Hepatitis represents an inflammatory condition that damages the liver, which performs essential functions that affect the entire body. It has the mission to break down proteins, fats and carbohydrates, to store minerals, vitamins and glycogen, to filter the toxins from the body and it produces bile, critical for digestion.   Hepatitis usually occurs following a viral infection or the consumption of alcohol, drugs or medications. There are several types of hepatitis, depending on the cause, spreading, symptoms, severity and treatment. Even though some of them do not cause serious issues for the patient, others are chronic resulting in liver scarring and even loss of function. Unfortunately, because certain types of hepatitis are silent meaning that they do not show characteristic symptoms, the person does not even realize that she needs proper diagnosis and treatment until liver failure happens. Blood tests represent the only way to determine the existence of the condition.


Types of Viral Hepatitis

Hepatitis A

Hepatitis A is very contagious and impedes the liver to work properly. People generally contract this type of hepatitis by consuming contaminated foods and beverages or having contact with an already infected person. Moreover, a poor level of hygiene increases the risk of contracting it. For this particular reason, in certain parts of the world, such as Africa, Central and South America, this condition is most widespread. Even though it is quite unpleasant, hepatitis A is not severe and it allows complete recovery within a few months.

Symptoms of hepatitis A are mild and sometimes do not even demand medical treatment. However, in certain cases it can prove to be life threatening if the liver does no longer work properly. Once a person becomes infected, it should experience signs or symptoms within four weeks. These include high temperature, pain in the muscles and joints, tiredness, loss of appetite, jaundice, which means that the skin and the eyes become yellow, dark urine and itchy skin, among others. If the symptoms do not disappear after a couple of months, the person in question must consult a doctor.

Fortunately, people who believe facing a high risk of infection can benefit from the existence of hepatitis A vaccine. Situations that may require vaccination involve traveling to those parts of the world where the condition is common, having a chronic liver disease, being around someone with hepatitis A, injecting illegal drugs, being exposed to the condition due to the work environment. In order to establish a diagnosis, doctors take a sample of the person’ blood and test it in the laboratory.

Although those infected with hepatitis A do not have the certainty of a cure, the condition simply disappears on its own. Nevertheless, while being ill, doctors recommend avoiding alcohol, consuming light foods to reduce vomiting, getting rest, taking good hygiene measures, avoiding hot because of the itchy skin, maintaining a cool environment, avoiding crowded places like school or work and taking painkillers. Self-care is very important when dealing with this condition. This practically represents the treatment for hepatitis A. In what concerns the outlook for hepatitis A, after it passes, the respective person develops immunity for the rest of her life. The possibility of this condition leading to life threatening complications is very small, although possible. Elders and those with underlying liver diseases or problems are more susceptible.

Hepatitis B

Hepatitis B represents a more serious infection of the liver that lingers over six months. This condition can lead to permanent scarring of the liver by increasing the chances of developing liver cancer and cirrhosis. In comparison to the first type of arthritis, it manifests with severe signs and symptoms, children being more prone to contracting the virus, living with it for years and experiencing severe liver damage.  Although the hepatitis B vaccine can prevent the contraction of the virus, once a person has the condition, doctors cannot provide a safe cure. However, recommend taking precautions to avoid the transmission of the virus to people who are not yet infected. Unlike children, adults may not notice obvious symptoms of hepatitis B because their body naturally fights off the virus. If the symptoms do appear, it usually happens approximately three months following the contraction and they involve loss of appetite, abdominal pain, diarrhea, jaundice and flu-like symptoms. They generally last between there months (acute hepatitis B infection) and six months (chronic hepatitis B infection), from case to case.

In terms of diagnosis, it is quite similar to the one for hepatitis A meaning that it consists in performing blood tests on the patient. Before giving a proper treatment, doctors must take into account the moment when the patient contracted the condition. Within a few days from the exposure, the patient can benefit from emergency treatment that will protect him from the infection. If the infection persists for weeks or months, the body obviously works against it and in the meantime, the doctor provides treatment in order to relieve the symptoms. After six months of infection, the doctor’s main concern and priority is preventing liver damage and keeping the virus under control.

Hepatitis B can spread through various ways that include sharing hygiene products with an infected person, having a medical treatment or a tattoo in a poorly sanitized environment, injecting drugs, having sexual contact with a contaminated person without using protection and even within families or a mother passing the virus to the newborn child. The hepatitis B vaccine represents the main prevention method and is very beneficial for certain situations. These include people who already have chronic diseases that may affect the liver or kidney, prisoners, people who receive blood, those surrounding someone with the condition, families who intend to adopt children from countries that present a high risk for hepatitis B, people with different sexual partners and people who inject drugs, among others.

When it comes to the outlook for hepatitis B adults can enjoy full recovery within a few months and become immune to the condition. Nevertheless, children face greater chances of developing a chronic infection. According to some studies, this type of hepatitis affects more babies than adults, which represents a concern.

Hepatitis C

Hepatitis C infects the liver and in the lack of an adequate treatment can lead to severe damage that might put the patient’s life in danger. Contaminated blood represents the main spreading way for this condition but advanced treatments can provide the necessary cure for the infected person. Nevertheless, considering that many people can live without noticing any alarming symptoms, they receive the medical treatment later in life when the liver already suffered major damaged. Early diagnosis as well as treatment prevents or controls the liver damage, besides ensuring that other people coming in contact with the patient do not contract the virus.

Sometimes, even when the patient experiences symptoms of hepatitis C, these can be quite misleading for the doctors because they involve fever and general aches, loss of appetite and implicitly weight loss, abdominal pain and tiredness. Being tested represents the only certain method that could confirm the existence of the virus in the person’s body. The infection can spread through the same methods like the hepatitis B, namely by sharing products for hygiene, from the infected mother to her child and though unprotected sexual contact. In addition, approximately half of drug fiends live with hepatitis C.

The treatment mostly includes medications that have the power to impede the virus multiplication inside the patient’s body. In the past, a capsule or tablet of ribavirin and a weekly injection were the only effective treatment for hepatitis C. These days, doctors rely solely on tablets for the patients’ recovery because the organism can tolerate them better. A very important difference between hepatitis C and the other types of hepatitis is that in this case, people do not become immune meaning that they must take measures for decreasing the chances of another infection. Without treatment, the infection can cause serious complications, such as:

  • Cirrhosis manifests by destroying healthy tissue from the liver and obstructing its normal function, resulting in characteristic symptoms like weakness and tiredness, tenderness or pain in the abdominal area, feeling sick, blood capillaries on the skin and very itchy skin. The only cure for cirrhosis is liver transplant, even though medications and self-care impede the progression of the disease.
  • Liver failure refers to that moment when the liver loses its functions. Symptoms involve bleeding gums and nosebleeds, fluid buildup in the legs and tummy, easy bruising, dark urine and hair loss as well as vomiting blood. A person continues living with liver failure for a number of years with treatment based on medication. Nevertheless, once again liver transplant represents the only solution for this end stage of disease.
  • Liver cancer will eventually develop in presence of cirrhosis and cause various symptoms including loss of appetite, tiredness, sickness, jaundice and swelling or pain in the abdominal area. Treatment can only help by controlling these symptoms and slow down the progression of cancer.

Unfortunately, the prevention of hepatitis C is not possible because there is no vaccine but people can reduce the exposure to the infection if they avoid sharing toothbrushes or other items contaminated as well as spoons or syringes, especially when injecting drugs.

Hepatitis D

Hepatitis D affects those people who already have hepatitis B. The spreading of the virus happens through sexual or blood-to-blood contact, birth or urine, mostly in certain parts of the world including Africa, South America, the Middle East and some parts of Europe. Living with hepatitis D and hepatitis B at the same time not only is possible but it also leads to the developing of severe problems like cirrhosis and liver cancer. Even though it does not have a vaccine for prevention, the one for hepatitis B can help.

The symptoms of hepatitis D include vomiting, fatigue, abdominal and joint pain, dark urine and yellowing of the eyes and skin. Because the two conditions are so similar, taking into account that they can appear together and manifest with the same symptoms, doctors encounter difficulties when it comes to making a distinction and establishing an accurate diagnosis. Usually, they perform blood tests for detecting antibodies in the patient’s blood because this inevitably proves his exposure to the virus. When suspecting liver damage, they immediately perform a test that allows them to measure the levels of protein and enzymes in order to assess the liver function and health. Unfortunately, doctors cannot provide a specific treatment because apparently, antivirus medications are useless when it comes to hepatitis D but they do use large doses of interferon, a type of protein that impedes the virus to spread and slows down the disastrous effects of the condition. If the patient already shows signs of liver damage, doctors will find themselves in the position of replacing the affected liver with a healthy one, usually coming from a donor. People who need blood transfusions or make abuse of injectable drugs face a higher risk of contracting hepatitis D.

Hepatitis E

Hepatitis E, unlike other types of hepatitis, does not cause serious damage to the liver or long-term illness. After contracting the virus, people show signs of recovery within a few months. A person can contract hepatitis E following the consumption of undercooked and even raw offal or meat, alcohol abuse, trauma or body injury. Even though this condition does not demand any treatment, those with weakened immune systems face more danger. Similar to hepatitis C, it does not have a vaccine for prevention so traveling to certain parts of the world that present poor sanitation, paying attention to food and hygiene becomes imperative. The symptoms of hepatitis E refer to numbness, weakness and tingling in the upper and lower limbs, fever, loss of appetite, arching muscles and joints, dark or brown urine color, fatigue, abdominal pain, jaundice, itching and flu-like symptoms. Taking into consideration that a number of conditions can provoke these symptoms, doctors must eliminate other types or forms of hepatitis first. They use the blood test to determine the existence of antibodies or protein substances that help the immune system fight the virus. This should allow them to make a difference between hepatitis D and the infection caused by hepatitis A or B. The condition has a limited course, which means that it does not raise concerns among the doctors because people fully recover within four weeks from the exposure to the virus.


Types of Noninfectious Hepatitis

Alcoholic hepatitis causes liver inflammation and appears after abusing alcohol for many years. Nevertheless, being a heavy drinker does not necessarily leads to the development of this condition. Most people do not even realize they have alcoholic hepatitis because the symptoms are not very alarming. These mainly include jaundice that comes along with weakness and fatigue, loss of appetite, weight loss, fever, abdominal tenderness and nausea. The consumption of great amounts of alcohol goes hand in hand with malnourishment because it suppresses the appetite. On the other hand, severe alcoholic hepatitis causes dangerous signs and symptoms including behavior changes, fluid accumulation in the stomach as well as liver and kidney failure.  Seeking medical attention and care is very important because this represents a serious condition that can kill a person within a month. Apart from malnutrition, other forms of hepatitis significantly contribute to severe alcoholic hepatitis.

According to researchers, in order to break down alcohol, the body must produce very toxic chemicals with harmful effects on the live. More specifically, they trigger inflammation thus leading to the destruction of liver cells. With the passage of time, scars begin to take healthy tissue’s place and impede normal liver function. This irremediable scarring, known as cirrhosis, represents the final stage of the condition. Obviously, the amount of alcohol is decisive because it increases the risk of alcoholic hepatitis but other factors can also lead to this negative result, such as genetics, gender and obesity. Apparently, women are more susceptible to the disease because they process alcohol differently.

Complications of alcoholic hepatitis involve enlarged veins, ascites, confusion and drowsiness, kidney failure and increased blood pressure in the liver. For establishing a diagnosis, the doctor engages in a conversation with the patient with the goal to discover more concerning his history of alcohol consumption then he continues with a thorough physical examination. This moment requires honesty from the patient and if the doctor has any doubts about it, he may require speaking with another member of the family. Tests for alcoholic hepatitis include blood samples, ultrasound, MRI or CT scan as well as liver function tests and liver biopsy.

The treatment for alcoholic hepatitis includes obviously, drinking cessation and customized therapy for the patient’s needs. For nutritional problems, the doctor will recommend and encourage the implication of a dietitian who can provide professional advice and help the patient with necessary diet changes. The absorption of nutrients and vitamins represents the main priority in terms of diet so if the patient cannot eat, the next step is resorting to tube feeding. For reducing liver inflammation, certain medications are beneficial for patients with alcoholic hepatitis, namely corticosteroids and other anti-inflammatory medicines. Liver transplant is the last solution for avoiding death in patients with this condition. However, in order to become a good candidate for the transplant centers, the patient must follow the medical treatment, participate in support groups and show determination in relation to eliminating alcohol from his life.

Autoimmune hepatitis happens when the immune system becomes hostile towards liver cells. Even though the condition does not have a clear and specific cause, a combination between genetics and environmental factors may trigger autoimmune hepatitis in time. If left untreated, it can provoke scarring of the liver and ultimately liver failure. However, with a proper diagnosis and treatment, doctors can control the disease with medications that have the power to restrain the immune system. In the lack of response to drugs, liver transplant becomes the last resort. Symptoms of autoimmune hepatitis may occur suddenly and range from minor to severe. These signs and symptoms include enlarged liver, skin rashes, a collection of blood vessels that appear on the skin, fatigue, joint pain, abdominal discomfort, jaundice as well as loss of menstruation in women.

There are two types of autoimmune hepatitis. Type 1 can affect people of all ages, especially those with underlying autoimmune disorders like rheumatoid arthritis and celiac disease while Type 2 affects mostly children and youngsters. Risk factors for autoimmune hepatitis involve heredity, a history of infections, gender and already having autoimmune diseases. Apparently, women are more prone to developing this condition. Complications of autoimmune hepatitis include ascites, which refers to the accumulation of fluid in the abdominal area that interfere with breathing, enlarged veins in the esophagus, liver failure and cancer.

In order to diagnose the patient, doctors perform various tests and procedures. First, they take a sample of the patient‘s blood in order to make a distinction and eliminate viral hepatitis and other similar disorders. Shortly, their intention is to narrow down the possibilities. Secondly, they perform a liver biopsy for confirmation and examination of the liver damage. Removal of a small amount of liver tissue by using a thin needle may be necessary for laboratory analysis.

When providing a treatment for autoimmune hepatitis, the doctor’s goal is to impede the attack of the immune system on the liver and to slow down the progression of the condition. He will prescribe medications that can decrease the activity of the immune system. Prednisone and azathioprine are common medications for these types of cases but they do cause major side effects like thinning or broken bones, weight gain, cataracts, high blood pressure, diabetes and glaucoma. For this reason, they start with a high dose and within several months, they reach the lowest dose possible that still offers effects in relation to the disease. Adding azathioprine diminishes the consequences of taking prednisone.


Last updated on March 2nd, 2018

Chris Riley

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