Hepatitis

Hepatitis means injury to the liver with inflammation of the liver cells. There are five main types of hepatitis and each type is commonly determined by a laboratory test.

The five main types of hepatitis are caused by viruses:

Globally, around 250 million people are affected by hepatitis C and 300 million people are estimated to be hepatitis B carriers.

  • Hepatitis A is caused by consuming contaminated food or water.
  • Hepatitis B is a sexually transmitted disease.
  • Hepatitis C is commonly spread via direct contact with the blood of a person who has the disease.
  • A person can only become infected with hepatitis D if they are already infected with hepatitis B.
  • Person can become infected with the hepatitis E virus (HEV) by drinking contaminated water.
  • Hepatitis that cannot be attributed to one of the viral forms of the disease is called hepatitis X.
  • Hepatitis G is another type of hepatitis caused by a specific virus (HGV).

The initial symptoms of hepatitis are similar to those of flu.

Hepatitis and the liver

The liver is the largest gland in the human body. It weighs approximately 3 lb (1.36 kg). It is reddish brown in color and is divided into four lobes of different sizes and lengths. It is also the largest internal organ (the largest organ is the skin). It is below the diaphragm on the right in the thoracic region of the abdomen. Blood reaches the liver through the hepatic artery and the portal vein. The portal vein carries blood containing digested food from the small intestine, while the hepatic artery carries oxygen-rich blood from the aorta.

The liver is made up of thousands of lobules, each lobule consists of many hepatic cells – hepatic cells are the basic metabolic cells of the liver.

The liver has a wide range of functions, including:

  • Detoxification (filters harmful substances form the blood, such as alcohol)
  • Stores vitamins A, D, K and B12 (also stores minerals)
  • Protein synthesis (makes certain amino acids – the building blocks of proteins)
  • The production of biochemicals needed for digestion, such as bile
  • Maintains proper levels of glucose in the blood
  • Produces 80% of your body’s cholesterol (cholesterol is vital)
  • The storage glycogen (also converts glucose to glycogen)
  • Decomposing red blood cells
  • Synthesizing plasma protein
  • The production of hormones
  • Produces urea (the main substance of urine).

Hepatitis can heal on its own with no significant consequence, or it can progress to scarring of the liver. Acute hepatitis lasts under six months, while chronic hepatitis lasts longer.

Most liver damage is caused by 3 hepatitis viruses, called hepatitis A, B and C. However, hepatitis can also be caused by alcohol and some other toxins and infections, as well as from our own autoimmune process (the body attacks itself).

Not all forms of hepatitis are infectious. Alcohol, medicines and chemicals may be bad for the liver and cause inflammation. A person may have a genetic problem, a metabolic disorder, or an immune related injury. Obesity can be a cause of liver damage which can lead to inflammation. These are known as non-infectious, because they cannot spread form person-to-person.

Hepatitis A

This is caused by eating infected food or water. The food or water is infected with a virus called HAV (hepatitis A virus). Anal-oral contact during sex can also be a cause. Nearly everyone who develops Hepatitis A makes a full recovery – it does not lead to chronic disease.

Hepatitis B

This is an STD (sexually transmitted disease). It is caused by the virus HBV (hepatitis B virus) and is spread by contact with infected blood, semen, and some other body fluids. You get hepatitis B by:

  • Unprotected sexual intercourse with an infected person (unprotected sex means without using a condom) Using a syringe that was previously used by an infected person (most commonly happens with drug addicts and people who inject steroids).
  • Having your skin perforated with unsterilized needles, as might be the case when getting a tattoo, or being accidentally pricked. People who work in health care risk becoming infected by accident in this way. Sharing personal items, such as a toothbrush or razor, with an infected person.
  • A baby can become infected through his mother’s milk if she is infected.
  • Being bitten by someone who is infected.

The liver of a person infected with hepatitis B swells. The patient can suffer serious liver damage due to infection, resulting in cancer. For some patients the hepatitis becomes chronic (very long-term or lifelong). Donated blood is always tested for hepatitis B.

Hepatitis C

Hepatitis C is usually spread through direct contact with the blood of a person who has the disease. It is caused by the virus HCV (hepatitis C Virus). The liver can swell and become damaged. In hepatitis C, unlike hepatitis B, liver cancer risk is only increased in people with cirrhosis and only 20% of hep C patients get cirrhosis. Donated blood is also tested for hepatitis C.

Misuse of anesthesia can result in the transmission of hepatitis B and hepatitis C viruses, researchers reported in the journal Gastroenterology. The cause of infection tends to be from anesthesia contamination, and not endoscopy contamination. Experts say that more effort is needed to better educate the health care community about the importance of strict sterile techniques when using any type of anesthesia.

Hepatitis D

Only a person who is already infected with hepatitis B can become infected with hepatitis D. It is caused by the virus HDV (Hepatitis D Virus). Infection is through contact with infected blood, unprotected sex, and perforation of the skin with infected needles. The liver of a person with Hepatitis D swells.

Hepatitis E

A person can become infected by drinking water that contains HEV (hepatitis E virus). The liver swells but there are no long-term consequence. Infection is also possible through anal-oral sex.

Hepatitis X

If hepatitis cannot be attributed to the viruses of hepatitis A, B, C, D, or E, it is called hepatitis X. In other words, hepatitis of an unknown virus.

Hepatitis G

This is a type of hepatitis caused by the hepatitis G virus (HGV). Usually there are no symptoms. When there are symptoms, they are very mild.

Symptoms of hepatitis

Many people with hepatitis experience either mild symptoms or none at all. Remember that an infected person’s feces are always infectious to other people. When symptoms appear, they usually do so about 15 to 180 days after the person has become infected.

The acute phase of hepatitis – symptoms

The initial phase of hepatitis is called the acute phase. The symptoms are like a mild flu, and may include:

  • Diarrhea
  • Fatigue
  • Loss of appetite
  • Mild fever
  • Muscle or joint aches
  • Nausea
  • Slight abdominal pain
  • Vomiting
  • Weight loss.

The acute phase is not usually dangerous, unless it develops into the fulminant or rapidly progressing form, which can lead to death.

As the patient gets worse, these symptoms may follow:

  • Circulation problems (only toxic/drug-induced hepatitis)
  • Dark urine
  • Dizziness (only toxic/drug-induced hepatitis)
  • Drowsiness (only toxic/drug-induced hepatitis)
  • Enlarged spleen (only alcoholic hepatitis)
  • Headache (only toxic/drug-induced hepatitis)
  • Hives
  • Itchy skin
  • Light colored feces, the feces may contain pus
  • Yellow skin, whites of eyes, tongue (jaundice).

Patient outcomes after the acute phase depend on various factors, especially the type of hepatitis.

If you’re not sure about proper treatments, or need advice, please don’t hesitate to consult with our pharmacists or excellent Clinic experts.