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Hepatitis
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International awareness day May 19 |
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Overview
Hepatitis is an inflammation of the liver that can be caused by viruses, chemicals, drugs, alcohol, inherited diseases, or the patient's own immune system.
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Causes
There are many causes of hepatitis: Infectious viral hepatitis such as hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E, other viral diseases, severe bacterial infections, amoebic infections, various medicines (eg paracetamol poisoning), Toxins like alcohol, autoimmune hepatitis,Inborn metabolic disorders
(Details: open / close) | The most common causes of hepatitis are the hepatitis viruses: Hepatitis A: You get it by eating food or drinking water contaminated with feces, or the bowel movement (BM), from a person infected with the hepatitis A virus (HAV). It can also be caused by anal-oral contact.
Hepatitis B: You get it by contact with a person infected with the hepatitis B virus (HBV). This can occur through having sex with an infected person, from an infected mother to her baby during childbirth, or through sharing needles with an infected person.
Hepatitis C: You get it most often through sharing injection drugs with a person infected with the hepatitis C virus (HCV). Many people don't have symptoms and don't know they have it.
Hepatitis D: You get it by contact with a person infected with the hepatitis D virus (HDV). You also must have current HBV infection to get HDV infection. HDV infection can occur by sharing needles to inject drugs, by having sex with an infected person, and from infected mother to child during childbirth.
Hepatitis E: A person can get infected with hepatitis E virus (HEV) by eating food or drinking water contaminated with feces from an infected person. Hepatitis E is usually a disease that occurs in persons who travel to areas that have high rates of HEV infection. |
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Epidemiology
Hepatitis A is the commonest form of viral hepatitis. It is most prevalent in Africa, South America, Middle East and south-east Asia. There is low prevalence in USA, north and west Europe, Australia and Japan.
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Prevention
Hepatitis A
It is highly contagious. Preventing the spread of the virus involves protecting both yourself and others from infection:
* Receive immune globulin or a hepatitis vaccine
* Follow safety precautions for international travelers. Prevent infection by peeling and washing all your fresh fruits and vegetables yourself, avoid eating raw or undercooked meat and fish, drink bottled water and avoid ice cubes in beverages.
* Practice good hygiene. Simply washing your hands well and often can help protect you from infection with a number of viruses and bacteria. If you have hepatitis A, the following measures can help prevent you from passing the virus to others:
* Avoid sexual activity, wash your hands thoroughly after using the toilet, use clean utensils, don't prepare food for others while you're actively infected.
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Hepatitis B
For active vaccination, a harmless hepatitis B antigen is given to stimulate the body's immune system to produce protective antibodies against the surface antigen of hepatitis B. Hepatitis B vaccines are 95% effective.
You can also protect yourself from hepatitis B virus (HBV) infection by avoiding contact with the body fluids of someone whose health and sexual history are not known to you Hepatitis C
There is currently no vaccine for hepatitis C.
Hepatitis C can also be prevented by avoiding exchange of body fluids.
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Symptoms
Some people who have hepatitis have no symptoms. Others may have * Loss of appetite
* Nausea and vomiting
* Diarrhea
* Dark-colored urine and pale bowel movements
* Stomach pain
* Jaundice, yellowing of skin and eyes
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Diagnosis
Your health care provider will ask you questions about your illness. You will be asked about your symptoms and about any possible exposures to hepatitis. If your health care provider determines that you may be at risk for contracting hepatitis, you will have blood drawn.
* The blood will be tested to determine how well your liver is functioning.
* A test will be done for antibody to hepatitis A. The test will show whether you have been exposed recently to HAV.
* Your blood probably will be tested for the hepatitis B and hepatitis C viruses as well.
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Treatment
Treatment of acute viral hepatitis and chronic viral hepatitis are different. Treatment of acute viral hepatitis involves relieving symptoms and maintaining adequate intake of fluids. Treatment of chronic viral hepatitis involves medications to eradicate the virus and taking measures to prevent further liver damage which can lead to cirrhosis or liver cancer.
(Details: open / close) Acute hepatitis e.g. Hepatitis A
In patients with acute viral hepatitis, the initial treatment consists of relieving the symptoms of nausea, vomiting, and abdominal pain. The patient must abstain from drinking alcohol since alcohol is toxic to the liver. It occasionally is necessary to provide intravenous fluids to prevent dehydration caused by vomiting. Patients with severe nausea and/or vomiting may need to be hospitalized for treatment and intravenous fluids. Chronic hepatitis e.g. Hepatitis B, C
Treatment of chronic infection with hepatitis B and hepatitis C usually involves medication or combinations of medications to eradicate the virus. Alcohol aggravates liver damage in chronic hepatitis, and can cause more rapid progression to cirrhosis. Therefore, patients with chronic hepatitis should stop drinking alcohol. Smoking cigarettes also can aggravate liver disease and should be stopped. |
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News
Sharp Rise in U.S. Hepatitis C-Related Deaths
Thursday, 27th March 2008
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Grapefruit Compound Inhibits Hepatitis C Virus
Tuesday, 6th May 2008
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Scientific Articles (a selection for patients)
Hepatitis B immunisation for newborn infants of hepatitis B surface antigen-positive mothers
Lee C, Gong Y, Brok J, Boxall EH, Gluud C
(Details: open / close) Background:
Hepatitis B vaccine and hepatitis B immunoglobulin are considered for newborn infants of HBsAg-positive mothers to prevent hepatitis B infection. Objectives:
To assess the beneficial and harmful effects of hepatitis B vaccines and hepatitis B immunoglobulin in newborn infants of HBsAg-positive mothers. Method:
Several relevant trials were selected from a group of databases companies where different types of vaccines against Hepatitis B had been compared with other types of intervention (other active vaccines or placebo) or no intervention. The same was done with the Hepatitis B immunoglobulin. Main results:
No significant differences of hepatitis B occurrence were found comparing the two active hepatitis B vaccines and high-dose versus low-dose vaccine. Compared with placebo/no intervention, hepatitis B immunoglobulin or the combination of vaccine plus hepatitis B immunoglobulin reduced hepatitis B occurrence. Compared with vaccine, vaccine plus hepatitis B immunoglobulin reduced hepatitis B occurrence. Conclusions: Vaccine, hepatitis B immunoglobulin, and vaccine plus hepatitis B immunoglobulin prevent hepatitis B occurrence in newborn infants of HBsAg positive mothers. The above is a summarization of the following article:
Full reference of the article: Lee C, Gong Y, Brok J, Boxall EH, Gluud C. Hepatitis B immunisation for newborn infants of hepatitis B surface antigen-positive mothers. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD004790. DOI: 10.1002/14651858.CD004790.pub2 |
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Interferon for acute hepatitis C
Myers RP, Regimbeau C, Thevenot T, Leroy V, Mathurin P, Opolon P, Zarski JP, Poynard T
(Details: open / close) Background:
Acute hepatitis C virus (HCV) infection progresses long term illness in the majority of patients. In order to prevent the progression to chronic disease, several studies have assessed interferon in patients with acute hepatitis C. Objectives:
The aim of this review was to assess the efficacy of interferon in acute HCV infection. Method:
Clinical trials comparing interferon with placebo or no treatment were selected from a variety of databases of clinical trials. Results:
When compared with no treatment, interferon alfa-2b was associated with an improvement. Interferon also improved the liver biochemistry. Conclusions:
Interferon alfa is effective in improving biochemical outcomes and achieving sustained virus clearance in patients with transfusion-acquired acute hepatitis C. The above is a summarization of the following article:
Full reference of the article: Myers RP, Regimbeau C, Thevenot T, Leroy V, Mathurin P, Opolon P, Zarski JP, Poynard T. Interferon for acute hepatitis C. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD000369. DOI: 10.1002/14651858.CD000369 |
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Medical Journals (for health professionals)
Journal of Viral Hepatitis
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