Hepatitis

Hepatitis is a general name for any infection that affects the liver. It’s caused by a group of viruses that attack the liver. Your liver is one of the body’s most important organs. It’s responsible for filtering your entire blood volume to remove wastes and toxins. The enzymes in the liver metabolize many medications so they can do their work. The liver produces bio-chemicals that allow you to absorb nutrients, stores energy absorbed from the foods you eat, and manufactures the necessary chemicals to control bleeding and fight infection. So, it’s easy to can see how a liver infection can spell trouble.

When your liver is impaired, it affects all of the body’s systems. A common problem caused by liver malfunction that most people are familiar with is jaundice. This condition causes a telltale yellowing of the skin. Acute hepatitis symptoms include feeling nauseous, vomiting, loss of your appetite and extreme fatigue. Although the liver is very tough, and has an incredible capacity to heal and regenerate, some forms of Hepatitis can cause irreversible liver damage.

There are several types of Hepatitis viruses, designated by the letters A, B, C, D, E and G, but types D through G are very rare. The viruses are usually referred to as abbreviations such as HAV, HBV or HCV. Hepatitis A is the most common cause of acute viral hepatitis in the world, while Hepatitis C is the most common cause of chronic Hepatitis.

The different types of Hepatitis are similar because they all affect the liver. However each type of Hepatitis is transmitted differently, has distinct symptoms and treatment. Hepatitis A, for example is very common. Signs of clinical exposure in young children in the US are less than 10%. Once children reach school age, where there is frequent exposure, the incidence rises. About 40% of children between the ages of 6-14 have been exposed, and by age 14, over 70% of the population has had the disease.

According to an article published in the Journal of the American Medical Association in July 2005, there has been a significant decrease in the rate of HAV infections since the widespread use of vaccines. In 2003, an incidence of 2.6 per 100,000 was reported; as 76% decrease from the rate between 1990 –1997. The rate of decrease was 83% in states where vaccination was recommended compared to 53% in other states. Young children represented the largest decline.

What are the symptoms of Hepatitis?
People with hepatitis usually experience nausea and vomiting, diarrhea, weakness, jaundice (yellowing of the skin), and loss of appetite. Symptoms last 2-3 weeks in the majority of cases. Most cases of Hepatitis A or B are self-limited. Hepatitis A will resolve completely and there is no chronic carrier state. Hepatitis B and C can become chronic, and even people who do not have symptoms can still pass the virus to others.

How can you be infected by Hepatitis? That depends on the type of Hepatitis.
Hepatitis A (HAV) is transmitted from person to person by mouth or contact with stool. It can be spread by contaminated food or water, but is very rarely spread through blood or other body fluids. For this reason, it usually occurs in a wave, affecting large groups of people, called an epidemic. About 1 out of every 3 people has been exposed to Hepatitis A at some point in their lives, even if they have not felt sick. Because symptoms are sometimes so mild, it’s possible to have HAV and not notice. For this reason, the number of people who get this form of Hepatitis is probably much greater that reported.

The Middle East has a particularly high prevalence of HAV infection. If you are planning to t ravel to any lesser-developed nations of Africa, Asia, and Central and South America or the Middle East, you should know that Hepatitis A is very common and most people have been exposed to it. For this reason, it’s a good idea to consider getting vaccinated before you visit these areas, especially if you have a poor immune system.

Hepatitis B is transmitted by blood or body fluids. Hepatitis C is most commonly transmitted by sexual contact or sharing needles used to take IV drugs.

How does my doctor diagnose Hepatitis?
First, you’ll be asked about your medical history, how you’re feeling, when first you noticed symptoms, if you have any other health problems and if you have had this problem before. A thorough exam by your doctor would include trying to feel the size of your liver by hand for enlargements and several blood tests.

Monitoring the levels of certain chemicals in your blood is used to check how well your liver is functioning. Your doctor will look at the level of aminotransferase, a liver enzyme, and bilirubin. People with high levels of bilirubin might notice darker urine.

A test of how long your blood takes to clot, called prothrombin time, might also be taken.

What kind of treatment is available?
In severe cases of hepatitis, your doctor might recommend medications to combat the virus, so your liver does not have to work as hard to repair itself. This class of drug is called antiviral. The first drug used for hepatitis was Interferon alfas-2b, and more recently an improved version of interferon. Patients need this medication injected one to three times a week, and about 40% of patients respond. By slowing down the rate that the virus could multiply and helping the body’s immune system fight the virus, it helped patients get better faster. A side effect of taking interferon is a flu-like illness. Some people have severe enough side effects to discontinue the treatment. If there is already significant liver damage, interferon cannot be used because it can make the liver worse.

Other drugs used for hepatitis seem to work better if there is severe liver damage, but must be taken for a much longer time. Lamivudine is a more effective drug for hepatitis, and is very helpful in patients who can’t tolerate or don’t respond to interferon. It is also given in pill form. Entecavir and Adefovir dipivoxil are the newest drugs for hepatitis and have shown in cases where hepatitis is resistant to previous treatments.

Although these drugs are more powerful and have fewer side effects than interferon, they are second line treatments. Unfortunately, once patients stop taking it, the infection can return. For some people, that means taking expensive medication indefinitely.

In severe cases, the liver fails. The only treatment for liver failure is transplantation.

What are the complications of Hepatitis?
Hepatitis A will resolve without any complications in over 95% of cases. Hepatitis B and C are more serious, and potentially dangerous. Of those with chronic Hepatitis B or C, up to 20% will develop changes in their liver cells called cirrhosis. It can take years for these people to develop the complications associated with liver disease. Not all people with cirrhosis have symptoms, although some may become very seriously ill.

The longer you have hepatitis, the more likely it is that chronic disease will develop. Almost 90% of infants develop chronic infection while only 30% of children under 5 develop chronic hepatitis. After age 5, the number of people who develop chronic infection drops to 10% or less.

Another complication of chronic hepatitis is a liver cancer called hepatocellular carcinoma. Between 15-15% of people who develop chronic hepatitis eventually die as a result.

Is there anything I can do to make myself feel better?
People with Hepatitis A and B seldom need any specific treatment. Rest, plenty of fluids and healthy foods should help you feel better faster. Rarely, lots of vomiting can cause severer dehydration and people need to have fluids replace through an intravenous line.

Drinking alcohol or using illicit drugs takes a toll on your liver and should be avoided until you have recovered. Chronic hepatitis may mean that you won't ever be able to drink alcohol.

Since many medications are metabolized in the liver, other medications you’re taking may work differently if your liver function is diminished. Make sure you tell your doctor about other prescription mediation you take and how much alcohol you typically drink.

Are there any ways to prevent Hepatitis?
For hepatitis A and B, vaccines are currently available. Vaccinations require three doses in a very strict time period to be effective. Until a test confirms that you have immunity, you are not protected from the virus. In 80-90% of cases, treatment with immune globulin after a know exposure to Hepatitis can prevent you from developing the infection. There is no vaccine for Hepatitis C.

Since HAV is transmitted through oral exposure to contaminated food or stool, strict sanitation and frequent hand-washing can dramatically reduce the infection rate. Hepatitis B prevention centers on protection from exposure to contaminated blood. Hepatitis C, transmitted through sexual contact of IV drug use is reduced by abstinence, use of condoms and not using shared needles.Indications for

Hepatitis A vaccine include

• People with chronic liver disease
• People who need to take blood product, like Hemophiliacs
• Workers in contact with contaminated water, human wastes, or such as day care center, hospitals and nursing homes.
• Employees or resident in institutions with high incidence of Hepatitis
• Kids who attend daycare centers
• IV drug users
• Men who have intimate contact with other men
• If you plan to travel to an area where Hepatitis A is common

You should get a Hepatitis B vaccination if

• You are a health care worker
• You have multiple sex partners
• You’ve been exposed to IV drugs
• You have sex with someone who uses IV drugs
• You are on dialysis
• You live with someone who as Hepatitis B

This article is provided as a source of information, if you have any health concerns , whatsoever , please consult your doctor.