Hepatitis

Hepatitis is defined as a disease process that causes inflammation of the liver. Inflammation of the liver may be caused by many different processes including infectious agents such as viruses, or toxins such as alcohol, or medications. This can also be seen in several types of disease states including inherited diseases, such as hemachromatosis and Wilson's Disease. The most common causes of viral hepatitis in the United States are from hepatitis A, hepatitis B and hepatitis C.

Hepatitis A

Hepatitis A is the most common form of an acute viral hepatitis in the United States which is caused by the hepatitis A virus. Hepatitis A can be obtained by eating or drinking infected food or water supplies. It can be obtained through patient to patient contact from one infected patient to the uninfected individual and can be sexually transmitted. Fortunately hepatitis A does not lead to chronic infection or to chronic liver disease, but can cause serious, short-term illness. The serious forms of hepatitis A are usually seen when patients are exposed during their adult years. A hepatitis A vaccine is currently available and should be administered to all patients who are infected with hepatitis C, as well as patients who will be traveling to areas of the world that are known to have a high rate of hepatitis A infection.

Hepatitis B

Hepatitis B is another form of viral hepatitis caused by the hepatitis B virus. Hepatitis B is one of the greatest health problems in the world today. Many people in the Asian nations and Africa are infected with hepatitis B. In the United States an estimated 1.2 million Americans are currently chronic carriers of the hepatitis B virus. Hepatitis B develops into chronic disease (which means hepatitis lasts for greater than six months) and up to 10% of the newly infected patients every year. Chronic hepatitis B infection can lead to cirrhosis (scarring of the liver) and liver cancer over time. Fortunately there is treatment available for hepatitis B for patients who are infected and this involves Interferon therapy. More importantly, however, hepatitis B vaccine has been available for more than ten years and all individuals who will be traveling to areas of the world that are endemic for hepatitis B should be immunized against this virus. All health care workers should be vaccinated against hepatitis B virus and it is currently recommended that all newborns be immunized to prevent these individuals from ever acquiring hepatitis B in the future.

Hepatitis C

Hepatitis C is another form of viral hepatitis caused by the hepatitis C virus. Hepatitis C is a major health problem in the United States today with approximately 1-2% of the population (4 million people) being currently infected with hepatitis C. Hepatitis C was previously known as non-A/non-B hepatitis and it is the major cause of chronic viral hepatitis in the United States. Hepatitis C is a bloodborn virus whose main line of transmission is by blood exposure. Today the most common means of transmission is by I.V. drug use, but prior to 1990, many patients contracted this virus through blood transfusion. There is treatment available for hepatitis C and this should be discussed further with your doctor.

Other Viruses

Several other viruses have also been known to cause liver disease, but these are not as frequent as hepatitis A, B or C. The other viruses which have been implicated in causing liver disease include hepatitis D, hepatitis E, cytomegalovirus (CMV) and herpes virus.

Symptoms of Hepatitis

Hepatitis can present with many different types of symptoms depending upon the severity of the hepatitis and the extent of injury to the liver. In mild hepatitis, patients may have simple flu-like symptoms and feel some fatigue. In severe hepatitis, patients may be jaundiced, have nausea, vomiting, right upper quadrant pain and diarrhea. At times patients with severe hepatitis may also suffer fever, body aches and joint pain. Acute hepatitis can last for several weeks to at times, several months. The diagnosis of hepatitis made by combining the patient's clinical presentation with various laboratory blood tests which illustrate liver disease and liver damage. Other tests are sometimes employed to further define the diagnosis of hepatitis and this usually includes various imaging studies, such as abdominal ultrasound examination, CT Scan of the abdomen and at times, liver biopsy. Treatment for hepatitis depends upon the underlying cause of this disease and various treatment strategies are available depending upon the cause, whether it be from viral hepatitis or toxic hepatitis or other types of liver disease.

Vaccination

Vaccination is available against hepatitis A and hepatitis B. Hepatitis A is currently recommended for all patients who are infected with the hepatitis C virus and those patients who are infected with the hepatitis B virus. The hepatitis A vaccination is also recommended for individuals who will be traveling to areas of the world that have high rates of hepatitis A infection. Hepatitis B vaccination is currently also available and recommended for the following high risk groups: this should include health care workers, individuals who are traveling to areas of the world with high rates of hepatitis B infections, individuals with multiple sexual partners and intravenous drug users. The American Pediatric Association has also recommended that all infants be vaccinated against hepatitis B.

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