Hepatitis - Symptoms, Types

The liver is one of the most important organs, as its functions are detoxification, synthesis, and storage. In the case of hepatitis, the condition will result in health issues and eventually lead to lethal conditions. Hepatitis can be caused by several factors, including viral infection, regular consumption of alcohol, side effects from medications, and exposure to toxins. Hence, the annual liver checkup is important, for it can both prevent and treat the disease in its infancy.

What is Hepatitis

Hepatitis is a condition of liver inflammation. The term is generally used in cases of an inflamed liver, regardless of the causes. Viral infection is one of the most popular causes of hepatitis. The condition can be caused by an overactive immune system as well. Despite usually being a chronic condition, hepatitis is quite manageable, depending on the signs and symptoms. The disease usually progresses over time. It is recommended that patients with hepatitis see a doctor and get proper treatments.

Hepatitis Types

There are many types of hepatitis since the condition can be caused by several factors. In this topic, we will categorize hepatitis types by their causes. Beginning with viral infection and progressing to autoimmune hepatitis, alcoholic hepatitis, and drug-induced hepatitis.

Hepatitis A

Hepatitis A is caused by a viral infection known as HAV. This type of hepatitis is acute and short-term. Hepatitis A is usually transmitted through the fecal-oral route. The common causes include poor hygiene after using the bathroom, i.e., the infected person didn’t wash their hands. The disease can also be transmitted by eating shellfish harvested from contaminated water. Hepatitis A has a good prognosis of an 85% recovery period within 3 months with no long-term complications.

Hepatitis B

Hepatitis B is more prevalent than Hepatitis A. The condition is chronic and long-term. It is transmitted through body fluids: blood, vaginal secretions, or semen. Hepatitis B is classified into two types: acute and chronic infection. People who have HBV are more likely to develop liver cancer.

Hepatitis C

Hepatitis C is transmitted through body fluids, just like Hepatitis B. This includes blood, semen, and vaginal secretions that contain HCV. HCV is one of the most common viral infections. It is usually a long-term condition. The signs and symptoms are different depending on the stage of the disease. Patients with HCV may experience fever, joint pain, rash, and edema in the early phase. Fatigue, anorexia, and myalgia are usually common symptoms in the preicteric phase. And during the icteric phase, patients may develop jaundice, worsening anorexia and nausea, and irritated skin lesions.

Hepatitis D

Hepatitis D is rare. It is only caused by the conjunction of HDV and HBV. People get HDV only if they are infected with HBV first. Hepatitis D causes liver inflammation just like other forms. The disease is transmitted through blood containing HDV. The symptoms of hepatitis D include jaundice, fever, dark urine, abdominal pain, and pruritus (severe itching of the skin).

Hepatitis E

Hepatitis E, contrary to other viral infections that lead to hepatitis, is a waterborne disease. HEV (Hepatitis E Virus) is mainly found in areas with poor sanitation. The disease is transmitted through the fecal-oral route, just like Hepatitis A. Hepatitis E is common in Asia and Africa. The disease is often considered non-fatal, despite being acute. However, it can be particularly dangerous for pregnant women. Hepatitis E has a good prognosis for complete recovery.

Autoimmune Hepatitis

In some people, the immune system overworks and leads to autoimmune disease. Autoimmune hepatitis is caused by the body mistaking the liver for something harmful and attacking it. This leads to inflammation ranging from mild to severe. The liver's function can be hindered as a result as well. The condition is chronic and frequently associated with other autoimmune disorders. People with thyroiditis, Type 1 diabetes, celiac disease, and hemolytic anemia are at higher risk of developing autoimmune hepatitis.

Alcoholic Hepatitis

Alcoholic hepatitis is generally caused by the regular or excessive consumption of alcohol. This damages the liver and leads to liver inflammation. As the liver's primary function is detoxification, excessive alcohol consumption directly damages the liver cells, permanently. The results of long-term alcohol consumption are liver failure or cirrhosis. It is a chronic condition that can lead to other complications.

Drug-Induced Hepatitis

Drug-Induced Hepatitis is a result of certain medications that damage the liver cells. Usually, the condition is caused by excess use or very high doses. Examples of these medications are vitamin A and acetaminophen (Tylenol). Hence, it is recommended that you consult your doctor about medications.

Hepatitis Symptoms

Hepatitis symptoms can vary depending on the causes and stages of the disease. Often, people with chronic hepatitis show no symptoms until their livers give up and fail to function. Acute hepatitis, on the other hand, usually shows signs and symptoms shortly after being exposed to the infection. Here are examples of hepatitis symptoms.

• Jaundice
• Loss of appetite
• Abdominal pain
• Unexplained weight loss
• Dark urine
• Pale stool
• Fatigue
• Flu-like symptoms
• Nausea with or without vomiting

Causes of Hepatitis

Hepatitis can be caused by several factors. Even though most people are familiar with hepatitis as a viral disease, there are other causes leading to liver inflammation. This topic will describe the causes of hepatitis, which will be divided into two groups: viral hepatitis and non-viral hepatitis.

Viral Hepatitis

Viral hepatitis is the most common type, with a high prevalence of HBV. The disease can be caused by one of several viruses: HAV, HBV, HCV, HDV, and HEV. The modes of transmission differ depending on the nature of the virus. For example, HAV and HEV are transmitted through the fecal-oral route, whereas HBV is transmitted through body fluids.

Non-Viral Hepatitis

Viral hepatitis is the most common type, with a high prevalence of HBV. The disease can be caused by one of several viruses: HAV, HBV, HCV, HDV, and HEV. The modes of transmission differ depending on the nature of the virus. For example, HAV and HEV are transmitted through the fecal-oral route, whereas HBV is transmitted through body fluids.

Non-Viral Hepatitis

Non-viral hepatitis, on the other hand, is generally caused by autoimmune diseases, excess alcohol consumption, and high-dose medications.

• Autoimmune hepatitis is caused by an autoimmune disease. The immune system mistakes the liver as harmful and attacks the organ, leading to liver damage and inflammation.
• Alcoholic hepatitis is a result of excessive alcohol consumption. This includes a regular consumption of alcohol over a long period of time.
• Drug-induced hepatitis is generally caused by certain medications, such as Tylenol and vitamin A. However, the medications have to be in high doses or used for a long period of time to develop the condition.
• Fatty liver can also lead to hepatitis. Obesity is one of the major factors contributing to the disease. This also includes people with Type 2 diabetes, hypertension, and hyperlipidemia.
• Other causes, such as dengue fever, typhus, malaria, and biliary obstruction.

Complications of Hepatitis

Hepatitis A and E are generally considered to be acute diseases, yet Hepatitis B and Hepatitis C are considered to be long-term conditions. The viral infection attacks the liver, causing chronic inflammation. Complications of hepatitis include:

• Chronic liver disease
• Liver cancer
• Cirrhosis

However, in severe cases, it is noted that hepatitis can also lead to liver failure. Here are examples of other complications due to liver failure:

• Kidney failure
• Portal hypertension
• Hepatic encephalopathy
• Bleeding disorders
• Death

Hepatitis Diagnosis

Hepatitis is generally a chronic condition. The disease can lead to other complications and other serious conditions, such as liver failure. Hepatitis usually results in liver damage due to chronic inflammation. It is important to get a precise diagnosis and the proper treatments. The diagnosis of hepatitis can be made by the following examinations:

Blood Test

Blood tests can help determine whether your liver still functions fine. It can also determine if you have infectious hepatitis by checking the presence of the antibodies or antigens in the body. Blood tests can also be used to determine whether you have autoimmune hepatitis.

Fibro scan

Fibro scan is a method used to diagnose the state of the liver. It aids in determining the amount of fat in the liver as well as the amount of scarring or fibrosis. The procedure is also helpful for patients with cirrhosis

Physical Exam

A medical history and physical examination are routine procedures. Your doctor will ask you about your symptoms and signs. Then the examination will be performed. The doctor may press down on your abdomen to locate the source of the pain, check on the swelling of the liver, and check if you have jaundice.

Liver Biopsy

A liver biopsy may be required to determine the extent of your liver damage. A sample of tissue from your liver will be cut out to be examined. The method involves using a needle and ultrasound for guidance. It is no surgery. A liver biopsy offers you a precise diagnosis regarding the state of your liver and how infection or inflammation have affected the organ.

Treatment for Hepatitis in Thailand

Hepatitis is considered manageable for both acute and chronic diseases. However, the treatments will be different according to the causes of the disease. It is important to get a precise diagnosis first. If you have hepatitis and are now living in Thailand, Nakornthon Hospital offers you a one-stop service for diagnosis, treatment, and prevention of liver diseases. Medical professionals at Nakornthon’s GI center are experts in this field. The hospital also offers you innovative medical technology and experienced gastroenterologists. You can assure that you will receive the best care from here.

Generally, treatments for hepatitis are categorized into 2 main groups: viral hepatitis and non-viral hepatitis. The treatments will be as follows

Viral Hepatitis

Treatment options vary depending on the type of hepatitis you have. For viral hepatitis, treatments will include:

• Antiviral medications.
• Liver transplant (for severe cases).
• A dietary program to stay hydrated and nutritious. This also includes rest.

Non-Viral Hepatitis

For non-viral hepatitis, it is typically recommended to follow these suggestions:

• Avoid alcohol consumption.
• Avoid taking some certain medications. (It is suggested that you consult your doctor about medications before taking them.)
• Lifestyle adjustments.

Hepatitis Prevention

• Vaccines for HAV and HBV are available even though there are currently no vaccines for HCV and HEV.
• Reducing exposure by maintaining your hygiene also helps. This includes avoiding eating raw fruits and vegetables, raw or undercooked shellfish or oysters.
• Not sharing needles, razors, or toothbrushes is another way to prevent yourself from blood-transmitted hepatitis. Avoid touching spilled blood helps as well.
• For HBV and HCV that transmit through body fluids, using barrier methods, such as condoms and dental gums are useful. They can reduce the risk of infection.

Hepatitis Conclusion

Hepatitis is a condition of liver inflammation. The disease can be caused by both viral and non-viral infections. Some types of hepatitis are acute, short-term, and at low risk of other complications. Other types of hepatitis are chronic and can potentially lead to other complications, such as liver cancer and liver failure. The diseases are manageable. It is recommended that you seek professional advice if you have been developing hepatitis symptoms. The diagnostic examinations may include a physical examination, a fibroscan, and a liver biopsy. Treatments for hepatitis will vary depending on the condition and the cause. It is suggested that you consult your doctor about the condition and your health issues.

Dr.Sombun Rungjiratananon
Internal Medicine/Gastroenterology
Gastrointestinal and Liver Center

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