Definition of Hepatitis

Description of Hepatitis
Causes and Risk Factors of Hepatitis
Symptoms of Hepatitis
Diagnosis of Hepatitis
Treatment of Hepatitis
Prevention of Hepatitis
Questions To Ask Your Doctor About Hepatitis
Definition of Hepatitis
Hepatitis is inflammation of the liver, which can be caused by viruses, medicati
ons, or toxic agents.

Description of Hepatitis
Hepatitis is usually characterized as viral hepatitis or non-viral hepatitis. Vi
ral hepatitis can be considered "acute" (a condition that comes on rapidly with
severe symptoms and a short course) or "chronic" (a condition that comes on slow
ly, may or may not have symptoms with has a long course).
Causes and Risk Factors of Hepatitis
Currently, there are at least five (5) forms of viral hepatitis:
Hepatitis A
Formerly called infectious hepatitis, hepatitis A is most common in children in
developing countries, but is being seen more frequently in people of all ages an
d in the developed world. Hepatitis A is thought to be spread by a virus from an
infected person's feces directly or indirectly contaminating food, raw shellfis
h, drinking water, cooking utensils or someone else's fingers. The incubation pe
riod is two to six weeks after infection. Hepatitis A is considered an acute con
dition.
Hepatitis B
Formerly called serum hepatitis, hepatitis B is the most serious form of hepatit
is.
Hepatitis B is caused by the hepatitis B virus and is spread through sexual cont
act, blood transfusion or exposure to an infected person's blood via cuts, open
sores, needle sharing, razor sharing or ear piercing tools. Additionally, hepati
tis B can be spread from mother to child at birth. The incubation period is four
to 25 weeks.
Ninety percent of all hepatitis B cases are considered acute, while the other 10
percent are considered chronic and may progress to cirrhosis (a disease of the
liver caused by chronic damage to its cells), liver failure or liver cancer. Not
e: a person is at greater risk of contracting hepatitis B if they are sexually a
ctive, have unprotected sex, have more than one sexual partner, have a sexual tr
ansmitted disease (STD), share needles for injecting drugs, work in health care,
or if they are a native of or spend large amounts of time in Alaska, the Pacifi
c Islands, Africa, Asia or the Amazon region of South America.
Hepatitis C
Formerly called non-A, non-B hepatitis, hepatitis C is transmitted primarily by
direct blood contact - via blood transfusion or and contaminated needles. Less c
ommon ways are through sexual contact or from mother to child at birth.
The incubation period is five to 10 weeks. Twenty-five percent of the hepatitis
C cases are considered acute, while the other 75 percent are considered chronic,
which may result in cirrhosis. Note: a person is at greater risk of contracting
hepatitis C if they had a blood transfusion prior to 1991, experimented with IV
drugs or intranasal cocaine, have been a long-term hemodialysis patient, work i
n health care, or have been exposed to unsterile equipment used for body piercin
g, tattooing, manicures/pedicures or acupuncture.
Hepatitis D
Formerly called delta hepatitis, hepatitis D is found mainly in intravenous drug
users who are carriers of the hepatitis B virus. Hepatitis D can cause both acu
te and chronic disease.
Hepatitis E
Formerly called enteric or epidemic non-A, non-B hepatitis, hepatitis E resemble
s hepatitis A, but is caused by a different virus from hepatitis C and is common
ly found in the Indian Ocean area. Hepatitis E is considered an acute condition.

There are two main types of nonviral hepatitis, called alcoholic hepatitis and t
oxic/drug-induced hepatitis, and two less common types of nonviral hepatitis, ca
lled autoimmune hepatitis and granulomatous hepatitis.
Alcoholic hepatitis is the most common precursor of cirrhosis in the U.S. While
it may not develop in many patients until several decades of alcohol abuse, it a
ppears in a few individuals within a year after onset of excessive drinking.
Toxic/drug-induced hepatitis is caused after inhalation or ingestion of a toxin,
such as carbon tetrachloride, vinyl chloride, poisonous mushrooms or the use of
certain medications. Several widely used drugs can produce an adverse liver rea
ction: Isoniazid (used for the treatment of tuberculosis), methyldopa (a treatme
nt for high blood pressure), acetaminophen (pain reliever), antibiotics such as
erythromycin, chlorpromazine, oral contraceptives and anabolic steroids.
Autoimmune hepatitis is a condition in which the liver is attacked by the body's
immune system.
Granulomatous hepatitis is a condition in which abnormal collections of white bl
ood cells collect in the liver.
Fortunately, most people recover completely from hepatitis A, E and nonviral hep
atitis. Mild flare-ups may occur over a period of several months with viral hepa
titis. Each flare-up is usually less severe than the initial attack, and a relap
se does not necessarily indicate that complete recovery will not take place.
Unfortunately, hepatitis B, C and D can linger in the body, producing chronic, p
erhaps lifelong, infection. Additionally, carriers of the hepatitis virus can in
fect others, even though they feel perfectly well. They may face risks of liver
disease (cirrhosis and liver cancer) in the future.

Symptoms of Hepatitis
Hepatitis produces an initial ?acute phase,? often with few if any symptoms. If
there are symptoms, they tend to mimic "flu-like" symptoms such as:

mild fever
muscle or joint aches
nausea
vomiting
loss of appetite
slight abdominal pain
diarrhea
fatigue
The acute phase and its symptoms is rarely serious or fatal, although occasional
ly a so-called fulminant or rapidly progressing form leads to death.

As the condition worsens, the person also may experience these additional sympto
ms:

jaundice (yellowed skin, mucous membranes and eye-whites)

dark urine
light colored stools that may contain pus
itching
enlarged spleen (symptom of alcoholic hepatitis only)
hives
headache (symptom of toxic/drug-induced hepatitis only)
dizziness (symptom of toxic/drug-induced hepatitis only)
drowsiness (symptom of toxic/drug-induced hepatitis only)
circulation problems (symptom of toxic/drug-induced hepatitis only)
The course of the hepatitis and the different outcomes after the acute phase tha
t distinguish the various types.

Diagnosis of Hepatitis
The doctor will take a thorough medical history with emphasis on the patient?s m
edications, alcohol consumption, previous surgeries and sexual activity. He or s
he may palpate the area over the liver to check for tenderness or enlargement.
If the skin becomes jaundiced and the person is exhibiting other symptoms of hep
atitis, the doctor will do various lab tests, such as blood tests and liver pane
l tests. Additional lab tests include the antibody tests (ELISA II, RIBA II) and
the hepatitis C RNA test via PCR technology for diagnosis of hepatitis C only.

If needed, the doctor may also perform a liver biopsy where a small portion of t
he liver would be taken for further examination under a microscope.

Treatment of Hepatitis
There is no specific treatment for hepatitis A. The doctor will recommend the ab
stinence of alcohol and drugs during recovery. Most cases of hepatitis A resolve
themselves spontaneously.
The only treatment for hepatitis B is rest, combined with a high protein/high ca
rbohydrate diet to repair damaged liver cells and protect the liver. If hepatiti
s B persists, the doctor may recommend an antiviral agent called interferon.

The only approved treatment for hepatitis C virus, and the only one with demonst
rated efficacy, is interferon alfa-2b (Intron A).

Currently, there is not effective treatment for hepatitis D and E.

For treatment of nonviral hepatitis, the doctor will first remove the harmful su
bstance by flushing out the stomach via inducing vomiting or hyperventilation. I
f necessary, the patient with drug-induced hepatitis will be treated with cortic
osteroids.

Prevention of Hepatitis
To prevent hepatitis A, remember to:

Wash hands well after using any washroom.

Eat only freshly cooked foods.
Drink only commercially bottled water or boiled water in places where sanitation
and the water supply are questionable and do not eat non-peelable raw fruits or
vegetables unless cleaned thoroughly.
Get a hepatitis A vaccination before traveling to areas such as Mexico, eastern
Europe and developing countries.
To prevent hepatitis B, remember to:

Tell your sex-partners if you are a carrier.

Practice safe sex.
Don't share needles, razors, toothbrushes, manicure tools or other items that co
uld bear contaminated blood.
Get the hepatitis B vaccination series if you are at risk.
Don't allow yourself to be pierced with non-sterile equipment.
To prevent hepatitis C, remember to:

(if carrier) Cover open wounds, don't share razors or manicure tools.
Practice safe sex.
Don't share needles, razors, toothbrushes, manicure tools or other items that co
uld bear contaminated blood.
Don't allow yourself to be pierced with non-sterile equipment.
Limit alcohol intake.
Never share IV drug needles or other drug equipment.
To prevent hepatitis D:
Since the hepatitis D virus cannot infect on its own without hepatitis B, use th
e preventive measures outlined in hepatitis B.

To prevent hepatitis E, remember to:

Wash hands well after using any washroom.

Eat only well and freshly cooked foods.
Drink only commercially bottled water or boiled water in places where sanitation
and the water supply are questionable, and don't eat non-peelable raw fruits or
vegetables unless cleaned thoroughly.
To prevent alcoholic hepatitis, remember to:

Limit the amount of alcohol consumption.

To prevent toxic/drug-induced hepatitis, remember to:

Be aware of the lethal contents of all chemicals.

Face the spray away from the body.
Wear protective equipment if applicable.

Questions To Ask Your Doctor About Hepatitis

What type of hepatitis is it?

What is the severity of the hepatitis?

What tests are performed to give an accurate diagnosis?

How much damage has been done to the liver?

Is the liver damage permanent or reversible?

What kind of therapy is recommended for this type of hepatitis?

What are the risks?

What precautions should be taken for the family?