Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Prevention of hepatitis involves measures to avoid exposure to the viruses,
using immunoglobulin in the
event of exposure, and vaccines. Administration of immunoglobulin is called
passive protection because antibodies from patients who have had viral hepatitis
are given to the patient. Vaccination is called active
protection because killed viruses or noninfective components of viruses are
given to stimulate the body to produce its own antibodies.
Avoidance if exposure to viruses
Prevention of viral hepatitis, like any other illness, is preferable to reliance
upon treatment. Taking precautions to prevent exposure to another individual's
blood (exposure to dirty needles), semen (unprotected sex), and other bodily
waste (stool) will help prevent the spread of these viruses.
Use of immunoglobulins
Immune serum globulin (ISG) is human serum that contains antibodies to hepatitis
A. ISG
can be administered to prevent infection in individuals who have been exposed to
hepatitis A. ISG works immediately upon administration, and the duration of protection
is several months. ISG usually is given to travelers to regions of the world
where there are high rates of hepatitis A infection and to close or household contacts
of patients with hepatitis A. ISG is safe with few side effects.
Hepatitis B immune globulin or HBIG (BayHep B), is human serum that contains
antibodies to hepatitis B. HBIG is made from plasma (a blood product) that is known to
contain a high concentration of antibodies to the hepatitis B surface antigen. If given
within 10 days of exposure to the virus, HBIG almost always is successful in
preventing infection. Even if given a bit later, however, HBIG may lessen the
severity of HBV infection. The protection against hepatitis B lasts for about three
weeks after the HBIG is given. HBIG also is given at birth to infants born to
mothers known to have hepatitis B infection. In addition, HBIG is given to individuals
exposed to HBV because of sexual contact or to healthcare workers accidentally
stuck by a needle known to be contaminated with blood from an infected person.
Vaccination
Hepatitis A. Two hepatitis A vaccines are available in the US, Havrix and Vaqta.
Both contain inactive (killed) hepatitis A virus. For adults, two doses of the
vaccine are recommended. After the first dose, protective antibodies develop in
70% of vaccine recipients in 2 weeks and more than 95% of recipients in 4 weeks.
After two doses of the hepatitis A vaccine, immunity against hepatitis A
infection is believed to last for many years.
Individuals at increased risk for acquiring hepatitis A
and individuals with chronic liver disease (e.g., cirrhosis or chronic hepatitis C) should be
vaccinated. Although individuals with chronic liver disease are not at increased
risk for acquiring hepatitis A, they can develop serious (sometimes fatal) liver failure
if infected with hepatitis A and, thus, they should be vaccinated.
Individuals at increased risk of acquiring hepatitis A are:
Travelers to countries where hepatitis A is common
Men who have sex with men
Illegal drug users (either injection or non-injection
drug use)
Researchers working with hepatitis A or primates that are susceptible to
infection with hepatitis A
Patients with clotting factor disorders who are receiving clotting factor
concentrates that can transmit hepatitis A
Some local health authorities or private companies may require hepatitis A
vaccination for food handlers.
Because protective antibodies take weeks to develop,
travelers to countries where hepatitis A is common should be vaccinated at least 4 weeks
before departure. The Centers for Disease Control (CDC) recommends immunoglobulin be given in addition
to vaccination if departure is prior to 4 weeks. Immunoglobulin provides quicker
protection than the vaccines, but the protection is short-lived.
Hepatitis B
For active vaccination, a harmless hepatitis B antigen is given to stimulate the body's
immune system to produce protective antibodies against the surface antigen of
hepatitis B. Vaccines that are currently available in the United States are made
(synthesized) using recombinant DNA technology (joining DNA segments). These recombinant
hepatitis B vaccines (Energix-B and Recombivax-HB) are
constructed to contain only that part of the surface antigen that is very potent
in stimulating the immune system to produce antibodies. The vaccine contains no
viral component other than the surface antigen and is not infectious. Hepatitis
B
vaccines should be given in three doses with the second dose 1-2 months after
the first dose, and the third dose 4-6 months after the first dose. For the best
results, the vaccinations should be given in the deltoid (shoulder) muscles and not in the
buttocks.
Hepatitis B vaccines are 95% effective. Five percent of vaccinated individuals will fail
to develop the necessary antibodies for immunity after the three doses. Patients
with weakened immunity (such as HIV infection), elderly
patients, and patients undergoing kidney hemodialysis are more likely to fail to respond to the
vaccines.
Hepatitis B vaccine is recommended for:
All infants
Adolescents under 18 years of age who did not receive
hepatitis B vaccine as infants
People occupationally exposed to blood or body fluids
Residents and staff of institutions for the
developmentally disabled
Patients receiving kidney hemodialysis
Hemophiliacs and other patients receiving clotting
factor concentrates
Household contacts and sexual partners of patients
infected with hepatitis B chronically
Travelers who will spend more than 6 months in
regions with high rates of hepatitis B infection
Injection drug users and their sexual partners
Men who have sex with men, men or women with multiple sex partners, or recent
infection with a sexually transmitted infection
Inmates of long-term correctional facilities
All pregnant women should have a blood test for the
antibody to hepatitis B surface antigen. Women who test positive for hepatitis B risk
transmitting the virus to their infants during labor, and, therefore, infants born to mothers with
hepatitis B infection
should receive HBIG in addition to hepatitis B vaccine at birth. The reason for giving
both immunoglobulin and vaccine is that even though hepatitis B vaccine can offer long
lasting, active immunity, immunity takes weeks or months to develop. Until
active immunity develops, the short-lived, passive antibodies from the HBIG
protect the infant.
Unvaccinated individuals exposed to materials infected with hepatitis B (such as
healthcare workers stuck by a contaminated needle) will need HBIG in addition to
hepatitis B vaccine for the same reason as infants born to mothers with
hepatitis B infection.
Many illnesses and conditions can cause inflammation
of the liver (hepatitis).
Viruses that primarily attack the liver are called
hepatitis viruses. There are several types of hepatitis viruses including
types A, B, C, D, E, F (not yet confirmed), and G. Types A, B, and C are the
most common.
Those at risk for viral hepatitis include workers in
the health care profession, people with multiple sexual partners, intravenous
drug abusers, and hemophiliacs. Blood transfusion is a rare cause of viral
hepatitis.
All hepatitis viruses can cause acute hepatitis.
Viral hepatitis types B and C can cause chronic
hepatitis.
Symptoms of acute viral hepatitis include fatigue, flu-like symptoms, dark
urine, light-colored stools, fever, and jaundice. Rarely, acute viral hepatitis
causes fulminant hepatic failure.
The symptoms of chronic viral hepatitis often are
mild and nonspecific, and the diagnosis of chronic hepatitis often is delayed.
Chronic viral hepatitis often requires treatment in
order to prevent progressive liver damage, cirrhosis, liver failure, and liver
cancer
Hepatitis infections can be prevented by avoiding exposure to viruses,
injectable immunoglobulins or vaccines.
Infectious mononucleosis is a virus infection in which there is an increase of white blood cells
that are mononuclear (with a single nucleus) "Mono" and "kissing
disease" are popular terms for this very common illness caused by the
Epstein-Barr virus (EBV).
Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded with abnormal cells or deposits. Symptoms of an enlarged spleen may include weakness and fatigue, easy bleeding, and poor white blood cell function. Treatment of an enlarged spleen is focused toward the cause of the splenomegaly. Surgery may be required to remove the spleen.
Sexually transmitted diseases, or STDs, are infections that are transmitted during any
type of sexual exposure, including intercourse (vaginal or anal), oral sex, and
the sharing of sexual devices, such as vibrators. Although treatment exists for many STDs, others currently are
usually incurable, such as those caused by HIV, HPV, hepatitis B and C, and HHV-8.
Encephalopathy means brain disease, damage, or malfunction. Causes of encephalopathy are varied and numerous. The main symptom of encephalopathy is an altered mental state. Other symptoms include lethargy, dementia, seizures, tremors, and coma. Treatment of encephalopathy depends on the type of encephalopathy (anoxia, diabetic, Hashimoto's, hepatic, hyper - hypotensive, infectious, metabolic, infections, uremic, or Wernicke's) are examples of types of encephalopathy.
The liver is the largest solid organ in the body, and is actually an gland. The liver has a wide variety of critical functions such as manufacturing proteins and metabolizing fats and carbohydrates. The liver also eliminates harmful biochemical waste products from the body (alcohol, drugs, toxins). The liver secretes bile that aids in digestion. Examples of diseases of the liver include cirrhosis, hepatitis, cancer, and fatty liver. Symptoms of liver disease include bleeding, easy bruising, edema, fatigue, and jaundice.
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, drug abuse, and more. Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Hepatitis means inflammation of the liver. Hepatitis A is one type of liver disease caused by a virus. Since hepatitis A is a virus, it can pass from person to person from eating or drinking contaminated food or coming into contact with contaminated materials containing the virus. Symptoms of hepatitis A include stomach pain, diarrhea, dark yellow urine, jaundice, and more. There is a vaccine to prevent contracting hepatitis A.
Hepatitis A and hepatitis B are the two most commnon viruses that infect the liver. Hepatitis A and Hepatitis B can be prevented and treated with immunizations (vaccinations) such as Havrix, Vaqta, Twinrix, Comvax, Pediarix, and hepatitis b immune globulin (HBIG).
Digestion RSS
Healthy Living Tips
This site complies with the