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Hepatitis - Liver Disease SymptomsHepatitis refers to inflammation of the liver. This may occur secondarily to alcohol use, drug use (medication side effect), acetaminophen overdose, or viral infection. There are 5 major types of viral hepatitis and we will discuss the first three in this section. 1. HEPATITIS A OR INFECTIOUS HEPATITIS 2. HEPATITIS B OR SERUM HEPATITIS 3. HEPATITIS C (transfusion hepatitis) also referred to as non-A non-B hepatitis. 4. HEPATITIS D (a rare form of transfusion hepatitis that can also be transmitted sexually) 5. HEPATITIS E (this form can not be specifically tested for and represents a "catch all" category for those forms of hepatitis acquired via the oral/fecal route, but test negative for the other forms of hepatitis. Hepatitis A (infectious hepatitis) is usually spread through personal contact with infected oral secretions or stool (i.e. contaminated food handled by infected individuals). This type of hepatitis can also be spread through sexual contact. The incubation period is approximately 4 weeks before the onset of symptoms. This infection is usually much less severe than hepatitis B. Common symptoms include: nausea, vomiting, right upper quadrant abdominal pain, weakness, malaise, and yellowing of the eyes and skin (jaundice). Resolution of symptoms occurs over weeks, and there are no chronic active forms of this disease. See below for additional information on signs and symptoms. Hepatitis B (serum hepatitis) is usually spread by sexual contact or contact with infected blood products (a cause of infection in health care workers). This type of hepatitis has an incubation period of approximately 6 weeks to 3 months before the onset of symptoms. Common symptoms are similar to those of hepatitis A: patients tend to be more ill and recovery takes longer. There is a small (1%) incidence of total hepatic failure [resulting in death] in patients with hepatitis B. Hepatitis B can also cause a chronic infection which is difficult to treat. Hepatitis B is also an important risk factor for the development of hepatocellular carcinoma (liver cancer). Carriers for hepatitis B may have no symptoms at all, making exposure to this disease unpredictable. Hepatitis C is a form of viral hepatitis once referred to as non-A non-B hepatitis. It is currently the leading cause of hepatitis secondary to blood transfusion, but not all cases of hepatitis C have been acquired through a blood transfusion. Hepatitis C is thought to be transmitted by the parenteral route (blood borne transmission rather than orally). Transmission through sexual contact is considered rare. Chronic hepatitis develops in about 50% of patients with this disease and about 25% of those patients develop cirrhosis. There is also an increased risk of hepatocellular carcinoma (liver cancer) in these patients. Up to 160,000 patients per year are infected with hepatitis C. Approximately 40% of these patients have NO identifiable source for their infection. Each year, approximately 4,000 patients will be hospitalized for hepatitis C and about 600 die with fulminant disease. Special antibody testing for hepatitis C has been available for approximately the past 1.5 years, and is utilized in the screening of potential blood donors. The incidence of a positive test is about 1% in the U.S. blood donor population (or 100,000 people per year in the U.S.). THE SYMPTOMS OF HEPATITISSymptoms common to ALL forms of hepatitis include: jaundice (dark urine, yellow eyes and skin), itching, weakness, nausea, and right upper quadrant abdominal pain. Upper respiratory symptoms can be seen early in the disease. Severe liver dysfunction can result in confusion, dementia, and coma. Evaluation by your doctor will include: blood tests (i.e. liver profile, complete blood count, and coagulation profile), hepatitis screen, and abdominal x-rays, if abdominal pain is severe. The hepatitis (blood) screen permits the doctor to determine the "type" (A, B, or C). Ultrasound of the gallbladder may be required to rule out gallbladder disease, which is often confused with viral hepatitis. A complete review of the patient's medications is necessary in order to confirm that none of them are causing liver inflammation which may resemble hepatitis. Patients who abuse alcohol may have alcohol induced hepatitis. Treatment for hepatitis is largely supportive. If drugs or alcohol are causative, then they must be avoided. Drugs which are metabolized by the liver (acetaminophen) must be used with caution and in reduced doses. To avoid spreading the disease, stress is placed on the practice of good personal hygiene. A diet of restricted protein and low fat is recommended. Alcohol should be avoided in all cases of liver disease. Most infections will resolve slowly over a period of several weeks. This recovery period is usually longer for hepatitis B infections. Chronic hepatitis has been treated successfully in some cases with an anti-viral medication known as interferon. Hospitalization may be necessary in cases involving the elderly, diabetic patient, or those with evidence of severe liver dysfunction. Close medical follow-up is necessary in all cases. Physicians will monitor the liver profile and coagulation profile. Patients should be wary of any increased vomiting, decreased urine output, increasing abdominal pain, and high fever (all of which are signs of a more serious hepatitis infection). Prevention of hepatitis B is now undertaken through the routine administration of hepatitis B vaccine. This can be administered to adults in high-risk occupations This can be given to infants at 2, 4, and 6 months of age. Hepatitis secondary to a drug side effect can be investigated in the DRUG FILE. DO NOT STOP ANY MEDICATIONS WITHOUT FIRST DISCUSSING IT WITH YOUR PHYSICIAN. Hope this article will provide you information about hepatitis - liver disease. |
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