abdominal pain
6.
loss of appetite
7.
unexplained weight
loss
8.
yellow skin and eyes,
which may be signs of jaundice
9.
Since chronic
hepatitis develops slowly, these signs and symptoms may be too subtle to
notice.
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Physical Exam
During a physical
examination, your doctor may press down gently on your abdomen to see if
there’s pain or tenderness. Your doctor may also feel to see if your liver is
enlarged. If your skin or eyes are yellow, your doctor will note this during
the exam.
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Liver Biopsy
A liver biopsy is an
invasive procedure that involves the doctor taking a sample of tissue from your
liver. This is a closed procedure. In other words, it can be done through the
skin with a needle and doesn’t require surgery. This test allows your doctor to
determine if an infection or inflammation is present or if liver damage has
occurred.
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Liver Function Tests
Liver function tests use blood samples to determine how
efficiently the liver works. These tests check how the liver clears blood
waste, protein, and enzymes. High liver enzyme levels may indicate that the
liver is stressed or damaged.
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Ultrasound
An abdominal
ultrasound uses ultrasound waves to create an image of the organs within the
abdomen. This test will reveal fluid in the abdomen, an enlarged liver, or
liver damage.
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Blood Tests
Blood tests used to detect the presence of hepatitis
virus antibodies and antigen in the blood will indicate or confirm which virus
is the cause of the hepatitis.
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Viral Antibody Testing
Further viral antibody
testing may be needed to determine if a specific type of the hepatitis virus is
present.
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Treatment options are
determined by which type of hepatitis you have and whether the infection is
acute or chronic.
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Hepatitis A
Hepatitis A isn’t
usually treated. Bed rest may be recommended if symptoms cause a great deal of
discomfort. If you experience vomiting or diarrhea, you will be put on a
special diet created by your doctor to prevent malnutrition or dehydration.
Vaccination can also prevent hepatitis A infections by helping your body
produce the antibodies that fight this type of infection. Most children receive
the vaccination between ages 12 and 18 months. Vaccination is also available
for adults.
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Hepatitis B
Acute hepatitis B
doesn’t require specific treatment. Chronic hepatitis B is treated with
antiviral medications. This form of treatment can be costly because it must be
followed for several months or years. Treatment for chronic hepatitis B also
requires regular medical evaluations and monitoring to determine if the virus
is progressing. The CDC recommends hepatitis B vaccinations for all
newborns. The vaccine is also recommended for all healthcare and medical
personnel.
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Hepatitis C
Antiviral medications
are used to treat both acute and chronic forms of hepatitis C. People who
develop chronic hepatitis C are typically treated with a combination of
antiviral drug therapies. They may also need further testing to determine the
best form of treatment. People who develop cirrhosis (scarring of the liver) or
liver disease as a result of chronic hepatitis C may be candidates for a liver
transplant.
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Hepatitis D
Hepatitis D is treated
with a medication called alpha interferon. According to the Public Health Agency of Canada,
between 60 to 97 percent of people develop hepatitis D again even after
treatment.
Ø Hepatitis E
There are currently no
specific medical therapies to treat hepatitis E. Because the infection is often
acute, it typically resolves on its own. People with this type of infection are
often advised to get adequate rest, drink plenty of fluids, get enough
nutrients, and avoid alcohol.
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Hygiene
Practicing good
hygiene is one key way to avoid contracting hepatitis. If you’re traveling to a
developing country, you should avoid:
- drinking local water
- ice
- seafood
- raw fruit and vegetables
Hepatitis contracted
through contaminated blood can be prevented by:
- not sharing drug needles
- not sharing razors
- not using someone else’s
toothbrush
- not touching spilled blood
Ø Vaccines
The utilization of
vaccines is a second key to preventing hepatitis. Vaccinations are available to
prevent the development of hepatitis A and B. Experts are currently developing
vaccines against hepatitis C, D, and E.
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Chronic hepatitis B or
C can often lead to more serious health problems. Because the virus primarily
affects the liver, people with chronic hepatitis B or C are at risk for:
·
chronic liver disease
·
cirrhosis (scarring of the
liver)
·
cancer of the liver (in
rare cases)
When the liver stops functioning normally, liver failure can
occur. Complications of liver failure include:
- bleeding disorders
- a buildup of fluid in the
abdomen
- increased blood pressure in
portal veins that enter the liver
- kidney failure
- hepatic encephalopathy, which
can involve fatigue, memory loss, and diminished mental abilities due to
the build Up of toxins that affect the brain (especially ammonia)
- hepatocellular carcinoma, which
is a form of liver cancer
People with chronic hepatitis C
are encouraged to avoid alcohol because it can accelerate liver disease and
failure. Certain supplements, prescription, and over-the-counter medications
can also affect liver function. If you have chronic hepatitis C, check with
your doctor before taking any new medications.
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