The word hepatitis comes from the Ancient Greek word hepar (root word hepat) meaning ‘liver’, and the Latin itis meaning inflammation. Hepatitis means injury to the liver with inflammation of the liver cells.
What is the liver?
The liver is the largest gland in the human body. It weighs approximately 3 lb (1.36 kg). It is reddish brown in color and is divided into four lobes of different sizes and lengths. It is also the largest internal organ (the largest organ is the skin). It is below the diaphragm on the right in the thoracic region of the abdomen. Blood reaches the liver through the hepatic artery and the portal vein. The portal vein carries blood containing digested food from the small intestine, while the hepatic artery carries oxygen-rich blood from the aorta.
The liver is made up of thousands of lobules, each lobule consists of many hepatic cells – hepatic cells are the basic metabolic cells of the liver.
The liver has a wide range of functions, including:
* 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)
Hepatitis can heal on its own with no significant consequence, or it can progress to scarring of the liver. Acute hepatitis lasts under six months, while chronic hepatitis lasts longer.
Most liver damage is caused by 3 hepatitis viruses, called hepatitis A, B and C. However, hepatitis can also be caused by alcohol and some other toxins and infections, as well as from our own autoimmune process (the body attacks itself).
About 250 million people globally are thought to be affected by hepatitis C, while 300 million people are thought to be carriers of hepatitis B.
Not all forms of hepatitis are contagious. Alcohol, medicines, and chemical may be bad for the liver and cause inflammation. A person may have a genetic problem, a metabolic disorder, or an immune related injury. Obesity can be a cause of liver damage which can lead to inflammation. These are known as non-infectious, because they cannot spread form person-to-person.
How many types of hepatitis are there?
There are five main types of hepatitis that are caused by a virus, A, B, C, D, and E – plus types X and G.
* Hepatitis A – this is caused by eating infected food or water. The food or water is infected with a virus called HAV (Hepatitis A Virus). Anal-oral contact during sex can also be a cause. Nearly everyone who develops Hepatitis A makes a full recovery – it does not lead to chronic disease.
* Hepatitis B – this is an STD (sexually transmitted disease). It is caused by the virus HBV (Hepatitis B Virus) and is spread by contact with infected blood, semen, and some other body fluids. You get Hepatitis B by:
o Unprotected sexual intercourse with an infected person (unprotected sex means without using a condom) Using a syringe that was previously used by an infected person (most commonly happens with drug addicts and people who inject steroids).
o Having your skin perforated with unsterilized needles, as might be the case when getting a tattoo, or being accidentally pricked. People who work in health care risk becoming infected by accident in this way. Sharing personal items, such as a toothbrush or razor, with an infected person.
o A baby can become infected through his mother’s milk if she is infected.
o Being bitten by someone who is infected.
The liver of a person infected with Hepatitis B swells. The patient can suffer serious liver damage due to infection, resulting in cancer. For some patients the hepatitis becomes chronic (very long-term or lifelong). Donated blood is always tested for Hepatitis B.
* Hepatitis C – This is also an STD, infection being most common through the blood, semen or body fluid of an infected person. It is caused by the virus HCV (Hepatitis C Virus). The liver can swell and become damaged, raising the risk of liver cancer. The majority of Hepatitis C patients develop chronic infection, leading to cirrhosis. Donated blood is also tested for Hepatitis C.
* Hepatitis D – only a person who is already infected with Hepatitis B can become infected with Hepatitis D. It is caused by the virus HDV (Hepatitis D Virus). Infection is through contact with infected blood, unprotected sex, and perforation of the skin with infected needles. The liver of a person with Hepatitis D swells.
* Hepatitis E – a person can become infected by drinking water that contains HEV (Hepatitis E Virus). The liver swells but there is no long-term consequence. Infection is also possible through anal-oral sex.
* Hepatitis X – if a hepatitis cannot be attributed to the viruses of hepatitis A, B, C, D, or E, it is called Hepatitis X. In other words, hepatitis of an unknown virus.
* Hepatitis G – this is a type of hepatitis caused by the Hepatitis G virus (HGV). Usually there are no symptoms. When there are symptoms they are very mild.
What are the signs and 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:
* Loss of appetite
* Mild fever
* Muscle or joint aches
* Slight abdominal pain
* 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)
* Itchy skin
* Light colored feces, the feces may contain pus
* Yellow skin, whites of eyes, tongue (jaundice)
Patient outcomes after the acute phase depend on various factors, especially the type of hepatitis.
Treatments for hepatitis
* Hepatitis A – There is no treatment specifically for hepatitis A. Doctor will advise the patient to abstain from alcohol and drugs during the recovery. The vast majority of patients with Hepatitis A will recover spontaneously.
* Hepatitis B – A patient with Hepatitis B needs to rest. He will require a diet that is high in protein and carbohydrate – this is to repair damaged liver cells, as well as to protect the liver. If this is not enough, the doctor may prescribe interferon. Interferon is an antiviral agent.
* Hepatitis C – A patient with Hepatitis C will be prescribed interferon alfa-2b (Intron A). It is the only approved treatment for this type of hepatitis.
* Hepatitis D or E – So far, there is no effective treatment for either Hepatitis D or E.
* Non-Viral Hepatitis – If the patient has non-viral hepatitis, the doctor needs to remove the harmful substance. It will be flushed out of the stomach by hyperventilation or induced vomiting. Patients with drug-induced hepatitis may be prescribed corticosteroids.
How to prevent hepatitis
How to prevent Hepatitis A
* Wash your hands with soap after going to the toilet
* Only consume food that has just been cooked
* Only drink commercially bottled water, or boiled water if you unsure of local sanitation
* Only eat fruits that you can peel if you are somewhere where sanitation is unreliable
* Only eat raw vegetables if you are sure they have been cleaned/disinfected thoroughly
* Get a vaccine for Hepatitis A if you travel to places where hepatitis may be endemic
How to prevent Hepatitis B
* Tell the partner if you are a carrier or try to find out whether he/she is a carrier
* Practice safe sex
* Only use clean syringes that have not been used by anyone else
* Do not share toothbrushes, razors, or manicure instruments
* Have a Hepatitis B series of shots if you are at risk
* Only allow well sterilized skin perforating equipment (tattoo, acupuncture, etc.)
How to prevent Hepatitis C
* If you are infected do not let others share your toothbrush, razor, manicure equipment
* If you are infected cover open wounds
* Do not share needles, toothbrushes, or manicure equipment
* If your skin is to be pierced, make sure equipment is well sterilized (tattoo, etc.)
* Go easy on the alcohol
* Do not share drug equipment
How to prevent Hepatitis D
* Use the same guidelines as for Hepatitis B. Only a person who is infected with Hepatitis B can become infected with Hepatitis D.
How to prevent Hepatitis E
* Do the same as you would to protect yourself from Hepatitis A infection.
How to prevent Alcoholic Hepatitis
* Go easy on the alcohol, or abstain from consuming alcohol
How to prevent Toxic/Drug Induced Hepatitis
* Make sure you know about the lethal contents of all chemicals
* Make sure the spray is not pointing at you
* Make sure you wear protective gear if you have to
News on hepatitis
For the latest news and research on hepatitis, and to sign up to newsletters or news alerts, please visit our hepatitis news section.