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Generally described as inflammation of the liver, hepatitis is commonly caused by viral infection. However, some drugs, toxins and alcohol can also lead to liver inflammation. Moreover, there are immunological causes such as autoimmune hepatitis, primary sclerosing cholangitis and primary biliary cirrhosis. When it comes to viral hepatitis, main causes are hepatitis viruses A, B, C, D and E. The World Health Organization (WHO) estimates that 354 million people are currently suffering with chronic hepatitis B and C worldwide.
To learn more about the diagnosis, treatment and prevention of hepatitis, we connected with Dr. Balbir Singh, Sr. Consultant-Liver Transplantation, HPB Surgery & Laparoscopic Surgeon, Yashoda Hospitals Hyderabad. Excerpts follow:
Common symptoms of hepatitis are yellowish discolouration of eyes and urine, nausea, malaise, fever, anorexia, fatigue, vomiting, abdominal pain and joint pain. Sometimes patients have complaints of itching. Patients with fulminant hepatitis may have bleeding from nose or gums. They may become comatose. Clinically they have jaundice, enlarged liver and patients with chronic liver disease may have fluid in belly or swelling of legs.
Liver function tests: People with hepatitis will have deranged liver function test like increased serum bilirubin, raised liver enzymes (SGOT/SGPT). In patients with chronic liver disease, serum albumin may be low.
Coagulation parameters: Patient with fulminant hepatitis may have deranged coagulation parameters such as increased INR or low platelet count.
Other blood tests: These tests can determine if you have infectious hepatitis by checking for the presence of hepatitis viruses or antibodies your body produces to combat them.
Ultrasound Abdomen: Ultrasound may show changes in size and echotexture of liver. In chronic hepatitis B and C or patients with cirrhosis, it may show presence of tumour or fluid in belly.
Liver biopsy: Sometimes to determine the cause of hepatitis you may be advised to undergo liver biopsy.
Treatment depends on type of hepatitis, its cause and whether it is acute or chronic. For example:
Hepatitis A and E: These are short-term illnesses lasting from 2-6 weeks and may not require any specific treatment. Patient may require symptomatic treatment for fever, nausea, diarrhoea, pain abdomen or joint pain. Pregnant women with hepatitis E should be advised for close monitoring.
Hepatitis B: Effective antiviral medications are currently available to treat chronic hepatitis B. People who develop cirrhosis or liver disease due to chronic hepatitis B may be candidates for a liver transplant.
Hepatitis C: Antiviral medications can treat both acute and chronic forms of hepatitis C. Usually medications are recommended for 3 months. People who develop cirrhosis or liver disease due to chronic hepatitis C may require a liver transplant.
Hepatitis D: Pegylated interferon alpha and antiviral drugs are used for treatment for hepatitis D.
Liver transplant: Patients with acute fulminant liver failure due to viruses or toxins and cirrhosis of liver may be advised to undergo liver transplantation.
Vaccines: Vaccines are available for prevention of hepatitis A and B. Government of India recommends hepatitis B vaccinations for all newborns. Doctors typically administer the series of three vaccines over the first 6 months of childhood. The government recommends the vaccine for all healthcare and medical personnel as well. Vaccination against hepatitis B can also prevent hepatitis D. There are currently no approved vaccines for hepatitis C or E.
Preventing exposure: Effective hygiene is best way to avoid contracting hepatitis A and E. These viruses can transmit through contaminated water or food.