Hepatitis

Overview

Hepatitis is an inflammation of the liver that results in liver cell damage and destruction.

Acute hepatitis

Acute hepatitis is a type of hepatitis that is quite common in the U.S.

Causes: 

Common causes of acute hepatitis may include:

  • Infection with a virus (viral hepatitis A, B, C, D, or E)
  • Overdose of drugs (such as acetaminophen)
  • Chemical exposure (such as drycleaning chemicals)

Symptoms: 

Acute hepatitis usually starts with flu-like symptoms. The following are the most common symptoms of acute hepatitis. However, each person may experience symptoms differently. Symptoms may include:

  • Jaundice (yellow color in the skin and/or eyes)
  • Nausea
  • Vomiting
  • Loss of appetite
  • Fever
  • Tenderness in the right, upper abdomen (belly)
  • Sore muscles
  • Joint pain
  • Clay-colored bowel movements
  • Itchy, red hives on skin

Diagnosis: 

In addition to a complete medical history and medical examination, diagnostic procedures for acute hepatitis may include the following:

  • Specific laboratory tests
  • Liver function tests

Chronic hepatitis

Some people do not recover fully from acute hepatitis and develop chronic hepatitis, as the liver continues to sustain more damage and inflammation. Hepatitis is considered chronic if symptoms persist longer than six months. Chronic hepatitis can last years.

Types of chronic hepatitis:

  • Alcohol-induced chronic hepatitis - This type is characterized by continued damage throughout the liver from heavy alcohol consumption.
  • Chronic active hepatitisAn aggressive inflammation and destruction of liver cells, which can lead to cirrhosis and has a myriad of causes. 

Causes:

Certain viruses, genetic disorders, autoimmune disease, and drugs may cause chronic hepatitis in some people, but not in others. Some common causes include:

  • Viral hepatitis
  • Heavy alcohol consumption
  • Autoimmune disorder (when the body attacks its own tissues)
  • Reaction to certain medications
  • Metabolic disorders (such as hemochromatosis or Wilson disease)

Symptoms:

Symptoms of chronic hepatitis are usually mild. Although the liver damage continues, its progression is usually slow. The following are the most common symptoms of chronic hepatitis. However, each person may experience symptoms differently. Some people may experience no symptoms, while others may experience:

  • Feeling ill
  • Poor appetite
  • Fatigue (extreme tiredness) 
  • Low-grade fever
  • Upper abdominal (belly) pain
  • Jaundice
  • Symptoms of chronic liver disease (such as enlarged spleen, spider-like blood vessels in the skin, and fluid retention)

Diagnosis:

In addition to a complete medical history and medical examination, diagnostic procedures for chronic hepatitis may include:

  • Specific laboratory tests
  • Liver enzymes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AP) and gamma-glutamyl transpeptidase (GGT) 
  • Liver function tests: albumin, bilirubin, and international normalized ratio (INR) 
  • Ultrasound of the liver 
  • Serologic, genetic, and other tests to focus on the disease 
  • Liver biopsy (to determine severity of inflammation, scarring, cirrhosis, and underlying cause)

Hepatitis virus types

There are five main types of the hepatitis virus that have been identified:

  • Hepatitis A - This type of hepatitis is usually spread by fecal-oral contact, or fecal-infected food and water. It may also be spread by blood-borne infection (which is rare).
  • Hepatitis B - Hepatitis B (HBV) has a wide range of clinical presentations. It can be mild, without symptoms, or it may cause chronic hepatitis and, in some cases, can lead to liver failure and death.
  • Hepatitis C - The symptoms of hepatitis C are usually mild and gradual. Children and adults often show no symptoms at all. Transmission of hepatitis C occurs primarily from contact with infected blood, but can also occur from sexual contact, or from an infected mother to her baby.
  • Hepatitis D - This form of hepatitis can occur only in the presence of hepatitis B. If an individual has hepatitis B and does not show symptoms, or shows very mild symptoms, infection with hepatitis D can put that person at risk for liver failure and liver cancer that progresses rapidly.
  • Hepatitis E - This form of hepatitis is similar to hepatitis A, in that transmission occurs through fecal-oral contamination. It is less common than hepatitis A. 

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