Viral hepatitis

Viral Hepatitis

Hepatitis A

Overview

This is a highly infectious liver condition caused by the hepatitis A virus. Most cases are mild and can recover completely with no permanent liver damage. Practicing good hygiene and washing hands frequently are good preventive measures to protect yourself from hepatitis A. A vaccine is also available for hepatitis A.

Signs and symptoms

Once infected, the symptoms of hepatitis A usually appear in the patient after 2-3 weeks. The symptoms include fatigue, nausea, vomiting, abdominal pain, clay-coloured stools, loss of appetite, low-grade fever, dark urine and jaundice. The symptoms could be mild and disappear within a few weeks, or they could last up to a few months.

Causes and risk factors

Hepatitis A is caused by a viral infection in the liver. The virus typically spreads via contaminated food and water and by eating with contaminated hands. People who travel frequently are at risk for acquiring hepatitis A infection.

Complications

Unlike other types of hepatitis, hepatitis A infection is usually mild and doesn’t cause any permanent liver damage. Occasionally, it may cause very severe liver injury causing acute liver failure and may even need an emergency liver transplant.

Diagnosis

After an initial patient medical history and physical exam, the doctor will confirm hepatitis A with a blood test.

Treatment and Surgical Interventions

There is no formal treatment for hepatitis A. In a typically mild infection, the body fights it on its own within a few weeks. Treatment is usually focused on mitigating the symptoms. Very severe liver injury may cause acute liver failure and the patient may need ICU care or even a liver transplant.

Prevention

Hepatitis A can be prevented by the hepatitis A vaccine. It is typically administered in 2 doses. The initial dose is followed by a booster dose after 6 months.

Hepatitis B

Overview

This is a severe and contagious liver disease caused by the hepatitis B virus. It causes severe inflammation and affects liver function. Most adults recover completely from a hepatitis B infection. However, it can become chronic and cause prolonged liver injury and scarring of the liver. Children and infants tend to develop chronic hepatitis B, which can cause permanent liver damage. There is a very effective vaccine to prevent hepatitis B.

Signs and symptoms

Once infected, the symptoms of hepatitis B usually appear in the patient after 1-4 months. However, they could appear as early as two weeks post-infection. Symptoms of hepatitis B include nausea, vomiting, abdominal pain, fatigue, loss of appetite, low-grade fever, dark urine and jaundice.

Causes and risk factors

Hepatitis B typically spreads via cross-contamination of blood, semen and other bodily fluids. It does not spread via sneezing or coughing. The disease commonly spreads through shared needles, contaminated needle use and unprotected sexual contact. If a pregnant mother has hepatitis B, the risk of it passing onto the baby is also very high.

Complications

Chronic infection with Hepatitis B can cause cirrhosis, liver cancer, kidney disease and acute liver failure.

Diagnosis

After an initial patient medical history and physical exam, the doctor will confirm hepatitis B with a blood test. A liver ultrasound and biopsy may also be required.

Treatment and Surgical Interventions

There is no formal treatment for acute hepatitis B as the symptoms usually recover spontaneously. The doctor may recommend rest, fluids and some painkillers. In very severe cases, anti-viral drugs may be prescribed, and if the liver damage is extensive, it may even need an emergency liver transplant as a life-saving measure. Chronic hepatitis B patients are treated with antiviral drugs, Interferon injections and, in case of cirrhosis, a liver transplant.

Prevention

Hepatitis B can be prevented by taking the hepatitis B vaccine. It is administered in 3 or 4 doses over six months. Chronic hepatitis B infection may sometimes be diagnosed incidentally on routine tests in a completely healthy individual. If this is diagnosed, the individual should be on a regular follow-up with a liver specialist to monitor liver function and development of tumours.

Hepatitis C

Overview

This is a serious, contagious liver disease caused by the hepatitis C virus. It causes severe prolonged inflammation and injury to the liver leading to cirrhosis and its complications and liver cancers. Unlike hepatitis A and B, hepatitis C has no vaccine. Until recently, medications to treat it effectively were not available. However, over the last decade, several new drugs have become available with success rates of nearly 100%.

Signs and symptoms

Patients with acute hepatitis C may experience abdominal pain, jaundice, fever, fatigue, nausea, vomiting, joint pain between 2 to 12 weeks after exposure to the virus and settle spontaneously. However, the virus remains within the body and continues to cause slow continued liver damage. Many infected patients never develop symptoms, and the diseases may go undiagnosed for years.

Causes and risk factors

Hepatitis C is caused by a viral infection in the liver. The virus typically spreads via cross-contamination of blood. Hepatitis C commonly spreads through shared needles, contaminated needle use , and unprotected sexual contact. Casual contact does not spread the infection.

Complications

Chronic hepatitis C causes cirrhosis, increased risk of liver cancer, kidney disease and acute liver failure. Early diagnosis is key to preventing any serious complications.

Diagnosis

After an initial patient medical history and physical exam, the doctor will confirm hepatitis C with a blood test. Blood tests and scans will help in assessing the severity of liver damage. Occasionally, a liver biopsy may also be required.

Treatment and Surgical Interventions

Hepatitis C can now be treated with highly effective anti-viral drugs, which can clear the virus from the body with a 12-week of treatment. The patient should be closely monitored during the course of the treatment. A liver transplant may be required in case of serious complications due to extensive liver damage or multiple liver tumors. The liver transplant will not cure the infection, so antiviral drugs are used to treat the condition even after transplant.

Prevention

There is no vaccine available to protect against hepatitis C. However, you can protect yourself by avoiding sharing needles, personal grooming items and practicing safe sex.

Hepatitis E

Overview

This is an infection of the liver caused by the hepatitis E virus. It causes severe inflammation and affects liver function. It is transmitted through the oral-faecal route. Practicing good hygiene and washing hands frequently are good preventive measures to protect yourself from hepatitis E. There is no vaccine available for Hepatitis E.

Signs and symptoms

Hepatitis E infections cause abdominal pain, clay-coloured stools, dark urine, fever, fatigue, nausea, vomiting, joint pain and jaundice. The symptoms may begin anywhere from 2-6 weeks after exposure to the virus. In extreme cases, it can cause liver cirrhosis and liver failure.

Causes and risk factors

The disease is transmitted via the oral-faecal route, i.e. through water contaminated with faeces. Inadequate sanitation facilities put a person at greater risk of contracting a Hepatitis E infection. It can also be transmitted by eating infected animal products. Pre-existing liver damage puts the patient at a higher risk of developing complications from a hepatitis E infection.

Complications

People who contract Hepatitis E usually recover within a few weeks. Still, in some cases, it causes severe liver damage. Pregnant women, people with weak immune systems and older people have a higher risk of developing serious complications.

Diagnosis

Hepatitis E infections are diagnosed based on patient medical history, physical exam, blood and stool tests.

Treatment and Surgical Interventions

Hepatitis E is usually cleared by the body’s own immune system in 4-6 weeks, provided the patient rests, drinks plenty of fluids and eats healthy, nutritious foods. However, in high-risk patients such as the pregnant, elderly or those with prior liver damage, the doctor may recommend a hospital stay until recovery is confirmed. Very sick patients will need hospital admission, may need ICU care and rarely a liver transplant as a life-saving treatment.

Prevention

To prevent hepatitis E infections, always wash your hands before eating and using the bathroom. Practice good hygiene and be careful with your drinking water.

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