Hepatitis is a collective name for a number of similar looking inflammatory liver diseases. Inflammation of the liver is very dangerous, because the liver has many functions. One in twenty people has suffered from hepatitis once and in the majority of cases, this inflammation is caused by a virus.
Cause
When hepatitis is caused by a virus infection, this is called viral hepatitis. The most common types of these are hepatitis A and B. Viral hepatitis is contagious. Hepatitis can also result from exposure to certain chemicals, use of certain types of medication or excessive alcohol consumption.
Symptoms
The signs and symptoms are dependent on the type of hepatitis. Fatigue, sometimes fever, lack of appetite and dark colored urine are common. The liver can become enlarged and the patient can have jaundice (a yellow appearance of the skin). Hepatitis can be acute or chronic. The acute form diminishes after about two months. Chronic hepatitis can eventually lead to liver cirrhosis and liver damage. The following types of hepatitis can occur:
- Hepatitis A (infectious hepatitis) is usually an acute form. The virus is generally transferred by feces and by food and water, which are contaminated with human waste. Two to six weeks after infection, the disease breaks out. The patient feels tired, has no appetite, is sick and can sometimes have jaundice. The enlarged liver causes abdominal pain. After six to eight weeks, it has usually passed. Adjusted diet helps: low in fat and high in proteins and carbohydrates.
- Hepatitis B (serum hepatitis) is similar to hepatitis A, but has more symptoms. Contamination is caused by saliva, blood or blood products (via injection needles) and via sexual intercourse. This type can also be transferred from the mother to the unborn baby. The disease usually heals, but sometimes a chronic form develops. Even after healing, the carrier of the virus can still infect other people. After infection, it takes two to six months before the first symptoms occur.
- Hepatitus C is the most common viral hepatitis. This type is distributed by blood and blood products and may be present in the body for years, without causing symptoms. Especially hepatitis C leads to chronic hepatitis and is considered as a serious threat to public health. In ten to forty percent of the cases of hepatitis, it is about hepatitis C. Hepatitis C is often seen with intravenous drug users. Fortunately, contamination by blood or blood products (with blood transfusion) does almost not exist anymore in many countries. In some countries, however, contamination is still a real danger. After infection, it takes fifteen to hundred and fifty days before the first symptoms occur.
- Infection with the hepatitis D virus takes place via blood-blood contact, perinatal or sexual contact. The hepatitis D virus is dependent on the hepatitis B virus. The symptoms are similar to those of hepatitis B.
- Hepatitis E is transferable via the stool-mouth tract. Especially with human feces polluted water is a major source of contamination. Hepatitis E is rare in Western countries, as opposed to developing countries (including North Africa and India). After infection, it takes two to ten weeks before the first symptoms occur.
Diagnosis
When the doctor suspects hepatitis, blood tests will be performed. The liver function is determined and there will be an attempt to identify the cause. If diagnosing doesn’t succeed, an ultrasound may be performed and sometimes liver biopsy. A piece of liver is then removed and examined under the microscope.
Treatment
There is usually no treatment for acute hepatitis. Rest will be advised. If alcohol abuse is the cause, then the patient will be advised to completely avoid alcohol consumption.
Since a few years there is a drug that is effective against the hepatitis C virus. This drug, an antiviral agent, is called alpha interferon. This is a natural protein that is produced by the immune system of our body.
Preventive vaccination for hepatitis A (two injections) offers a minimum of fifteen years of protection. The administration of immunoglobulin against hepatitis A offers a protection of a few months and is given only in exceptional cases. Vaccination for hepatitis B protects almost everyone. For hepatitis E, no vaccine is available yet.
Prognosis
Approximately seventy-five percent of people with hepatitis C and five percent of people with hepatitis B or D, will be dealing with chronic hepatitis. If acute hepatitis is not caused by a virus but by another micro-organism, the patient will usually heal completely. When hepatitis is caused by alcohol, drugs or other harmful substances, recovery will depend on the degree of damage to the liver. If hepatitis leads to liver failure, a liver transplant may be needed. This is fortunately rare.
Considerations
- Hepatitis A and E can be prevented by good hygiene.
- The risk of hepatitis A, B, C and D can be reduced by having safe sex and not sharing needles or other items, which may be polluted by infected body fluid.
- Babies are vaccinated against hepatitis B according to the vaccination program.
- Vaccination against hepatitis A is recommended for people at risk of the disease, for example when a person is going to a developing country or on holiday to a country where the virus is common, such as Egypt and Turkey.
- Blood at the blood bank is tested for hepatitis B and C viruses, in order to prevent infection of hepatitis by blood transfusion.
