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The main function of the liver in our body is the production of bile to aid in the digestion process.
Hepatitis is basically inflammation of the liver. It can be acute or chronic in nature and the most common causative organisms are viruses.
Plasma proteins such as albumin and blood clotting factors are synthesized in the liver.
Viral hepatitis is classified into the following types of hepatitis: A, B, C, D, and E.
Hepatitis is mainly caused by viruses, but it is also caused by chemicals, drugs, alcohol, inherited diseases, or autoimmune diseases.
Hepatitis is diagnosed by the presence of inflammatory cells in organ tissues, and hepatitis can occur with or without symptoms.
The study of hepatitis indicates that this is a disease that leads to jaundice and anorexia.
This is a high-risk disease that worsens when it lasts more than six months.
Most cases of hepatitis around the world are caused by the group of viruses known as the hepatitis viruses.
The liver is the most important organ located in the upper right side of the abdomen and performs many functions such as processing the body’s nutrition, manufacturing bile that aids in the digestion of fats, synthesizing proteins, and assisting in carbohydrate metabolism.
It is responsible for excreting bilirubin, regulating blood clotting, and breaking down toxic substances into harmless substances that the body can use.
The liver when affected by inflammation causes the disease hepatitis, which is a serious health problem when discovered in an advanced stage.
In general, hepatitis is classified as acute and chronic, where acute is the condition that develops severe symptoms and chronic is hepatitis that develops slowly, which has a long course.
Hepatitis can be cured without any medicine when diagnosed in the early stage, but when hepatitis is discovered in the advanced stage it can be serious and can lead to liver cancer .
Previous prevention and leading a healthy life always help to avoid hepatitis to a great extent.
Types of hepatitis
There are several types of hepatitis, and the most common types of hepatitis are described below:
Hepatitis A
Hepatitis A is the most common type of viral hepatitis.
It is generally seen in areas where sanitation and wastewater disposal are poor.
This disease is commonly spread through the fecal-oral route (ingestion of contaminated food and water).
Hepatitis A is caused by eating foods like shellfish, fruits, and vegetables.
The virus spreads mainly through irrigation water and in food handling. It is usually a short-term infection, and its symptoms clear up within three months.
There is no specific treatment for hepatitis A, other than the use of medications, such as the pain reliever ibuprofen, to relieve symptoms.
Hepatitis A mainly develops between 2 to 6 weeks after infection, and symptoms are usually very severe.
Hepatitis presents with a wide range of symptoms ranging from mild itching to severe liver failure.
Vaccination is recommended if a person travels to countries where the virus is common, such as the Indian subcontinent, Africa, Central and South America, the Far East, and Eastern Europe.
Hepatitis B
Hepatitis B can be found in blood and body fluids, such as semen and vaginal fluids, so it is usually spread during unprotected sex.
By sharing needles to inject drugs, which come from the person who is already affected and the infection can also spread through the air, saliva, cough, surfaces, blood, needles, blood transfusions, among others.
Hepatitis B is commonly seen in drug users.
It is common in India and other parts of the world, such as China, Central and Southeast Asia, and Sub-Saharan Africa.
Most people infected with hepatitis B can fight the virus and fully recover from the infection within a couple of months.
The infection can be unpleasant to live with, but it usually doesn’t cause any lasting damage.
However, a small minority of people can develop a long-term infection called chronic hepatitis B.
There is a vaccine available for hepatitis B, which is recommended for people in high-risk groups for contamination.
Hepatitis C
Hepatitis C can be found in the blood and to a much lesser extent in the saliva, semen, or vaginal fluid of an infected person.
It is particularly concentrated in the blood, which is why it is generally transmitted through contact of blood to blood or blood products.
Hepatitis C is generally contagious and the most common causes include:
- Exchange of contaminated needles between users.
- Transfusion with infected blood.
- Organ transplantation from an infected person.
- From mother to baby.
Hepatitis C often does not cause obvious symptoms or causes symptoms that are mistaken for the flu, therefore many people do not know if they are infected. Many people with proper treatment will be free of the virus.
In the rest, the virus could remain in the body for many years. This is known as chronic hepatitis C.
Chronic hepatitis C can be treated by taking antiviral medications, although there can be some unpleasant side effects.
There is still no vaccine for hepatitis C.
Alcoholic hepatitis
Drinking excessive amounts of alcohol over many years can damage the liver and lead to hepatitis. This type of hepatitis is known as alcoholic hepatitis.
Heavy drinkers are estimated to have some degree of alcoholic hepatitis.
The condition usually doesn’t cause any symptoms and is often found with a blood test.
If a person with alcoholic hepatitis continues to drink alcohol, there is a real risk that they could develop cirrhosis and possibly liver failure.
Hepatitis D
Hepatitis D is only present in people who are already infected with hepatitis B (it needs the presence of the hepatitis B virus in order to survive in the body).
Hepatitis E
Hepatitis E is generally a mild and short-lived infection. It also spreads through the fecal-oral route.
Autoimmune hepatitis
Autoimmune hepatitis is a very rare cause of chronic (long-term) hepatitis. White blood cells attack the liver, causing chronic inflammation and damage.
This can lead to more serious problems, such as liver failure.
The reason for this reaction is unknown.
Symptoms include tiredness, abdominal pain, joint pain, jaundice (yellow tint to the skin and the whites of the eyes), and cirrhosis.
Treatment for autoimmune hepatitis involves medications that suppress the immune system and reduce inflammation.
Steroid medication ( prednisolone ) can gradually reduce swelling over several weeks and can then be used to control symptoms.
Symptoms
The symptoms of hepatitis cannot be easily diagnosed, as the symptoms are similar to most diseases, and in some cases, the patient does not show signs or symptoms.
The most common symptoms of hepatitis are:
- Loss of appetite
- Fatigue.
- Slight fever.
- Muscle or joint pain
- Nausea, diarrhea and vomiting.
- Eruption.
- Fatigue.
- Abdominal pain.
If hepatitis develops, its symptoms begin to target the liver and chemicals secreted by the liver begin to accumulate in the blood and this causes.
- Jaundice.
- Short of breath.
- A bitter taste in the mouth.
- Dark or tea-colored urine.
- White, clear, or clay-colored stools.
The most common symptoms of hepatitis are abdominal pain that focuses below the right ribs or below the left ribs.
Disease development
The onset of hepatitis is with a prodromal phase characterized by nonspecific symptoms such as fever, malaise, nausea, vomiting, headache, etc.
Later on, specific symptoms of liver disorders may develop as strong yellow urine and clay-colored stools.
This is followed by a yellowish discoloration of the skin and the whites of the eyes.
This stage is called acute hepatitis and can last up to 4 weeks.
The last stage is the recovery phase where clinical symptoms begin to recede and laboratory values of liver functions remain high. The liver is also enlarged.
Hepatitis A and E are normally acute in nature and resolve completely in 1 to 2 months.
Drug-induced hepatitis and autoimmune hepatitis also present with similar symptoms.
If the symptoms of acute hepatitis do not resolve within 6 months, it is called chronic hepatitis.
Initially, there are only non-specific symptoms, but gradually as the hormonal metabolism in the liver is affected, deeper symptoms such as hirsutism and amenorrhea appear.
Long-term liver disease and damage to liver functions ends in cirrhosis of the liver and its complications.
Diagnosis of hepatitis
The presence of the above symptoms or a history of exposure to contaminated blood should be investigated.
The abdominal exam will reveal an enlarged liver.
The most indicative tests are blood tests called liver function tests that provide a complete breakdown of liver enzymes and proteins.
If the levels are elevated, it indicates impaired liver function.
The diagnosis is usually confirmed by an ultrasound of the abdomen and viral markers that detect the presence of antibodies in the blood.
Diagnosis of hepatitis is made by biochemical evaluation of liver function.
- Initial laboratory evaluation should include bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, prothrombin time, total protein, albumin, globulin, complete blood count, and coagulation studies.
- The diagnosis of hepatitis depends on the demonstration of specific antigen and / or antibody (detected by enzyme-linked immunosorbent assay) in the serum.
- Liver biopsy tests are also done to find out the degree of liver damage.
Treatments
Acute types such as hepatitis A and E have an infectious etiology and are generally self-limiting and resolve symptoms.
Symptomatic treatment may be necessary for vomiting or diarrhea.
The hepatitis A vaccine is given mainly to babies between 12 and 18 months of age and is quite effective.
Chronic forms of hepatitis like hepatitis B are resolved by treatment with antiviral drugs.
The hepatitis B vaccine is recommended for all infants and healthcare personnel who are at risk of being in contact with infected blood.
Hepatitis C is a chronic disease and leads to liver damage and cirrhosis. Severe cases may need a liver transplant.
Hepatitis D is usually treated with a medicine called interferon alpha.
Treatments for hepatitis are based on the type and stage of the disease and there is also no treatment for hepatitis A, but in recent years, treatments for hepatitis B and C are available.
The following are generally used in treatment:
Rest
Some types of hepatitis, such as acute viruses, such as hepatitis A and B, are self-limited diseases, which means that the patient’s immune system can destroy any type of virus that develops hepatitis disease.
Therefore, medications are rarely provided for these self-limited hepatitis diseases, but supportive therapies are provided to treat nausea or pain.
People are advised to rest and allow time for the body to fight viruses on its own.
Antiviral drugs
Interferon is the treatment that is made up of proteins that are manufactured by the body’s immune system to fight against viruses.
Interferon has antiviral properties that play a vital role and act as a powerful weapon against hepatitis B and C.
This treatment is expensive and usually causes side effects.
Patients who are affected by hepatitis are advised to take different antiviral medications to better fight the virus.
The patient with hepatitis B is treated with interferon with the other antiviral drug lamivudine, but the patient with hepatitis C is treated with interferon along with the anti-Ribavirin drug.
Liver transplant
In some cases, hepatitis causes severe symptoms that lead to liver damage, and for such patients, the only treatment is liver transplantation.
Liver transplantation is a complex surgery that involves transformation of the defective liver with a donor liver.
Scientists are working to provide an effective treatment for a specific type of hepatitis and to offer a new antiviral drug that helps prevent viral replication in liver cells.
Prevention of hepatitis
Hepatitis prevention helps to destroy any type of viral infection in the body and part of the prevention procedure for hepatitis disease includes:
- Follow good hygiene and avoid unsanitary living conditions.
- People should be especially careful when drinking water and swimming, especially when traveling to infected areas.
- Do not eat shellfish that is suspected of coming from infected sewage water.
- Wash your hands well before eating and after using the bathroom.
- Always use an antiseptic cleaner to clean the toilet, sink, or utensils used by any family member already infected with hepatitis.
- Do not share needles, razor blades, toothbrushes, manicure tools of an affected person.
- If a person is found to be at high risk of developing hepatitis, they are advised to take hepatitis A vaccines.
- Cover open wounds.
- Drink only commercially bottled water while traveling.
Hepatitis and pregnancy
Acute viral hepatitis is a very common cause of jaundice during pregnancy and is commonly caused by ingesting contaminated food and water.
Jaundice is an indicator of liver disease, but the type of hepatitis cannot be assessed clinically.
Detailed tests may be required to isolate the type of hepatitis.
The most useful tests here are serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase levels.
High levels of serum glutamic pyruvic transaminase during pregnancy can be harmful to the fetus.
Hepatitis B can be transmitted to the unborn fetus through blood, so all pregnant women are routinely screened for hepatitis and AIDS.
If a pregnant woman is found to be positive, routine vaccinations can help protect the baby.
Hepatitis Vaccination in Babies
The hepatitis A vaccine is recommended between 12 and 18 months of age. A booster dose is given 6 to 18 months after the first dose.
The hepatitis B vaccine is given to babies during the first days after birth. The first dose is given while they are still in the hospital.
There are a total of four doses and the gap will depend on the type of vaccine used.
Children receive the first dose in the first week, the second between the first and second month, and complete all four doses by the age of six months.
Immunization
Hepatitis A: Immunization of children (1 to 18 years of age) consists of two or three doses of the vaccine.
Adults need a booster dose six to 12 months after the initial dose of the vaccine. The vaccine is believed to be effective for 15-20 years or more.
Hepatitis B – Safe and effective vaccines provide protection against hepatitis B for 15 years and possibly much longer.
Currently, it is recommended that all newborns and persons up to 18 years of age and adults who are involved in the risk of infection be vaccinated.
Three injections are required over a six to 12 month period to provide full protection.
The hepatitis B vaccine also provides protection against infection with the hepatitis D virus.