Hepatitis

What is hepatitis?

Hepatitis is the Latin word for liver inflammation. It is characterised by the destruction of a number of liver cells and the presence of inflammatory cells in the liver tissue.

Hepatitis can be caused by diseases that primarily attack the liver cells. It can also arise as a result of a disease such as mononucleosis. Hepatitis can be divided into two subgroups according to its duration:

• acute hepatitis - lasting less than six months
• chronic hepatitis - lasting longer than six months.

What can cause acute hepatitis?

Acute hepatitis has a number of possible causes.

• Infectious viral hepatitis such as hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E
• Other viral diseases such as: mononucleosis and cytomegalovirus
• Severe bacterial infections
• Amoebic infections
• Medicines, eg paracetamol poisoning and halothane (an anaesthetic)
• Toxins: alcohol and fungal toxins, eg toadstool poisoning

What can cause chronic hepatitis?
Chronic hepatitis also has a number of different causes.

• Contagious viral hepatitis such as hepatitis B, hepatitis C and hepatitis D
• Medicines
• Toxins such as alcohol
• Autoimmune hepatitis. This is a disease in which a number of liver cells are destroyed by the patient's own immune system. Autoimmune hepatitis can also sometimes occur as acute hepatitis. The cause is unknown
• Inborn metabolic disorders, such as Wilson's disease (disorder of the body's copper metabolism) and haemochromatosis (disorder of the body's iron metabolism)

What are the symptoms of hepatitis?
Acute hepatitis
The symptoms of acute hepatitis vary considerably from person to person. Some patients have no symptoms at all, and in most cases, children only show mild symptoms.
In the early stages:

• tiredness, general malaise, slight fever
• nausea, poor appetite, changes in taste perception
• pressure or pain below the right ribs caused by an enlarged liver
• aching muscles and joints, headache, skin rash

The jaundice phase:

• yellowing of sclerae (the white portions of the eyes), skin and mucous membranes
• dark urine
• light-coloured stools, around this time, the other symptoms subside

The recovery phase:

• tiredness that can last for weeks

Chronic hepatitis

• Many patients have no symptoms
• Tiredness, an increased need for sleep, aching muscles and joints
• Periodic light pressure or pain below the right ribs - enlarged liver
• Jaundice is a very late symptom of chronic hepatitis. It is a sign that the disease has become serious

How do you get hepatitis?
A person can develop hepatitis if they contract one of the viruses that can cause liver inflammation, or as a result of exposure to substances that can cause hepatitis - alcohol, fungal toxins and certain medicines.
There are two ways in which medicines can lead to hepatitis: it can either occur as a result of medicine poisoning through overdoses of a medicine (eg paracetamol), or it can occur as a result of an abnormal reaction of the liver to a normal dose (eg halothane, the anaesthetic). Fortunately, the latter type of hepatitis is rare.
Who is at risk of hepatitis?

• Patients with jaundice or other symptoms of hepatitis
• People who are very likely to have contracted the hepatitis B or the hepatitis C virus
• People who are at increased risk due to a hereditary type of hepatitis in their families

How can hepatitis be prevented?

• By avoiding exposure to the infectious hepatitis viruses
• By being vaccinated against hepatitis A and hepatitis B, if you run a high risk of being infected
• By refraining from drinking large amounts of alcohol

How is hepatitis treated?

• No medical treatment is available for acute viral hepatitis
• Chronic hepatitis B can be treated with interferon alfa or lamivudine (Zeffix)
• Chronic hepatitis C can be treated with interferon alfa and ribavirin (tribavirin)
• Autoimmune hepatitis can by treated with corticosteroids