Q: Re: Liver Disorders, Hepatitis A/b/c Question
asked by:
v00d00cita
on June 6th, 2007
Active User, very eHealthy
| PatientQuestion wrote: |
Liver Disorders, Hepatitis A/B/C
Question: Is this something I should be worried about? All I was told that it wasnt good and that I needed to be schedule for ultrasound and further tests.
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Hepatitis is a damaging disease, so you should be concerned about it, but not extremely obcessed about it?
Get information about it and do some routine tests to see if everything is okay.
About hepatitis:
Causes
Acute hepatitis
* Viral Hepatitis: Hepatitis A to E (more than 95% of viral cause), Herpes simplex, Cytomegalovirus, Epstein-Barr, yellow fever virus, adenoviruses.
* Non viral infection: toxoplasma, Leptospira, Q fever, [2] rocky mountain spotted fever[3]
* Alcohol
* Toxins
* Drugs
* Circulatory insufficiency
* pregnancy
* Auto immune conditions e.g. SLE
* Metabolic diseases e.g. Wilson's disease
Chronic hepatitis
* Viral Hepatitis: Hepatitis B with or without hepatitis D, Hepatitis C (Hepatitis A and E do not lead to chronic disease)
* Autoimmune: Autoimmune hepatitis
* Alcohol
* Drugs
* Non-alcoholic steatohepatitis
* Heredity
* Primary biliary cirrhosis and primary sclerosing cholangitis occasionally mimic chronic hepatitis
Signs and symptoms
Acute Hepatitis
Clinically the course of acute hepatitis varies widely from mild symptoms requiring no treatment to fulminant hepatic failure needing liver transplantation. Acute viral hepatitis are more likely to be asymptomatic in younger people. Symptomatic individuals may present after convalescent stage of 7 to 10 days, with the total illness lasting 2 to 6 weeks.
Initial features are of nonspecific flu-like symptoms, common to almost all acute viral infections and may include: malaise, muscle and joint aches, fever, feeling sick or vomiting, diarrhea and headache. More specific symptoms, which can be present in acute hepatitis from any cause are: profound loss of appetite, aversion of smoking among smokers, dark urine, yellowing of the eyes and skin i.e. jaundice and abdominal discomfort. Physical findings are usually minimal, apart from jaundice (33%) and tender hepatomegaly (10%).
Chronic Hepatitis
Majority of patients will remain asymptomatic or mildly symptomatic, abnormal blood tests being the only manifestation. features may be related to extent of liver damage or the cause of hepatitis. Many experience return of symptoms related to acute hepatitis. Jaundice can be a late feature and may indicate extensive damage. Other features include abdominal fullness from enlarged liver or spleen, low grade fever and fluid retention (ascites). Extensive damage and scarring of liver i.e. cirrhosis leads to weight loss, easy bruising and bleeding tendencies. Acne, abnormal menstruation, lung scarring, inflammation of the thyroid gland and kidneys may be present in woman with autoimmune hepatitis.
Findings on clinical examination are usually those of cirrhosis or are related to aetiology.
Types of hepatitis
Hepatitis A
Hepatitis A or infectious jaundice is caused by a picornavirus. It is transmitted by the orofecal route, transmitted to humans through methods such as contaminated food. It causes an acute form of hepatitis and does not have a chronic stage. The patient's immune system makes antibodies against hepatitis A that confer immunity against future infection. People with hepatitis A are advised to rest, stay hydrated and avoid alcohol. A vaccine is available that will prevent infection from hepatitis A for life. Hepatitis A can be spread through personal contact, consumption of raw sea food or drinking contaminated water. This occurs primarily in third world countries. Strict personal hygiene and the avoidance of raw and unpeeled foods can help prevent an infection. Infected people excrete the hepatitis A virus with their stool two weeks before and one week after the appearance of jaundice. The time between the infection and the start of the illness can run from 15 to 45 days, and approximately 15% of sufferers may experience relapsing symptoms from six months to a year following initial diagnosis.
Hepatitis B
Hepatitis B is caused by a hepadnavirus, which can cause both acute and chronic hepatitis. Chronic hepatitis develops in the 15% of patients who are unable to eliminate the virus after an initial infection. Identified methods of transmission include blood (blood transfusion, now rare), tattoos (both amateur and professionally done), sexually (through sexual intercourse or through contact with blood or bodily fluids), or in utero (from mother to her unborn child, as the virus can cross the placenta). However, in about half of cases the source of infection cannot be determined. Blood contact can occur by sharing syringes in intravenous drug use, shaving accessories such as razor blades, or touching wounds on infected persons. Needle-exchange programmes have been created in many countries as a form of prevention. In the United States, 95% of patients clear their infection and develop antibodies against hepatitis B virus. 5% of patients do not clear the infection and develop chronic infection; only these people are at risk of long term complications of hepatitis B.
Patients with chronic hepatitis B have antibodies against hepatitis B, but these antibodies are not enough to clear the infection that establishes itself in the DNA of the affected liver cells. The continued production of virus combined with antibodies is a likely cause of immune complex disease seen in these patients. A vaccine is available that will prevent infection from hepatitis B for life. Hepatitis B infections result in 500,000 to 1,200,000 deaths per year worldwide due to the complications of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis B is endemic in a number of (mainly South-East Asian) countries, making cirrhosis and hepatocellular carcinoma big killers. There are six FDA-approved treatment options available for persons with a chronic hepatitis B infection: alpha-interferon, pegylated interferon adefovir, entecavir, telbivudine and lamivudine. About 45% of persons on treatment achieve a sustained response.
Hepatitis C
Hepatitis C (originally "non-A non-B hepatitis") is caused by a Flavivirus. It can be transmitted through contact with blood (including through sexual contact where the two parties' blood is mixed). Hepatitis C may lead to a chronic form of hepatitis, culminating in cirrhosis. It can remain asymptomatic for 10-20 years. No vaccine is available for hepatitis C, although in January 2007 researchers at the University of Washington announced a breakthrough which they predict will lead to a vaccine within five years.[7] Patients with hepatitis C are prone to severe hepatitis if they contract either hepatitis A or B, so all hepatitis C patients should be immunized against hepatitis A and hepatitis B if they are not already immune. The virus can cause cirrhosis of the liver. HCV viral levels can be reduced to undetectable levels by a combination of interferon and the antiviral drug ribavirin. The genotype of the virus determines the rate of response to this treatment regimen. Genotype 1 is more resistant to interferon therapy than other HCV genotypes. The cellular receptors for the virus are CD81 and SR-B1 with claudin-1 as a co-receptor required for a late-step in entry.
Hepatitis E
Hepatitis E produces symptoms similar to hepatitis A, although it can take a fulminant course in some patients, particularly pregnant women; it is more prevalent in the Indian subcontinent.
Hepatitis F
Hepatitis F is a hypothetical virus linked to hepatitis. Several hepatitis F candidates emerged in the 1990s; none of these reports have been substantiated.
Hepatitis G
Another type of hepatitis, hepatitis G, has been identified, and is probably spread by blood and sexual contact. There is, however, doubt about whether it causes hepatitis, or is just associated with hepatitis, as it does not appear to be primarily replicated in the liver.
Alcoholic Hepatitis
Ethanol, mostly in alcoholic beverages, is a significant cause of hepatitis. Usually alcoholic hepatitis comes after a period of increased alcohol consumption. Alcoholic hepatitis is characterized by a variable constellation of symptoms, which may include feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests. Alcoholic hepatitis can vary from mild with only liver test elevation to severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure. Severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories is 50% within 30 days of onset.
Alcoholic hepatitis is distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. Patients who drink alcohol to excess are also more often than others found to have hepatitis C. The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis in Western countries.
From wikipedia
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