Hepatitis

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Hepatitis is a medical condition primarily associated with gastroenterology that involves the inflammation of the liver. The specific symptoms, prognosis, and recommended treatments are contingent on the underlying cause.

Recognizable Symptoms and Signs

Hepatitis often manifests through symptoms like exhaustion, general discomfort or malaise, joint pain, abdominal distress, and vomiting, typically two to three times daily during the initial five days. Other signs include a lack of appetite, dark urine, fever, an enlarged liver or hepatomegaly, and jaundice (icterus). Chronic forms of hepatitis may exhibit few or none of these symptoms until advanced stages where persistent inflammation has replaced liver cells with connective tissue, leading to cirrhosis. Certain liver function tests can help in the diagnosis of hepatitis.

Different Forms of Hepatitis

Viral Hepatitis

The majority of acute hepatitis cases are attributable to various viral infections, including:

1. Hepatitis A
2. Hepatitis B
3. Hepatitis C
4. D-agent (requires the presence of the Hepatitis B virus for propagation)
5. Hepatitis E
6. Hepatitis F (considered discredited)
7. Hepatitis G

Additionally, other viruses such as cytomegalovirus, Epstein-Barr virus, and yellow fever can also lead to hepatitis.

Refer to the individual articles for more comprehensive information.

Also see infectious canine hepatitis.

Hepatitis A

Hepatitis A, also known as infectious jaundice, is an enterovirus transmitted through the orofecal route, often through contaminated food. It results in an acute form of hepatitis and does not progress to a chronic stage. The immune system of the affected individual produces antibodies against Hepatitis A, providing immunity against future infections. Those with Hepatitis A are usually recommended to rest, maintain hydration, and abstain from alcohol. A vaccine is available that provides lifelong protection from Hepatitis A. The virus can spread through personal contact, consumption of raw seafood, or drinking contaminated water. Hepatitis A is predominantly found in developing countries, and is more common in southern Europe compared to northern and western Europe. The virus is transmitted fecal-orally, often through the consumption of contaminated water or food. Strict personal hygiene and avoidance of raw and unpeeled foods can help prevent an infection. Infected individuals begin to excrete the Hepatitis A virus in their feces two weeks after the onset of the first symptoms. The incubation period between infection and the onset of the disease can range from 15 to 45 days.

Hepatitis B

Hepatitis B can cause both acute and chronic hepatitis in patients who are unable to eliminate the virus. It can be transmitted through blood (rarely through blood transfusion), tattoos (both amateur and professional), sexually or through contact with blood or bodily fluids, or vertically (from mother to her unborn child). However, in about half of the cases, the source of infection cannot be identified. Blood contact can occur through the sharing of syringes in intravenous drug use, use of common shaving accessories like razor blades, or touching wounds on infected persons. Needle-exchange programmes have been introduced in many countries as a preventive measure. In the United States, 95% of patients clear their infection and develop used to determine the likelihood of autoimmune hepatitis; this system has been devised by the International Autoimmune Hepatitis Group.

Non-alcoholic steatohepatitis (NASH)

Non-alcoholic steatohepatitis, also known as NASH, is a type of liver disease that is characterized by fat accumulation in the liver (hepatic steatosis) along with liver inflammation. It resembles alcoholic liver disease but occurs in people who drink little or no alcohol. The cause of NASH is still not entirely clear, but it is associated with conditions such as obesity, insulin resistance, high blood pressure, and high levels of fats in the blood. It's often a silent disease with few or no symptoms, but when symptoms do occur, they can include fatigue, weight loss, and abdominal pain. Over time, NASH can progress to cirrhosis and liver failure.

Other Forms of Hepatitis

Other forms of hepatitis can be caused by a variety of factors, including certain types of medications, exposure to certain toxins, and certain medical conditions. For instance, some types of medications, including over-the-counter pain relievers and prescription medications, can cause drug-induced hepatitis. Certain industrial toxins, such as yellow phosphorus, and natural toxins, like those found in poisonous mushrooms, can also cause hepatitis. Moreover, certain medical conditions, such as celiac disease, can cause hepatitis in some people.

Treatment

The treatment of hepatitis is largely determined by the type and stage of the disease. Acute hepatitis may require only supportive treatment, while chronic types of hepatitis may require antiviral medications. In all types of hepatitis, lifestyle modifications, including avoiding alcohol and maintaining a healthy weight, can help to manage the disease. In the most severe cases, a liver transplant may be necessary.

Prevention

Prevention strategies for hepatitis include practicing good hygiene, safe sex, and avoiding sharing personal items like razors or toothbrushes. Vaccinations are available for hepatitis A and B. For those traveling to areas where hepatitis is prevalent, taking precautions with food and water is advised. For hepatitis types caused by alcohol or drugs, abstinence or responsible use is the best prevention strategy.

Outlook

The outlook for people with hepatitis varies depending on the type and stage of the disease. Some people with acute hepatitis recover completely with no lasting liver damage. However, chronic hepatitis can lead to cirrhosis, liver failure, or liver cancer, which can be life-threatening. Regular follow-up with a healthcare provider is important for managing the disease and monitoring for any complications.

See Also

• Liver disease
• Liver cancer
• Cirrhosis
• Viral hepatitis

External Links

• CDC - Viral Hepatitis
• WHO - Hepatitis

Further Reading

• Sjogren MH, et al. (2002). Hepatitis C Infection in Patients With Primary Sjogren's Syndrome. Am. J. Gastroenterol. 97(3): 579–84.
• Liaw YF, et al. (2000). Hepatitis B Virus Replication in Patients With Fulminant Hepatitis (Acute Liver Failure): A Western Pacific Region Multicentre Study. Journal of Gastroenterology and Hepatology. 15(12): 1352–1355.
• Di Bisceglie, AM (2009). Natural History of Hepatitis C: Its Impact on Clinical Management. Hepatology. 41(4): 875–879.
• Anstee, QM, et al. (2011). From NASH to HCC: current concepts and future challenges. Nat Rev Gastroenterol Hepatol. 16(7): 411–428.
• Manns, MP, et al. (2010). Diagnosis and Management of Autoimmune Hepatitis. Hepatology. 51(6): 2193–2213.

Hepatitis Resources
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