Hepatitis is the inflammation of the liver. It is caused mostly by a viral infection, although there are other possible causes as to why it develops. These can include autoimmune hepatitis. The hepatitis condition usually happens as a secondary result of alcohol, toxins, drugs, and medications. The autoimmune hepatitis disease is one that happens when the body produces antibodies against the liver tissue.
The liver is located in the upper right area of the abdomen. It has a lot of critical functions of the body that affects the metabolism, including the following:
- Filtering of toxins from the body
- Production of bile, which is essential for digestion
- Excretion of the bilirubin, which is the product of the red blood cells that are broken down, including drugs, hormones, and cholesterol
- Storage of minerals, vitamins, and glycogen, which is some form of sugar
- Synthesis of the clotting factors
- Synthesis of the blood proteins like the albumin
- Activation of the enzymes, which are the specialized proteins that are essential for the functions of the body
- Breakdown of proteins, fats, and carbohydrates
Based on the reports of Centers for Disease Control and Prevention, around 4.4 million Americans are living today with chronic hepatitis C, and B. Other people do not even know they have hepatitis.
The treatment options available for hepatitis will depend on the type of hepatitis that the person is infected with. People can prevent some form of hepatitis through lifestyle changes and immunizations.
Understanding hepatitis in history
Records showed on the understanding of how hepatitis came to be in 1963 by Dr. Baruch Blumberg. He discovered an antigen wherein it detects the presence of HBV or hepatitis B in various blood samples. During that time, Dr. Blumberg was in the middle of researching on the subject of genetics regarding disease susceptibility. He wasn’t set out to find out or discover hepatitis, but with his work, it led him to a breakthrough, which increased more understanding regarding the disease.
Around the 1950s, Dr. Blumberg began to explore whether the traits inherited could make various groups of people get susceptible to the same kind of disease. Together with his team, they traveled all over the world visiting different native and remote populations to gather blood samples for their analysis. Their initial intention was to search for any genetic differences and seeing whether the differences they see were linked with a certain disease.
What they studied closely were the hemophiliac patients that have received several blood transfusions. It makes them the best carriers because their blood got exposed to another blood other than their own, particularly the ones that came from donors. The risk of receiving blood from other people is that the immune system of the body creates ‘antibodies’ which will fight against the properties of foreign blood or the ‘antigens’ coming from the donors.
Dr. Blumberg with his team was able to discover one unusual antigen coming from one of the blood sample belonging to an Australian Aborigine, which they defined as the Australia antigen. They conducted further research on it and then discovered that it is an antigen that causes hepatitis B. It was in 1967 wherein the discovery became officially recognized.
Two years after the recognition of the antigen, a hepatitis B vaccine was invented by Dr. Blumberg and his partner Dr. Irving Millman. The USA’s FDA named the vaccine as the first ‘anti-cancer’ vaccine since it helps prevent the infection of chronic hepatitis which also results in the prevention of the primary liver cancer because of HBV. Around 80 percent of the population that has the chronic hepatitis B is highly likely to develop liver cancer. Over 500,000 people die annually due to liver cancer.
The vaccine for hepatitis B has already been administered to millions all over the world, including Africa and Asia. It resulted in saving millions of lives, too.
Back in the early 1970s, the main cause of the infectious hepatitis was discovered and defined as the Hepatitis A virus or HAV. In the year 1989, the HCV or hepatitis C virus was separated. It seemed that they couldn’t find any vaccine for hepatitis C, but around 80 percent of the cases, the carriers that get to complete the treatment course has a high possibility of getting cured.
Next, in the year 1990, the HEV or hepatitis E was identified, followed by HGV or hepatitis G in the year 1995.
Types of Hepatitis
Liver viral infections are classified into different types of hepatitis which include their suffix letters A, B, C, D, E. Each of these virus types come with a different virus that affects the immune system and the liver of the body.
Hepatitis A remains as the short-term and acute hepatitis type, while the B, C, D hepatitis types are highly likely to go chronic and ongoing. The Hepatitis E type is most acute, but it is highly dangerous when it affects pregnant women.
The hepatitis A virus is the cause of hepatitis A, hence the name. This hepatitis type is commonly transmitted through consuming water or food that is contaminated by the feces of a person infected with the same virus found in this type.
This hepatitis type is transmitted via contact with an infected body fluid like semen, vaginal secretions or blood that contains the HBV virus. Other means that this virus gets transmitted is through injection of drugs, engaging in sexual intercourse with an infected partner, or using razors used by an infected person.
The estimated number of people that are affected with this chronic disease is at 1.2 million, according to the records in CDC. That number is in the US alone. If you were to include the whole world, it amounts to 350 million.
This hepatitis type comes from the HCV virus. It is transmitted via direct contact with an infected person’s body fluids, mostly from sexual contact or injection drugs. The most common kind of blood-borne viral infection is HCV, particularly in the US. Around 2.7 million to 3.9 million of Americans are recorded to be living currently with this chronic infection.
Also referred to as delta hepatitis, this is a serious type of liver disease caused by the HDV virus. It is contracted via direct contacted with infected blood. It is a very rare hepatitis that only happens when it is in conjunction with the hepatitis B infection. The HDV virus will not multiply without hepatitis B around. It is a very rare disease in the US.
It is a waterborne disease that is caused by the HEV virus. Hepatitis E is mostly found in places that have very poor sanitation and usually results from ingesting the fecal matter that contaminates the supply of water. This hepatitis type is rare in the US but is widely reported to be around places in the Middle East, Central America, Africa and Asia, according to the CDC records.
Causes of the noninfectious Hepatitis
Alcohol and the other toxins – excessive consumption of alcohol can damage the liver and develop into inflammation. It is called alcoholic hepatitis. The alcohol injures the cells of the liver. As time passes by, it can leave permanent damage and will lead to failure and even cirrhosis, which is the scarring and thickening of the liver.
The other toxic triggers of hepatitis are the overdose or overuse of medications and even one’s exposure to poisons.
Autoimmune system response – there are some cases wherein the immune system mistakenly thinks the liver is a harmful entity and starts to attack it. It results in an ongoing inflammation that can run from a mild condition to very severe, and when left alone can hinder normal liver function. This disease is three times more common among women compared to men.
If you have infectious hepatitis seen as chronic such as the hepatitis C and hepatitis B, the symptoms may not appear in the beginning. The symptoms will only start appearing up to the point that the damage affects liver function.
The symptoms and signs of acute hepatitis can appear quickly:
- Pale stool
- Dark urine
- Flu-like symptoms
- Flu-like symptoms
- Loss of appetite
- Abdominal pain
- Yellow eyes and skin; signs of having jaundice
- Unexplained weight loss
Chronic hepatitis gradually develops so the signs and symptoms associated with it can be too subtle to get it noticed.
First, the doctor will take a history of your health to determine any of the risk factors that you may have for noninfectious and infectious hepatitis.
During the physical examination, which is conducted after asking you regarding the history of your health, the doctor may press gently on your abdomen to see whether there is tenderness or pain. The doctor may also feel in those areas to check whether the liver is enlarged. If the eyes or skin are yellowish, the doctor will take note of these during the exam.
Tests on liver function
The liver function tests make use of blood samples that will determine how your liver is efficiently working. If the results of these tests are abnormal, it may be the first signs that there is a problem, especially when there aren’t any signs on the physical exam with your liver disease. High levels of liver enzymes that may show that the liver is damaged, stress or is already malfunctioning.
It is usually blood tests, and they are conducted when the liver function test results are abnormal. The doctor may order other kinds of blood tests to determine the problem’s source. These tests can check out for viruses that triggered hepatitis. They can also be utilized in checking for the antibodies that are commonly found in conditions such as the autoimmune hepatitis
An ultrasound of the abdomen will be conducted, which makes use of ultrasound waves to create the image of organs within the abdomen. This test will allow the doctor to see the conditions of the liver and other nearby organs. It will reveal:
- Liver tumors
- Liver enlargement or damage
- Fluid in the abdomen
- Abnormalities in the gallbladder
Often the pancreas shows up in the ultrasound images. It is also a useful test to determine the cause of the abnormalities with your liver.
It is an invasive procedure wherein the doctor will take samples of tissue from the liver. It entirely depends on the technology used, but the latest one will only take quite a while by using a needle through the skin and take the samples right away. It doesn’t require any surgery, unlike the previous technology. This test will allow the doctor to determine how the inflammation or infection has affected the liver.
The treatments are determined according to the type of virus that has affected the person.
It doesn’t usually require any treatment since this illness is only short-term. It is highly recommended for the patient to have a complete bed rest, especially when the symptoms causes great discomfort. If the patient experiences any diarrhea or vomiting, they need to follow the orders of the doctor for nutrition and hydration.
There is a hepatitis A vaccine available to prevent this from happening. Children ages 12 to 18 months are already good for vaccination. It is a series of 2 vaccines. There are also vaccinations for adults and can be combined with the vaccine for hepatitis B.
There is no specific treatment for acute hepatitis B. This is instead treated with antiviral medications. The antiviral medications include entecavir (Baraclude), telbivudine (Tyzeka), adefovir (Hepsera) and lamivudine (Epivir). These can help fight against the virus and will slow down the damage done to the liver.
There are vaccinations available, and it is highly recommended for newborns to be vaccinated with hepatitis B vaccine.
The antiviral medications are used for treating hepatitis C, which is used to treat both chronic and acute forms. Some of these medications include Pegylated interferon (Peg-IFN), Ribavirin (RBV), VICTRELIS (boceprevir), INVICEK (telaprevir), OLYSIO (simeprevir), SOVALDI (sofosbuvir), and HARVONI (ledipasvir/sofosbuvir), among others.
As of the moment, there are no vaccinations available for hepatitis C.
There are no antiviral medications to treat hepatitis D. There is a drug referred to as alpha interferon that is used in treating hepatitis D, but it only showed between 25 and 30 percent of improvement.
It can still be prevented in children if they are vaccinated with the hepatitis B. HBV is required for the HDV to develop.
As of this writing, there are no specific therapies available to treat this particular hepatitis. Since the infection is sometimes acute, it usually resolves on its own. People with this disease are advised to take a lot of rest, drink lots of water and enough nutrients for the body. They should also avoid alcohol.
For the early treatment of autoimmune hepatitis, budesonide or prednisone, both kinds of corticosteroids, are very important to be taken right away. They are 80 percent effective on people that have this condition.