Overview – What is it?
Hepatitis is an inflammatory condition of the liver caused by the hepatitis virus. This virus can be of 5 different types: hepatitis A, B, C, D and E viruses. However, hepatitis B and C are the most common. The causes of this condition include excessive alcohol intake and autoimmune system disorders. Some of the common symptoms of hepatitis are fatigue, dark urine and pale stool.
Hepatitis can be diagnosed through a liver function test, liver biopsy and imaging tests, among other diagnostic procedures. Some types of hepatitis such as hepatitis A do not require treatment while others may lead to excessive liver damage that may require a liver transplant.
You can prevent yourself from getting this condition through getting vaccinated for hepatitis B, practising good hygiene and practising safe sex, among other preventive measures.
Causes – What causes it?
The cause of hepatitis depends on the type of hepatitis you have. These are the different types of the hepatitis virus and their causes:
- Hepatitis A: This type of hepatitis is caused by the hepatitis A virus (HAV) which is spread through consuming food or taking water that has been contaminated with faeces from a person who is infected with the virus.
- Hepatitis B: This is caused by the hepatitis B virus (HBV) which is spread through body fluids such as semen, vaginal fluid, and blood from an infected person. Health care workers are at a high risk of getting the virus because of the high chance of injecting themselves with needles while caring for patients.
- Hepatitis C: This type of the virus is caused by the hepatitis C virus (HCV) which, like HBV, is transmitted through direct contact with bodily fluids from an infected person.
- Hepatitis D: This is a rare type of hepatitis that is caused by the hepatitis D virus (HDV) and which cannot multiply without the presence of the hepatitis B virus. Hepatitis D is transmitted through direct contact with the blood of an infected person.
- Hepatitis E: This type of hepatitis is caused by the hepatitis E virus which is mostly found in contaminated water. It is transmitted through ingesting water that has been contaminated with the faeces of an infected person.
Other causes of hepatitis
Apart from the hepatitis virus that is transmitted through bodily fluids and contaminated food and water, hepatitis can also be caused by:
- Autoimmune system response: This refers to the body’s immune system attacking the body’s organs, and in this case, the liver is attacked the same way a harmful substance in the body could be attacked, causing inflammation which can be mild or severe.
- Excessive alcohol intake: This causes damage and injury directly to the cells of the liver which can lead to what is referred to as alcoholic hepatitis. If the damage continues, it can lead to liver cirrhosis and liver failure which cause inflammation and scarring of the liver.
- Certain medications and toxins: Taking certain medications for a long period or being exposed to toxins can also lead to scarring and inflammation of the liver.
Symptoms – What do you feel?
Hepatitis can either be acute or chronic. The symptoms can appear from 5 to 180 days after infection.
This form of hepatitis is short-term and can last for about 6 months. The symptoms for this initial stage of the disease can be mild flu-like symptoms like:
- Loss of appetite
- Nausea and vomiting
- Abdominal pain
- Unintentional weight loss
- Joint and muscle pain
- Mid fever
Chronic hepatitis lasts for more than 6 months and can lead to liver failure. In most cases, it may not manifest any symptoms at the beginning until the liver is adversely affected. The common symptoms of chronic hepatitis include:
- Pale or light-coloured stool
- Dark urine
- Itchy skin
Diagnosis – How do you diagnose it?
- Initial consultation and physical exam: During this, the doctor finds out your medical history and whether you are at a high risk of developing infectious or non-infectious hepatitis. You give information about the symptoms you have been experiencing and your family’s medical history, especially whether a close family member has had hepatitis before. A physical exam is then carried out to check for any symptoms such as abdominal pain and tenderness as well as liver enlargement.
- Liver function test: This is done to determine whether your liver is functioning properly through a blood sample. If you have high liver enzymes, that may indicate damage to your liver.
- Blood tests: If there are any abnormalities found in the liver function tests, other blood tests are carried out to determine the cause of the liver problem.
- Liver biopsy: This procedure involves taking a sample of liver tissue and examining it under a microscope to determine whether you have any liver infection or inflammation and whether there are areas of your liver that appear normal.
- Imaging tests: These are done to give images of the abdomen, including the liver, to check for any abnormalities such as liver tumours, damage to the liver and the presence of fluid in the abdomen.
Treatment – How do you treat it?
Treatment of hepatitis depends on which type of hepatitis you have and whether it is acute or chronic.
- Hepatitis A: This type of hepatitis usually does not require treatment as it is short-term. However, the doctor may recommend bed rest in cases where a person is experiencing severe symptoms. Hydration can also be recommended for a person who is experiencing vomiting and diarrhoea.
- Hepatitis B: A person with acute hepatitis B does not require any treatment. Chronic hepatitis B on the other hand, requires antiviral medications which must be continued for several months or years. This hepatitis can also be prevented through a vaccine.
- Hepatitis C: Antiviral medications are used for both acute and chronic hepatitis C. In cases where the scarring is severe, and the liver is unable to function properly, a liver transplant may be required. This involves replacing a damaged liver with a healthy liver from a donor.
- Hepatitis D: There is no medication available for this type of hepatitis yet. However, it can be prevented by preventing hepatitis B through the use of a vaccine.
- Hepatitis E: This type of hepatitis also has no treatment available for it. However, in most cases it is acute rather than chronic and so does not require treatment. People with this type of hepatitis are usually required to have adequate rest, drink plenty of water, eat a healthy diet and avoid alcohol intake.
- Autoimmune hepatitis: Hepatitis which occurs when the immune system attacks the liver can be treated using immune suppressive drugs such as Azathioprine and corticosteroid medications like predesonide.
Prevention – How do you prevent it?
The main ways to prevent yourself from getting hepatitis are:
- Vaccination against hepatitis A and B
Other types of hepatitis for which there are no vaccinations, can be prevented through:
- Immunoglobulins: These are medications that are taken after exposure to the hepatitis virus
- Preventing exposure to the hepatitis virus: This can be done by:
- Practising safe sex
- Avoiding coming into contact with the blood
- Avoiding the sharing of sharp piercing or cutting objects
- Taking precautionary measures, especially if you are a health care worker
- Practising good hygiene by:
- Taking clean water that is treated or boiled
- Avoiding the eating of raw or undercooked food like shellfish
- Avoiding the eating of raw fruits and vegetables
- Washing your hands after using a toilet and before eating
- Washing vegetables thoroughly before preparing them