This blog is intended to be an introduction to hepatitis with an emphasis on some of the more common causes. Hepatitis is a disease characterized by inflammation of the liver. It can broadly be differentiated into acute (<6 months) or chronic.
1. ACUTE HEPATITIS
Acute hepatitis may be accompanied by fatigue, abdominal pain, and jaundice. Viral infections are important causes of acute and chronic liver disease worldwide. The five primary hepatitis viruses that have been identified are A, B, C, D, and E. Epstein-Barr virus, Cytomegalovirus, and Herpes Simplex virus also can result in hepatitis. In addition, toxins, medications, autoimmune hepatitis, and Wilson disease may cause acute or chronic hepatitis.
Common causes of acute hepatitis include:
- • Viruses
- –Hepatitis A
- –Hepatitis B
- • Drug induced
- • Toxins
- • Alcoholic hepatitis
- • Ischemic hepatitis
- • Uncommon causes
- –Cytomegalovirus
- –Epstein-Barr virus
- –Herpes simplex virus
- –Hepatitis E
- –Severe cardiovascular disease
- –Autoimmune hepatitis
- –Wilson’s disease
Hepatitis A
Common routes of transmission of hepatitis A (HAV) include ingestion of contaminated food or water and contact with an infected person. Hepatitis A is almost always self-limited. Treatment is supportive. Post exposure prophylaxis with hepatitis A vaccine or immune serum globulin (or both) is advised. Hepatitis A vaccine is recommended for all children at 12 months of age and should be considered in travelers to areas with high prevalence of hepatitis A, to men who have sex with men, to intravenous drug users, and to patients with chronic liver disease.
For more information on Hepatitis A from Uptodate.com refer to:
https://www.uptodate.com/contents/hepatitis-a-beyond-the-basics
Hepatitis B
Hepatitis B virus (HBV) leads to approximately 30% of the cases of acute viral hepatitis and 15% of the cases of chronic viral hepatitis in the United States. Risk factors for contracted HBV in the United States are sexual contact with an infected person and intravenous drug use. Patients with chronic hepatitis B and cirrhosis are at high risk for the development of hepatocellular carcinoma, Hepatitis B immunoglobulin should be given to nonimmune household and sexual contacts of patients who have acute hepatitis B. All infants should receive hepatitis B vaccine.
For more information on HBV refer to:
https://www.uptodate.com/contents/hepatitis-b-beyond-the-basics
Toxins
The use of certain complementary and alternative medicines (CAM) may potentially lead to acute hepatitis and sometimes fulminant hepatic failure. LiverTox- https://livertox.nih.gov/ is an online resource developed as a collaborative effort between the liver disease branch of the NIDDK and the National Library of Medicine.
- 2. CHRONIC HEPATITIS
Diseases that produce sustained (>6 months) increases in aminotransferase levels (liver enzymes) are included in the category of chronic hepatitis.
The most important disorders that cause chronic hepatitis include:
- • Viruses
- —Hepatitis C
- –Hepatitis B
- • Nonalcoholic fatty liver disease
- • Alcoholic liver disease
- • Autoimmune hepatitis
- • Primary biliary cirrhosis
- • Primary sclerosing cholangitis
Hepatitis C
HCV is the cause of the most common chronic blood-borne infection in the United States, where an estimated 3 to 4 million persons are infected. HCV is a factor in 40% of all cases of chronic liver disease and is a leading indication for liver transplant. Newer medications are having a major impact in the treatment success and eradication of HCV in individuals.
Nonalcoholic fatty liver disease
The obesity epidemic has increased the prevalence of nonalcoholic fatty liver disease (NAFLD). It currently is the most common cause of chronic liver disease in Western nations. NAFLD can be associated with cardiovascular disease, obstructive sleep apnea, type 2 diabetes mellitus, and other manifestations of the metabolic syndrome.
Click here for more information on NAFLD from Uptodate.com.
Alcohol-induced liver disease
Alcoholic liver disease is a major cause of morbidity and mortality worldwide. Globally, approximately 2 billion people consume alcohol, and alcohol use disorders are diagnosed in more than 75 million people.
If you have any questions about hepatitis, please contact your physician at Granite Peaks Gastroenterology. Call 801-619-9000 or click here to request an appointment.