Liver Hepatitis

Liver Hepatitis

Hepatitis is a medical condition in which the liver gets inflamed. This affects its ability to fulfil its functions properly, such as removing unwanted impurities from the blood, making proteins, etc. Hepatitis can occur due to multiple causes, of which infection is very common. There are other types of hepatitis that are not due to an infection such as alcoholic and autoimmune hepatitis. Alcoholic hepatitis causes liver inflammation due to consumption of excess alcohol for too long and autoimmune hepatitis occurs as a result of antibodies damaging liver cells. 

The signs and symptoms of various types of hepatitis are:

1. Hepatitis A: Fever, nausea, loss of appetite, fatigue, vomiting, diarrhoea, jaundice (yellowing of eyes and skin), abdominal pain, joint pain, dark urine, and clay-coloured stool (in adults and older children). Children who are less than six years of age, usually do not show hepatitis symptoms
2. Hepatitis B: The symptoms of hepatitis B may differ with age. Adults and older children have symptoms such as fatigue, fever, nausea, dark urine, loss of appetite, vomiting, abdominal pain, joint pain, jaundice, and clay-coloured faeces. Children under five years of age typically do not have any symptoms.
3. Hepatitis C: Individuals with hepatitis C mostly have mild symptoms or do not have any symptoms. The symptoms include nausea, joint pain, jaundice, vomiting, fever, fatigue, loss of appetite, dark urine, clay-coloured stools, and abdominal pain. 
4. Hepatitis D: Individuals infected with hepatitis B may have hepatitis D.
5. Hepatitis E: Hepatitis E starts with mild fever, nausea, loss of appetite, and vomiting that lasts for a few days. Some individuals may also experience joint pain, skin rash, itching, abdominal pain, dark urine, jaundice, and pale stools.

The causes of liver hepatitis are:

1. Hepatitis A: Infection with hepatitis A virus by:
   1. Person-to-person contact with an infected person
   2. Water or food contaminated with hepatitis A virus
   3. Sexual contact with person infected with hepatitis A virus (HAV)
2. Hepatitis B: Exposure to body fluids or blood of a person infected with hepatitis B virus (HBV)
3. Hepatitis C: Contact with the blood of a person infected with hepatitis C virus (HCV)
4. Hepatitis D: Liver infection caused by hepatitis D virus, especially in individuals who are already infected with HBV
5. Hepatitis E: Caused by hepatitis E virus (HEV)

Hepatitis can occur due to the following risk factors in individuals:

1. Who have sexual intercourse with an infected person
2. With the disorders of blood clotting factor
3. Working with nonhuman primates e.g. monkeys 
4. Travelling to countries where hepatitis A is common
5. Who are human immunodeficiency virus (HIV) positive
6. Having direct contact with the infected people
7. Who live unsheltered 
8. Having contact with an open sore or with the blood of an infected person
9. Being born to an infected mother
10. Sharing needles or other equipment to inject or prepare drugs
11. Getting a piercing or a tattoo from a place that does not use sterile instruments

If acute hepatitis is not treated in time, it can progress to chronic hepatitis that may lead to:

1. Liver cirrhosis
2. Liver cancer
3. Death in rare cases

Disease Progression

The progression of hepatitis may lead to long-term/chronic liver damage, liver cirrhosis, and liver cancer.

The doctor will do the following things to the patient:

1. Examine and check for hepatitis symptoms.
2. Confirm the type of hepatitis with a blood test and liver function tests like SGOT, SGPT, bilirubin, albumin, etc., that assess the level of liver enzymes which tend to rise when the liver gets infected or damaged. They also check the presence of any of the five viruses in the blood test responsible for causing hepatitis.
3. Ultrasound of the liver. This is done to check if there are any changes in the structure of the liver and damage to cells.
4. Liver biopsy to check the exact extent of liver damage.

Hepatitis infection can be prevented by vaccination. Vaccination is advised for children and all who have not taken hepatitis vaccination. Only vaccination for hepatitis A and B are available. There is no vaccination for hepatitis C, D, or E. There is no cure for hepatitis. Once infected, it can be treated with antivirals and supportive treatment for the symptoms to prevent further liver damage, relieve symptoms, and, if possible, reverse the existing damage.

One must consult a doctor if they notice the following:

1. Yellowing of the eye or jaundice
2. Changes in the faeces and urine colour
3. Swelling in the legs or arms
4. Pain/ache in the upper right side of the stomach