Hepatitis is a disease that affects the liver. We distinguish different types of hepatitis ( A , B , C ,…). Here is our complete file on this condition.
* Chronic phase: in the sense that the virus persists indefinitely or until the disease is treated and the virus eliminated.
Most individuals with chronic hepatitis B or C virus infection are unaware that they carry the virus. Thus, they are exposed to an increased risk of developing severe chronic liver disease and may unknowingly transmit the virus to others.
Read also: Hepatitis A – Hepatitis B – Hepatitis C – Hepatitis D – Hepatitis E
Index
ToggleDefinition
Hepatitis is an acute and chronic inflammation of the liver (see photo opposite). In fact, it is very important to talk about this disease, as it is quite common and occurs due to several factors. It can be of viral origin (hepatitis A, B, C, D and E), toxic and drug, alcoholic, bacterial or parasitic. More information about the different causes of hepatitis is detailed in the causes of hepatitis section .
The disease is usually acute, but it can progress and become chronic if it lasts longer than six months.
The symptoms of hepatitis vary according to its origin, but certain signs, such as jaundice (yellow), darkened urine, whitish stools, nausea, or liver sensitive to touch, are common to all types of hepatitis.
The mode of transmission of hepatitis also depends on its origin, so this phenomenon will be explained in detail in the causes of hepatitis section .
The disease can be acute and evolve spontaneously in a favorable way in most cases, without leaving any sequelae. However, poorly managed hepatitis can evolve and become chronic, cirrhosis, or even cancer ( liver cancer ).
Epidemiology
– In Brazil, it is estimated that in 2005 alone, around 120,000 people contracted the disease.
– 2 to 3 million Brazilians were infected by the hepatitis C virus .
– Hepatitis B and C kill about 1.3 million people annually worldwide1 . These deaths most often occur in poor countries, from cirrhosis or liver cancer (900,000 deaths from hepatitis B and 400,000 from hepatitis C).
– China has the highest number of cases of hepatitis B and Egypt has the highest number of cases of hepatitis C , according to the WHO. [July 2011]
Causes
As we saw in the definition of hepatitis section, there are different origins and different types of hepatitis: viral, toxic, drug-induced, acute bacterial or parasitic.
> Viral hepatitis, A, B, C, D or E, are the most frequent. Other viruses can also cause this disease, such as the Epstein-Barr virus ( infectious mononucleosis ) and the Cytomegalovirus (which infects blood cells).
– Hepatitis A is caused by the A virus. Its contamination occurs mainly through the digestive tract, through food and water contaminated by fecal matter, as well as through the consumption of seafood. Hepatitis A is rarely transmitted sexually or parenterally (from mother to fetus). The incubation time ranges from 15 to 45 days. Hepatitis A is the most anodyne form, as it is the only one that hardly evolves into chronicity. However, in some cases, in elderly patients, it can prove to be deadly. This hepatitis is also known as “traveller’s hepatitis”, as it is usually tourists who contract it, mainly in countries of the South or East.
Hepatitis A virus is transmitted through water, juice or poorly cooked food (salads, unpeeled fruits, seafood, ice), in insufficiently hygienic conditions.
– Hepatitis B is caused by the B virus, transmitted through blood (transfusion of contaminated blood or use of contaminated syringes in drug addicts) or body fluids (exudates from wounds, semen, cervical (uterine cervix), vaginal secretions and saliva of people carriers of the virus), with the highest concentration of the virus found in blood and the lowest in saliva. The incubation time ranges from 30 to 180 days. This hepatitis can become chronic and turn into cirrhosis or cancer.
– Hepatitis C is caused by the C virus, transmitted through the bloodstream (transfusions, hemophiliacs, drug addicts, patients undergoing hemodialysis, sexual intercourse or via the placenta, the latter being rarer). Incubation ranges from 30 to 100 days.
– Hepatitis D is caused by the D virus, transmitted by blood or sexual transmission. The presence of the hepatitis B virus is necessary for hepatitis D to develop. It can be a co-infection (the person is infected simultaneously by the B virus and the D virus) or a superinfection (the person is already a carrier of the B virus and ends up being infected by the D virus). Incubation ranges from 45 to 180 days. This type of hepatitis almost exclusively affects drug addicts. In 80% of cases, hepatitis D becomes chronic and rapidly progresses to cirrhosis.
– Hepatitis E is caused by the E virus, transmitted by the fecal-oral route. It is often acute and benign, with no chronic form. However, mortality is highest in pregnant women, where it reaches 20%.
> Toxic or drug-induced hepatitis are those induced by the ingestion of certain medicinal or non-medicated substances. These can cause serious damage to the liver. This is the case of amanita falloide (poisonous fungus). This can occur in the case of certain hepatotoxic drugs, such as paracetamol, which must be consumed in moderation and according to the prescribed dosage.
> Acute alcoholic hepatitis is a type of toxic hepatitis induced by alcoholism. It leads to cirrhosis and massive destruction of the liver.
> Acute bacterial or parasitic hepatitis can arise from certain diseases, such as tuberculosis, brucellosis, leptospirosis, or bilharzia. Certain opportunistic germs can cause acute bacterial hepatitis in AIDS patients, as they are already immunosuppressed.
> Chronic hepatitis. In general, its cause is similar to that of acute hepatitis. As we saw in the definition of hepatitis section, chronic hepatitis is one that lasts for more than six months. It can occur because of viruses (especially hepatitis B and C), but also because of medications. We noticed the existence of a so-called autoimmune chronic hepatitis, mainly in young women. In these cases, there is a production of antibodies, directed against the liver.
Groups of risk
Here are the different groups of people at risk:
– Travelers (hepatitis A, B and C), in case of risky behavior, such as consumption of contaminated food and water, as well as unprotected sexual intercourse;
– Drug addicts (hepatitis B, C and D) in case of using dirty or shared needles;
– Immunosuppressed people (seropositive patients, cancer patients, etc.);
– The alcoholics
– Health professionals
– People who need polytransfusions
– People who need hemodialysis
– People who engage in risky sexual behavior (without protection).
Symptoms
As we saw in the definition section, the symptoms are generally related to the type of hepatitis. Some symptoms are common to all types, such as jaundice (better known as yellowing).
Jaundice is a yellowish coloration of the skin, mucous membranes and white of the eye. Symptoms of different types of hepatitis are detailed below.
– Hepatitis A: in general, acute infection goes unnoticed in children, which does not occur in adults (in two thirds of cases).
The evolution takes place in three stages:
– Flu-like symptoms: fever , joint and muscle pain.
– Icteric phase with a great fatigue (=asthenia). This phase lasts about two weeks. The jaundiced phase is characterized by darkened urine, whitish stools, nausea and loss of appetite.
– Convalescence phase: lasts from two to six weeks (or more), with the progressive disappearance of the signs, with the exception of fatigue, which may persist.
– Hepatitis B: in general, 25% of hepatitis B cases are symptomatic. The symptoms are equivalent to those of hepatitis A. See: hepatitis B
– Hepatitis C: in general, only 5 to 10% of acute hepatitis C cases are symptomatic. The symptoms are equivalent to that of hepatitis A.
– Acute alcoholic hepatitis: it can also be asymptomatic. However, the most frequent signs are fever, swelling of the liver and jaundice.
– Chronic hepatitis. In general, we observe the same symptoms as acute hepatitis: abdominal pain, fatigue, jaundice.
Diagnosis
The diagnosis of hepatitis can be confirmed by:
– Blood tests, identifying a significant increase in liver enzymes (transaminases) due to the destruction of liver tissue.
– Serologies, identifying the type of virus.
– A liver biopsy, for patients suffering from hepatitis for more than six months, in order to observe the state of liver destruction.
Complications
The course of hepatitis depends on the initial state of the liver, before the liver infection, as well as the cause. (see photo opposite = “le foie”)
– Viral hepatitis are usually acute and heal spontaneously. Types B and C can progress to the chronic state, with the possibility of cirrhosis and cancer.
– Complications of alcoholic hepatitis are essentially disturbances of consciousness, gastrointestinal bleeding, pancreatitis. The prognosis depends, above all, on ceasing alcohol consumption.
– Drug-induced hepatitis returns after stopping drug intoxication.
– Bacterial hepatitis usually returns after the administration of the appropriate antibiotic.
Treatments
There are preventive measures and effective treatments against hepatitis.
- hepatitis prevention
Preventive measures vary according to the type of hepatitis:
Hepatitis A (“traveler’s hepatitis”)
– Hygiene measures such as hand washing, caution with food, seafood, especially when traveling.
– Vaccination for travelers and professionals at risk (health professionals, for example).
Hepatitis B
– Use of condoms
– Use of new and sterilized syringes
– Vaccine for travellers, health professionals, drug addicts,….
Hepatitis C
– Safety for transfusions (identification of antibodies in blood donors)
Hepatitis D
– Use of condoms
– Use of new and sterilized syringes
Hepatitis E
– Hygiene measures, such as hand washing, caution with food, seafood, especially when traveling.
alcoholic hepatitis
– Fight against alcoholism
hepatitis treatments
The treatments are also specific to the different types of hepatitis. Viral hepatitis usually heals spontaneously, within one or two months. Treatment essentially consists of rest and a ban on any alcohol consumption, an action that can lead to liver fatigue. General fatigue may persist.
Hepatitis A: it does not have a chronic form, the treatment consists of rest.
Chronic hepatitis B: alpha interferon.
Chronic hepatitis C: combination of alpha interferon and ribavirin.
New treatments have recently emerged for hepatitis C. See our page on treatments for hepatitis C.
Herbal medicine
Phytotherapy is not the main treatment for hepatitis, but it can be an interesting complementary measure, especially to improve the state of the liver. Before starting any treatment, we advise you to ask a doctor for advice.
Below you will find medicinal plants that have a positive effect on the liver (hepatoprotective) and that can help in cases of hepatitis.
– Milk thistle , to be used in tablet or capsule form.
– The artichoke , to be used in tablet or capsule form
Tips
– Rest
– Completely stop drinking alcohol
– Discontinue the use of hepatotoxic drugs (paracetamol…)
Prevention
– Adoption of hygiene measures, such as hand washing, care with food, especially with the consumption of raw food and seafood, especially when traveling ( hepatitis A and E );
– Vaccination for travelers and professionals who belong to a risk group (health professionals), people with risk behaviors (drug addicts) (hepatitis A, B);
– Use of new and sterilized syringes (drug addicts) (hepatitis B and D)
– Use of condoms ( hepatitis B and D )
– Fight against alcoholism (alcoholic hepatitis)
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