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Hepatitis is the inflammations of the liver, with accompanying damage to the liver cells. The condition may be acute or chronic and may have various causes.

ACUTE HEPATITIS

Acute hepatitis is a short-term inflammation of the liver. Acute hepatitis usually clears up in one or two months. In some cases, the disorder may progress to chronic hepatitis, but it rarely leads to acute liver failure.

Acute hepatitis is fairly common. The most frequent cause is infection with a hepatitis virus, but it can also be due to other infections, such as cytomegalovirus infection. It may also occur as a result of paracetamol overdose or exposure to toxic chemicals, including alcohol. However, in some cases no cause can be found. Symptoms of acute hepatitis range from mild to severe. They include tiredness; fever; nausea and vomiting; pain in the upper right side of the abdomen; and jaundice.

Blood tests, including liver function tests, may be used for diagnosis. In most cases, natural recovery occurs within a few weeks. If the disorder is caused by exposure to chemical or drug, detoxification using an antidote may be possible. Intensive care may be required if the liver is badly damaged. Rarely, a liver transplant is the only way of saving life.In all cases, alcohol should be avoided after the illness.

CHRONIC HEPATITIS

Chronic hepatitis is an inflammation of the liver that persists for a prolonged period. Eventually, chronic hepatitis causes scar tissue to form and may lead to the development of cirrhosis and portal hypertension. The disorder may develop following an attack of acute hepatitis or hepatitis C. It may also occur as the result of an autoimmune disorder, a viral infection, a reaction to certain types of prescribed drugs or, more rarely, to a metabolic disorder such as haemochromatosis or Wilson’s disease. In some cases, no obvious cause can be found.

Symptoms of chronic hepatitis, such as jaundice and slight fatigue, may alternate with periods in which there are no symptoms at all. If left untreated, the condition may progress to liver failure.

Chronic hepatitis is diagnosed by liver biopsy. Autoimmune hepatitis is treated with corticosteroid drugs and immunosuppressants. Viral infections often respond to interferon. In the drug-induced type of chronic hepatitis, withdrawal of the medication can lead to recovery. For metabolic disturbances, treatment is for the underlying disorder.

HEPATITIS A

Hepatitis A is a disorder caused by hepatitis A virus, which is in the urine and faeces of infected people and is transmitted in contaminated food (commonly shell-fish) or drink. The incubation period is 15-40 days, after which nausea, fever, and jaundice develop.

Recovery usually occurs within three weeks. Serious complications are rare. Active immunization protects against hepatitis A, and may be advised for people travelling to Mediterranean or developing countries.

An attack of the disease can confer immunity against subsequent infection.

HEPATITIS B

Hepatitis B is a disorder caused by the hepatitis B virus. The infection is transmitted in blood, blood products, or other body fluids (often through contact with used needles and syringes); blood transfusions; or sexual contact. After an incubation period of one to six months, the onset of symptoms, such as headache, fever, and jaundice, may be sudden or gradual; sometimes, there are no symptoms.

Most affected people recover, but hepatitis B can be fatal. A vaccine is available; it is usually given to people at high risk of coming into contact with the virus, such as health-care workers or people visiting areas where the disease is common.

In some cases, the virus continues to cause inflammation and can still be detected in the blood for longer than six months after infection. People who suffer from persistent infection are at long-term risk of liver cancer and cirrhosis and may need to be treated with interferon.

HEPATITIS C

Caused by the hepatitis C virus and formerly known as non-A non-B hepatitis, this infection is often transmitted through sharing needles. Blood transfusions no longer pose a significant risk in the UK because all blood used for transfusions is now routinely screened for the virus.

Hepatitis C has an incubation period of six to 12 months. It begins as a mild illness, which may go undetected.

In about three in four patients, chronic hepatitis develops, which can progress to cirrhosis of the liver and an increased risk of hepatoma (a type of liver cancer).

There is no vaccine for hepatitis C.

HEPATITIS D

Hepatitis D is an infection of the liver caused by the hepatitis D virus, which occurs only in people who already have hepatitis B infection. People who develop hepatitis D will usually suffer from severe chronic liver disease. Hepatitis D is also known as delta hepatitis.

HEPATITIS E

Hepatitis E is a type of hepatitis caused by the hepatitis E virus, which is transmitted in contaminated food or drink. The disease is similar to hepatitis A.

Source: A-Z family medical encyclopedia by BMA

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