Hepatitis Health Article

Definition

Hepatitis is inflammation of the liver.

Causes, incidence, and risk factors

The disease can be caused by:

• Infections from parasites, bacteria, or viruses (such as hepatitis A, B, or C)
• Liver damage from alcohol, drugs, or poisonous mushrooms
• An overdose of acetaminophen, which is rare but deadly
• Immune cells in the body attacking the liver and causing autoimmune hepatitis

Other medications that can cause damage to the liver include methyldopa (used uncommonly for high blood pressure), isoniazid for tuberculosis, seizure medications (like valproate and phenytoin), chlorpromazine, amiodarone (for irregular heart rhythm), and certain antibiotics (including trimethoprim-sulfamethoxazole and erythromycin). If you need to take any of these, your doctor will follow your liver function closely.

Liver disease can also be caused by inherited disorders such as cystic fibrosis and Wilson's disease, a condition that involves having too much copper in your body (the excess copper deposits in organs like the liver).

Hepatitis may start and resolve quickly (acute hepatitis), or cause long-term disease (chronic hepatitis). In some instances, progressive liver damage, liver failure, or even liver cancer may result.

The severity of hepatitis depends on many factors, including the cause of the liver damage and any underlying illnesses you have. Hepatitis A, for example, is generally short-lived, not leading to chronic liver problems.

Common risk factors include:

• Intravenous drug use
• Overdosing on acetaminophen -- the dose needed to cause damage is close to the effective dose, so be careful to take it only as directed -- ask your doctor what amount of acetaminophen is safe for you; if your liver disease is severe, your doctor may also tell you to avoid certain anti-inflammatory medicines
• Engaging in risky sexual behaviors (like having multiple sexual partners and unprotected intercourse)
• Eating contaminated foods
• Traveling to an area where certain diseases are common
• Living in a nursing home or rehabilitation center
• Having a family member who recently had hepatitis A
• Using or abusing alcohol
• Being an organ transplant recipient
• Having HIV or AIDS
• Having received a blood transfusion before 1990 (hepatitis C blood test was not available)
• Being a newborn of a mother with hepatitis B or C (can be transmitted during delivery)
• Being a healthcare worker, including dentist and dental hygienist, because of blood contact
• Receiving a tattoo

See also:

• Hepatitis A
• Hepatitis B
• Hepatitis C
• Autoimmune hepatitis
• Drug-induced hepatitis
• Alcoholic hepatitis

Symptoms

The symptoms of hepatitis include:

• Dark urine and pale or clay-colored stools
• Loss of appetite
• Fatigue
• Abdominal pain or distention
• General itching
• Jaundice (yellowing of the skin or eyes)
• Nausea and vomiting
• Low grade fever
• Weight loss
• Breast development in males

Many people with hepatitis B or C do not have symptoms when first infected and can still develop liver failure later. If you have any risk factors for either type of hepatitis, you should be tested periodically.

Signs and tests

A physical examination may show yellowing of the skin, an enlarged and tender liver, or fluid in the abdomen (ascites) that can become infected.

Your doctor may order laboratory tests, including:

• Hepatitis virus serologies
• Liver function tests
• Autoimmune blood markers
• Abdominal ultrasound
• Liver biopsy to determine severity of the liver damage
• Paracentesis if fluid in your abdomen is present

Treatment

Your doctor will discuss possible treatments with you, depending on the cause of your liver disease. Your doctor may recommend a high-calorie diet if you are losing weight. You can take these steps yourself:

• Eat most of your calories early in the day.
• Rest, especially when you feel symptoms.

Support Groups

There are support groups for people with all types of hepatitis, which can help you learn about the latest treatments and better cope with having the disease.

See: Liver disease support groups

Expectations (prognosis)

The outlook depends on many factors, including the cause of the hepatitis and whether or not you have additional illnesses or conditions that complicate treatment or recovery. Many people recover fully. However, it may take months for the liver to heal.

Eighty percent of those with hepatitis C go on to have chronic liver disease and, possibly, liver failure (cirrhosis) or liver cancer. Hepatitis C is the number one reason for receiving a liver transplant in the United States.

Complications

Permanent liver damage, liver failure, or liver cancer can occur. Other complications include spontaneous bacterial peritonitis (when fluid in the abdomen becomes infected), and esophageal varices, which can bleed significantly.