Hepatitis is the condition that causes the inflammation of the liver, it can be acute, that is lasting less than six months or acute, lasting more than six months.
The infectious form of the condition can be classified on the basis of the virus that causes it:
- 1) Hepatitis A (HAV)
- 2) Hepatitis B (HBV)
- 3) Hepatitis C (HCV)
- 4) Hepatitis D (HDV)
- 5) Hepatitis E (HEV)
SIGNS & SYMPTOMS
- In acute hepatitis;
- Fatigue & poor appetite
- Nausea & vomiting
- Joint pain & headaches
- Yellowing of the skin & of the whites of the eyes
- Dark urine
- Enlarged liver
- Enlarged Spleen
- Pain in the upper right abdomen
- In chronic hepatitis;
- Abnormal hair growth
- Lack of menstruation in women
- Fluid accumulation in the abdomen & legs
- Weight loss.
CAUSES & RISK FACTORS FOR HEPATITIS
- Liver inflammation can be due to the five viruses that cause it, that are, A, B, C, D & E.
- These can be transmitted due to fecal-oral route, unsanitary conditions like unhygienic water & food, infected blood, needles & needle sharing, & due to sexual intercourse (STD).
- Even Parasite like malaria causing protozoa can lead to acute liver inflammation.
- Liver worms
- Bacteria like E.Coli can lead to the condition.
- Excessive consumption of alcohol can lead to alcoholic liver disease & is the leading cause of liver cirrhosis.
- Non-alcoholic liver disease, which is associated with diseases & comorbidities like diabetes, insulin resistance, metabolic syndrome, etc.
- Drug induced liver damage, following allergy or side effects of drugs like some antibiotics, phenytoin, steroids, paracetamol consumption for a long time, etc.
- Autoimmune hepatitis, in which the immune system of the human body can abnormally attack its own liver cells.
- Genetic Factors
- Reduced blood flow to the liver.
- Transmission of viral load from a pregnant woman to her fetus.
COMPLICATIONS ARISING FROM HEPATITIS
- Liver cirrhosis
- Liver failure
- Liver Cancer
- Liver abscess
- Inflammation of the pancreas
- Reduction in the production of Red blood cells
- Damage to the nerves
- Inflammation of the muscles of the heart wall
- Fulminant hepatitis or a superinfection that can increase the chances of mortality
- Disorder of the brain like confusion & sleepiness
- Fluid accumulation in the brain
- Bleeding in the gastrointestinal tract
- Kidney failure
- Enlargement of the veins in the esophagus
- Respiratory failure
- Primary diagnosis is made by observing physical symptoms like nausea, tiredness, yellowing of the skin, etc.
- Alcohol related, non-alcohol related & drug induced liver inflammation is differentiated by noting the lifestyle factors like consumption of alcohol, abuse of prescription drugs or presence of allergy, similarly the presence of comorbidities like diabetes, hypertension, etc.
- In infectious & viral hepatitis blood tests are ideal diagnosis, the viral load can be detected by nucleic acid determination, presence of antigen & the subsequent antibody release by the immune system.
- Ultrasound, MRI, CT scan to detect the extent of presence of fatty deposits.
- Liver biopsy/testing liver tissue is the gold standard for detecting the extent of damage to the Liver.
TREATMENT FOR HEPATITIS
- Antiviral drugs are used to treat viral hepatitis.
- Interferon therapy has been particularly effective in treatment of inflammation of the liver.
- Monoclonal Antibodies
- HAV & HEV do not usually progress to chronic condition and need behavioral & nutrition changes, can be treated easily.
- HDV is relatively difficult to treat
- Drugs that do not produce an adverse effects on liver are preferred.
- To treat alcoholic hepatitis, drugs that can discourage the person from intake of alcohol like disulfiram are prescribed.
- When the condition has progressed to liver cancer, a liver transplant is the only option.
PREVENTION & MANAGEMENT
- Inhibiting oneself from intake of alcohol when one has liver inflammation or is at risk.
- Hep-A & Hep-B vaccines are available and can effectively prevent contracting the virus.
- Access to clean sanitized water, food & hygiene.
- Practicing safe sex & using condoms.
- In case a person is affected with an existing STI, treatment is the best course along with communication to the partner.
- Not coming in contact with infected blood.
- Prohibiting from using needles for drugs, sharing needles & injections.
- Treatment of comorbid conditions like diabetes, hypertension, metabolic disorders, etc.
- In pregnant women who are infected, intake of antivirals can prove effective & prevent transfer of viral load to fetus.