Hepatitis: Types, Symptoms, Diagnosing and Treating
Hepatitis is a term that is used to refer to an inflammation of the liver. It is often caused by an infection, but sometimes, it is a result of excessive alcohol consumption or a side effect of some medications. In other cases, the immune system of the body starts producing antibodies against its own liver tissues. This condition is called autoimmune hepatitis. Hepatitis can become chronic, and sometimes, patients aren’t even aware of their condition.
Since the liver is crucial to the normal functioning of the body, hepatitis can have rather grave consequences. The exact symptoms and complications depend on the type of hepatitis, as hepatitis that is caused by viral infections is classified into five types: hepatitis A, B, C, D, E. Hepatitis A is the least aggressive form of the disease, while hepatitis C and D are the most dangerous ones. It is important to correctly identify the hepatitis type, because treatment varies according to the type.
Types and Symptoms
The five types of viral hepatitis are as follows:
- Hepatitis A. Normally, it is contracted when someone consumes food or water that are contaminated with excrements of an infected person. It is caused by the Hepatitis A Virus (HAV).
- Hepatitis B. According to statistical data, approximately 350 million people around the world suffer from chronic hepatitis B. This type is contracted when someone’s punctured skin contacts with an infected person’s wound or infected body fluids, such as blood, saliva or semen. Hepatitis B can also be transmitted through sexual contact. It is caused by the Hepatitis B Virus (HBV).
- Hepatitis C (caused by HCV). This form of hepatitis is transmitted during sexual intercourse or through injection drug use, both of which involve direct contact with infected body fluids. Hepatitis C is a rather common infection, and it is estimated that a significant part of the world population lives with chronic hepatitis C.
- Hepatitis D. This infection is transmitted in a way similar to hepatitis B, and it often comes in conjunction with it. Hepatitis D can lead to serious complications, but, unlike the previous types, it is rather rare. It is sometimes called delta hepatitis and it derives from the Hepatitis D Virus (HDV).
- Hepatitis E. This infection is caused by the Hepatitis E Virus (HEV), which is normally water-borne. It is transmitted in the same way as hepatitis A. Hepatitis E is common in areas with low sanitation levels, but virtually non-existent in most developed countries.
The blood-borne forms of hepatitis (B, C and D) are often more dangerous than A and E, and more likely to become chronic (particularly B and C).
Symptoms of hepatitis vary depending on the disease type, and sometimes, they don’t appear until the condition becomes chronic.
If hepatitis is acute, its symptoms will appear rather quickly:
- dark urine
- feeling exhausted all the time
- sudden weight loss
- yellowish tinge to skin
- pain in the abdominal area
- lack of appetite
Chronic hepatitis sometimes develops for a rather long time, so an infected person might start experiencing the abovementioned symptoms long after contracting the disease.
Diagnosing and Treating Hepatitis
A number of methods can be used to diagnose hepatitis, such as:
- Physical examination. During the examination, your healthcare provider will apply some pressure to the abdominal area to see if it is sore or tender. The doctor might also palpate the liver to check whether it is enlarged or not. If your eyes or skin are yellow, it will also be noticed during the test.
- Liver function tests. A sample of blood can be examined to determine the efficiency of liver function. If a patient’s liver is damaged, it will fail to deal with all waste chemicals inside the body, so their amount in the blood will rise. This will be reflected in the blood sample.
- Liver biopsy. During this procedure, your healthcare provider will use a special needle to penetrate your skin and collect a sample of liver tissue. It will be sent to a specialised laboratory for examination. The results will help determine whether there is an inflammation in the liver or not.
- Other tests. Some additional tests might have to be taken to ensure that a diagnosis is correct. An ultrasound test provides the doctor with a picture of a patient’s internal organs, so that any visible changes to the liver are detected. A sample of blood can be analysed for hepatitis antibodies, the presence of which indicates that the patient is infected. A more detailed analysis of the antibodies will help determine the exact hepatitis type.
Once the hepatitis type has been determined, it is possible to start the treatment. Treatment varies for all five viral hepatitis types:
- Hepatitis A. This condition is usually left untreated, although in some cases, your healthcare provider might prescribe a special diet to avoid dehydration. It is recommended that hepatitis A patients stay in bed for some time if the symptoms are particularly painful.
- Hepatitis B. Similarly to hepatitis A, the acute form of hepatitis B doesn’t normally call for any particular treatment. When a patient is suffering from chronic hepatitis B, antiviral therapy might be recommended by the healthcare provider. The therapy can last for multiple months and even years, so this is a rather expensive measure. In addition, regular medical checks will be required to see whether the treatment is effective.
- Hepatitis C. Both acute and chronic forms of hepatitis C generally demand proper treatment in the form of antiviral medications. Sometimes further tests are required to determine what therapy will yield the best results. The chronic form of hepatitis C can lead to permanent liver damage, so in some cases, a liver transplantation is inevitable.
- Hepatitis D. Alpha interferon is normally recommended to treat this disease type. However, according to statistical data, the majority of patients tend to suffer from hepatitis D even after receiving proper treatment.
- Hepatitis E. This hepatitis type is mostly acute, so it doesn’t require any specific treatment, and there is currently none available on the pharmaceutical market. Patients with hepatitis E should be drinking sufficient amounts of water, resting a lot, and restraining themselves from alcohol consumption.
Since the nature of autoimmune and alcoholic hepatitis is not viral, these types require different forms of treatment.
Hepatitis: Possible Complications
Complications are normally only caused by hepatitis B and C types. Since the disease affects the liver, it can lead to permanent damage of the organ, scarring (known as cirrhosis), and in some rare cases, liver cancer.
When liver function is disrupted by hepatitis for a long time, it can sometimes result in liver failure, a condition with the following consequences:
- kidney failure
- development of liver cancer
- build-up of toxic substances that affect the brain function and are detrimental to one’s mental capabilities
- bleeding disorders
- excessive fluids in the abdominal area
Chronic hepatitis C patients are highly recommended to abstain from alcohol consumption, as it could contribute to liver failure in the long run. It is also unadvisable for them to start taking new medications without consulting their medical practitioner first, as these medicines could have a negative impact on liver function.
Since several forms of hepatitis are associated with poor hygiene, it is prudent to avoid eating raw fruits and vegetables, as well as to avoid drinking local water in countries with low hygiene levels.
Other forms, which are transmitted through blood, can be avoided if the following measures are taken:
- no contact with spilled blood
- no sharing of toothbrushes or razors
- no reusing drug needles, especially not after someone else
Another form of hepatitis prevention is vaccination. Vaccines for hepatitis types A and B are currently available, while vaccines for other hepatitis types are being developed. Vaccines are recommended for new-born children and all medical staff.