Viral hepatitis
Hepatitis refers to an inflammatory condition of the liver. It’s commonly
caused by a viral infection, but there are other possible causes of hepatitis.
These include autoimmune hepatitis and hepatitis that occurs as a secondary
result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a
disease that occurs when your body makes antibodies against your liver
tissue.
Hepatitis is an inflammation of the liver. The condition can be self-limiting
or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis
viruses are the most common cause of hepatitis in the world but other
infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune
diseases can also cause hepatitis.
There are 5 main hepatitis viruses, referred to as types A, B, C, D and E.
These 5 types are of greatest concern because of the burden of illness and
death they cause and the potential for outbreaks and epidemic spread. In
particular, types B and C lead to chronic disease in hundreds of millions of
people and, together, are the most common cause of liver cirrhosis and
cancer.
The liver has a wide range of functions, including:
Most liver damage is caused by 3 hepatitis viruses, called hepatitis A, B and C.
Detoxification (filters harmful substances form the blood, such as alcohol)
Stores vitamins A, D, K and B12 (also stores minerals)
Protein synthesis (makes certain amino acids - the building blocks of
proteins)
The production of biochemicals needed for digestion, such as bile
Maintains proper levels of glucose in the blood
Produces 80% of your body's cholesterol (cholesterol is vital)
The storage glycogen (also converts glucose to glycogen)
Decomposing red blood cells
Synthesizing plasma protein
The production of hormones
Produces urea (the main substance of urine)
The specific mechanism varies and depends on the underlying cause of the
hepatitis. Generally, there is an initial insult that causes liver injury and
activation of an inflammatory response, which can become chronic, leading
to progressive fibrosis and cirrhosis.[14]
bile production that’s essential to digestion
filtering of toxins from the body
excretion of bilirubin, cholesterol, hormones, and drugs
metabolism of carbohydrates, fats, and proteins
activation of enzymes, which are specialized proteins essential to metabolic
functions
storage of glycogen, minerals, and vitamins (A, D, E, and K)
synthesis of plasma proteins, such as albumin
synthesis of clotting factors
Symptoms of hepatitis
Many people with hepatitis experience either mild symptoms or none at all.
Remember that an infected person's feces are always infectious to other people.
When symptoms appear, they usually do so about 15 to 180 days after the person
has become infected.
The acute phase of hepatitis - symptoms
The initial phase of hepatitis is called the acute phase. The symptoms are like a
mild flu, and may include:
Diarrhea
Fatigue
Loss of appetite
Mild fever
Muscle or joint aches
Nausea
Slight abdominal pain
Vomiting
Weight loss.
The acute phase is not usually dangerous, unless it develops into the fulminant or
rapidly progressing form, which can lead to death.
As the patient gets worse, these symptoms may follow:
Circulation problems (only toxic/drug-induced hepatitis)
Dark urine
Dizziness (only toxic/drug-induced hepatitis)
Drowsiness (only toxic/drug-induced hepatitis)
Enlarged spleen (only alcoholic hepatitis)
Headache (only toxic/drug-induced hepatitis)
Hives
Itchy skin
Light colored feces, the feces may contain pus
Yellow skin, whites of eyes, tongue (jaundice).
Medications for chronic hepatitis C infection include:
injectable alpha interferons (Pegasys)
oral ribavirin (Rebetol, Copegus)
oral boceprevir (Victrelis)
simeprevir (Olysio)
oral sofosbuvir (Sovaldi)
oral simeprevir (Olysio)
oral daclatasvir (Daklinza)
oral ledipasvir/sofosbuvir (Harvoni)
oral ombitasvir/paritaprevir/ritonavir (Technivie)
oral ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak)
Medications for chronic hepatitis B infection include:
injectable alpha interferons
oral lamivudine (Epivir)
oral adefovir (Hepsera)
oral entecavir (Baraclude)
orak telbivudine (Tyzeka)
oral tenofovir (Viread)
Complications of Hepatitis:
Chronic hepatitis B or C can often lead to more serious health problems. Because
the virus primarily affects the liver, people with chronic hepatitis B or C are at risk
for:
chronic liver disease
cirrhosis (scarring of the liver)
cancer of the liver (in rare cases)
When the liver stops functioning normally, liver failure can occur. Complications
of liver failure include:
bleeding disorders
a buildup of fluid in the abdomen
increased blood pressure in portal veins that enter the liver
kidney failure
hepatic encephalopathy, which can involve fatigue, memory loss, and
diminished mental abilities due to the build up of toxins that affect the brain
(especially ammonia)
hepatocellular carcinoma, which is a form of liver cancer
Genetic causes of hepatitis include alpha-1-antitrypsin deficiency,
hemochromatosis, and Wilson's disease.
Wilson's disease is a genetic disorder in which copper builds up in the body.
Symptoms are typically related to the brain and liver. Liver related symptoms
include vomiting, weakness, fluid build up in the abdomen, swelling of the legs,
yellowish skin, and itchiness.
Alpha-1 antitrypsin deficiency (α1-antitrypsin deficiency, A1AD) is a genetic
disorder that causes defective production of alpha 1-antitrypsin (A1AT), leading to
decreased A1AT activity in the blood and lungs, and deposition of excessive
abnormal A1AT protein in liver cells.[
Haemochromatosis (or hemochromatosis) type 1[1] (also HFE hereditary
haemochromatosis[2] or HFE-related hereditary haemochromatosis[3]) is a
hereditary disease characterized by excessive intestinal absorption of dietary iron
resulting in a pathological increase in total body iron stores
