The Health Counsellor

WHAT IS HEPATITIS?

Hepatitis means inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs, alcohol, chemicals, and autoimmune diseases. Many viruses, for example, the virus causing mononucleosis and the cytomegalovirus , can inflame the liver. Most viruses, however, do not attack primarily the liver; the liver is just one of several organs that the viruses affect. When most doctors speak of viral hepatitis, they are using the definition that means hepatitis caused by a few specific viruses that primarily attack the liver and are responsible for about half of all human hepatitis. There are several hepatitis viruses; they have been named types A, B, C, D, E, F (not confirmed), and G. As our knowledge of hepatitis viruses grows, it is likely that this alphabetical list will become longer. The most common hepatitis viruses are types A, B, and C.

Hepatitis viruses replicate (multiply) primarily in the liver cells. This can cause the liver to be unable to perform its functions. The following is a list of major functions of the liver:

• The liver helps purify the blood by changing harmful chemicals into harmless ones. The source of these chemicals can be external, such as medications or alcohol, or internal, such as ammonia or bilirubin. Typically, these harmful chemicals are broken down into smaller chemicals or attached to other chemicals that then are eliminated from the body in the urine or stool.

• The liver produces many important substances, especially proteins that are necessary for good health. For example, it produces albumin, the protein building block of the body, as well as the proteins that cause blood to clot properly.

• The liver stores many sugars, fats and vitamins until they are needed elsewhere in the body.

• The liver builds smaller chemicals into larger, more complicated chemicals that are needed elsewhere in the body. Examples of this type of function are the manufacture of a fat, cholesterol , and the protein bilirubin.

When the liver is inflamed, it does not perform these functions well, which brings about many of the symptoms, signs, and problems associated with any type of hepatitis.

Common types of Hepatitis

Although the most common types of viral hepatitis are HAV, HBV and HCV, some clinicians had previously considered the acute and chronic phases of hepatic infections as “types” of viral hepatitis. HAV was considered to be acute viral hepatitis because the HAV infections seldom caused permanent liver damage that led to hepatic (liver) failure. HBV and HCV produced chronic viral hepatitis. However, these terms are outdated and not currently used as frequently because all of the viruses that cause hepatitis may have acute phase symptoms.

People who are at risk for Hepatitis

People who are most at risk for developing viral hepatitis are:

• Workers in the health care professions,

•  Asians and Pacific Islanders,

• Sewage and water treatment workers,

• People with multiple sexual partners,

• Intravenous drug users,

• HIV patients,

• People with hemophilia who receive blood clotting factors.

Blood transfusion, once a common means of spreading viral hepatitis, now is a rare cause of hepatitis. hepatitis is generally thought to be as much as ten times more common among lower socioeconomic and poorly educated individuals. About one third of all cases of hepatitis come from an unknown or unidentifiable source. This means that a person does not have to be in a high risk group in order to be infected with a hepatitis virus. In countries with poor sanitation, food and water contamination with HAV increases risk. Some day care centers may become contaminated with HAV, so children at such centers are at a higher risk for HAV infections.

Symptoms/Signs of Hepatitis

The period of time between exposure to hepatitis and the onset of the illness is called the incubation period. The incubation period varies depending on the specific hepatitis virus. Hepatitis A virus has an incubation period of about 15 to 45 days; Hepatitis B virus from 45 to 160 days, and Hepatitis C virus from about 2 weeks to 6 months.Many patients infected with HAV, HBV, and HCV have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu- like symptoms including:

• Loss of appetite

• Weakness

• Tiredness

• Aching in the abdomen

• Less common symptoms include:

• Dark urine

• Light-colored stools

• Fever

TREATMENT

Treatment of acute viral hepatitis and chronic viral hepatitis are different. Treatment of acute viral hepatitis involves resting, relieving symptoms and maintaining adequate intake of fluids. Treatment of chronic viral hepatitis involves medications to eradicate the virus and taking measures to prevent further liver damage.