Hepatitis is a group of diseases affecting the liver. The liver is responsible for assisting the body in digesting foods, removing toxins, and storing energy. Hepatitis makes the liver inflamed and compromises its functioning. This can lead to scarring of the liver, also called cirrhosis, and in some cases, cancer. Hepatitis can be caused by viruses, alcohol, certain toxins, medications, autoimmune disorders, and hereditary conditions. Hepatitis is thus divided into two main groups: viral and non-viral.
There are four forms of non-viral hepatitis: alcoholic hepatitis, toxin or drug induced hepatitis, autoimmune hepatitis, and hepatitis caused by hereditary conditions. Alcoholic hepatitis is the result of chronic over-consumption of alcohol and is the number one precursor to liver cirrhosis (scarring). While the onset of alcoholic hepatitis often begins after decades of heavy drinking, this condition can develop within one year of heavy alcohol consumption.
Toxin or Drug Induced Hepatitis
Hepatitis can be caused by adverse reaction to certain toxins or medications. The inhalation or ingestion of the following toxins may cause toxin-induced hepatitis:
Carbon tetrachloride including chloroform, trichloroethylene, and chlorinated hydrocarbons.
White phosphorus, an industrial toxin
Certain poisonous mushrooms
If you have been exposed to a toxic that caused hepatitis, you may wish to consult with a legal expert to determine your legal rights and options. You may be able to seek compensation for your losses and suffering.
A number of medications can also cause hepatitis. Medications that are known to cause drug-induced hepatitis include:
Acetaminophen (pain reliever- when taken in excess)
Halothane (a specific type of anesthetic gas)
Ibuprofen and indometacin (NSAIDs)
Isoniazid (INH), rifampicin, and pyrazinamide (tuberculosis-specific antibiotics)
Minocycline (tetracycline anitbiotic)
Phenytoin and valproic acid (antiepileptics)
Zidovudine (antiretroviral i.e. against AIDS)
Some herbs and nutritional supplements
Common Symptoms of Hepatitis
With both viral and non-viral hepatitis, patients may show mild, moderate, or severe, or symptoms of hepatitis. In some cases, patients do not experience any hepatitis symptoms at all. In mild cases, a patient may only experience fatigue. In the case of severe hepatitis, a patient may develop more significant symptoms such as:
Jaundice (yellowing of skin and the whites of the eyes)
Dark “tea-colored” urine
Pale colored feces
Additional symptoms of drug-induced or toxin-induced hepatitis include:
Diagnosis of Hepatitis
To diagnose or rule out hepatitis, a doctor will take a thorough medical history to gather information particularly about a patient’s drug and medication use, alcohol consumption, family history, exposure to toxins, past surgeries, past travels, and sexual history. The doctor may also palpate the liver area to look for signs of swelling or tenderness. If a person is exhibiting symptoms of hepatitis, the doctor may perform laboratory tests and, in some cases, will order a liver biopsy.
Treatment of Non-viral Toxin or Drug Induced Hepatitis
In order to treat non-viral hepatitis caused by medications or toxins, the doctor will first flush out the stomach, via vomiting induction or hyperventilation, to remove the harmful substance from the body. In some cases, hepatitis treatment will also involve corticosteroid drug treatment.
There are five primary types of viral hepatitis, each with their own causes, symptoms, methods of transmission, and effects. These types of hepatitis are labeled with the letters A through E. The most common types of hepatitis in the United States are Hepatitis A, B, and C. The following information explains the ways of acquiring the disease, who is at risk for the disease, its effects, and how it can be prevented and treated.
Hepatitis A is a common form of hepatitis in the United States. In fact, the Center for Disease Control reports that one-third of the US population shows evidence of a past infection (immunity).
How do you get hepatitis A?
Hepatitis A is found in the fecal matter of infected persons and can is usually spread through oral contact with something that has been contaminated by the stool of an infected person.
Hepatitis A is acquired by drinking water or eating foods that have been contaminated with fecal matter from a person carrying the hepatitis A virus (HAV). For instance, if a person with HAV prepares food after using the restroom without washing their hands, this could contaminate the food.
Eating raw shellfish, which came from sewage-contaminated waters, can also cause hepatitis A.
Acquisition of hepatitis A can also occur through anal-oral contact with someone infected with the hepatitis A virus.
Unclean diaper changing stations may also be another site for hepatitis A transmission.
Who is at risk for Hepatitis A?
The following people are at a higher risk for infection:
People who live in the same household with a person who has hepatitis A.
People who have sexual contact with infected persons, particularly men who have sex with other men
Injecting and non-injecting drug users
People traveling to countries where hepatitis A is more common
People, particularly children, who lived in areas with increased hepatitis A rates between 1987 and 1997
Effects of Hepatitis A
Hepatitis A does cause swelling of the liver but doesn’t typically result in permanent liver damage.
Prevention of Hepatitis A
In order to prevent Hepatitis A, the Center for Disease Control recommends that the following persons over the age of one receive the hepatitis A vaccine:
People traveling to areas with high rates of hepatitis A
Men who have sex with men
People who have blood clotting-factor diseases
People who have chronic liver disease
Injecting and non-injecting drug users
Children living in areas with increased rates of hepatitis A (see the CDC website for more information)
Other ways to prevent hepatitis A include washing your hands well with soap and water before preparing foods and after changing a diaper and using the restroom. Short-term prevention against hepatitis A is available from immune globulin.
Treatment of Hepatitis A
Most hepatitis A patients get better on their own. People who get hepatitis A once develop immunity and cannot get the virus again.
Approximately 60,000 people acquire hepatitis B each year. Individuals aged 20 to 49 have the highest rate of hepatitis B. There are an estimated 1.25 million people in the US chronically infected with hepatitis B.
How do you get Hepatitis B?
Hepatitis B is spread through contact with someone infected with hepatitis B. This contact can occur in the following ways:
Sexual activity with an infected partner
Living with a chronically infected person
Newborns can acquire the virus from an infected mother during childbirth
Sharing needles with an infected person
Who is at a higher risk for Hepatitis B?
People with multiple sexual partners
People who have been diagnosed with a sexually transmitted disease
Injection drug users
People who live with others who are chronically infected
People born to infected mothers
Children of immigrants from nations with a higher rate of hepatitis B
Health care and public safety workers
People who have not received the hepatitis B vaccination
The effects of hepatitis B
Hepatitis B causes the liver to swell and often causes liver damage. While some people are able to recover from the virus within a few months, some people become chronically infected. Chronic infection occurs in 90% of newborns infected at birth, 30% of children infected between 1 and 5 years of age, and 6 percent of those infected after the age of 5. Fifteen to twenty-five percent of all cases of chronic hepatitis B are fatal.
Preventing Hepatitis B
The best way to protect against hepatitis B is to receive the hepatitis B vaccine. However, some people are allergic to this vaccine or its constituents.
If you are having sex with more than one partner, your risk of contracting hepatitis B is lowered by using latex condoms during every sexual encounter.
Another way to reduce the risk of hepatitis B is to not share anything with an infected person that might have their blood on it such as a toothbrush, razor, washcloth, or nail clippers.
If you are considering getting a tattoo or a body piercing be sure that the provider follows good health practices. Hepatitis B can be transmitted through unsterilized tattoo or piercing instruments.
Don’t shoot drugs. If you do, don’t share drugs, needles, syringes, water, or “works” with others
If you are exposed to the virus, get a hepatitis B immune globulin injection within two weeks of exposure.
To prevent passing hepatitis to your infant, get a blood test for hepatitis B and receive appropriate injections if infected
If you are a health care or public safety worker, follow standard barrier precautions, safely handle all sharps and needles, and get the hepatitis vaccine
Hepatitis B treatment
Acute hepatitis B typically gets better on its own. Immunity typically occurs after infection or after receiving the hepatitis B vaccination. Chronic hepatitis B, which can be passed to others, can be treated with drugs, though these drugs are not effective for all patients.
Approximately 4.1 million Americans have been infected with the virus that causes hepatitis C. Of this population, approximately 3.2 million are chronically infected.
How do you acquire hepatitis C?
Hepatitis C is primarily spread through the blood of an infected person, most often through the sharing of needles when injecting drugs. Hepatitis C can be transmitted through exposure to needles or other sharps on the job. It can also be passed from an infected mother to her child during birth.
Who is at risk for hepatitis C?
Injecting drug users, and people who received clotting factors before 1987 are at the highest risk of hepatitis C. Patients on hemodialysis, recipients of blood and/or organs prior to 1992, people with undiagnosed liver problems, and infants of infected mothers are at an intermediate risk. Health care and public service employees, people with multiple sex partners, and people having sex with infected partners are at a low risk of infection.
What are the effects of Hepatitis C?
Hepatitis C causes swelling and damage of the liver. In cases of chronic hepatitis C, cirrhosis of the liver, liver failure, and liver cancer may develop.
Prevention of Hepatitis C
There is no vaccine for hepatitis C. To prevent this virus, do not shoot drugs, and if you are unable to stop, do not share needles, drugs, or other paraphernalia. Don’t share personal items that might have blood on them. If your liver is damaged, get a hepatitis A vaccine. Get a hepatitis B vaccine if you at risk for this disease.
Treatment of Hepatitis C
People with hepatitis C should seek a medical evaluation for liver disease. Combination drug therapy is often used to treat this type of hepatitis. Stopping consumption of alcohol can help protect the liver.
Hepatitis D is less common in the United States. In order to get hepatitis D, you must have a current hepatitis B infection. The three primary ways that you can acquire hepatitis D is from:
Sharing needles to inject drugs
Having sex with an infected partner
An infected mother to a child during childbirth
The best ways to prevent hepatitis D are to get a hepatitis B vaccine (there is no hepatitis D vaccine), don’t shoot drugs, don’t share personal items with someone who has hepatitis, and use latex condoms during all sexual activity.
The rate of hepatitis E in the United States is comparatively low. This form of hepatitis is most often acquired during travels to areas with high rates of hepatitis E. Hepatitis E is transmitted through food or water contaminated by the feces of someone with hepatitis E. To prevent hepatitis E, it is important to take caution when drinking tap water and eating uncooked foods during international travel.
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