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
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
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
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
In severe cases, the
liver fails. The only treatment for liver failure is
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.
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
- People with chronic liver
- 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
- You have sex with someone who
uses IV drugs
- You are on dialysis
- You live with someone who as
is provided as a source of information, if you have
any health concerns , whatsoever , please consult your