What Causes Hepatitis?

Common causes of hepatitis are viruses, infections, alcohol, drugs, toxins, and others.

Hepatitis is an inflammation of the liver. It can occur due to a variety of factors, but the most common cause is a virus infection. Hepatitis can be acute (short-term) or chronic (long-term) and can have fatal complications.

The liver is in the right upper part of the abdomen and serves several important functions:

• The metabolization of carbohydrates, fats, proteins, and drugs
• Storage of sugars, vitamins, and minerals
• Synthesis of certain proteins like albumin and blood clotting factors
• Production of bile for digestion of fats
• Activation of enzymes required for body functions

• Virus and other infections
• Alcohol
• Drugs
• Toxins
• Autoimmune response (the body’s immune system attacks its own tissues)
• Ischemia (decreased oxygenation of the liver)
• Metabolic disorders

The types of viral hepatitis are:

• Hepatitis A
  • An acute illness caused by the hepatitis A virus (HAV).
  • Transmitted through food and water contaminated by feces of infected people.
• Hepatitis B
  • An acute or chronic infection caused by the hepatitis B virus (HBV).
  • Transmitted through contact with infectious body fluids. It can be sexually transmitted or transmitted through infected needles.
• Hepatitis C
  • An acute or chronic illness caused by the hepatitis C virus (HCV).
  • Transmitted through contact with infectious body fluids. It can be sexually transmitted or transmitted through infected needles.
• Hepatitis D
  • Caused by the hepatitis D virus (HDV).
  • Transmitted through contact with infected blood.
  • It is rare, but very serious.
  • It only occurs in the presence of hepatitis B. HDV cannot multiply in the absence of HBV.
• Hepatitis E
  • An acute disease caused by the hepatitis E virus (HEV).
  • Like HAV, it is transmitted through food and water contaminated by the feces of infected people.

Infectious viral hepatitis involves four phases:

• Phase 1:
  • Patients may be asymptomatic
  • Liver function tests may be abnormal
• Phase 2:
  • Flu-like symptoms
  • Loss of weight and appetite
  • Nausea
  • Vomiting
  • Altered taste
  • Joint and muscle pain
  • Fatigue
  • Rashes
  • Skin itching
  • Aversion to cigarette smoke
• Phase 3:
  • Worsening of phase 2 symptoms
  • Dark urine
  • Pale-colored stools
  • Yellow discoloration of eyes (icterus)
  • Yellow discoloration of skin and mucosa (jaundice)
  • Pain over the location of the liver
  • Enlargement of the liver (hepatomegaly)
• Phase 4 (convalescent stage):
  • Jaundice and icterus resolves
  • Liver enzymes return to normal

• The physician records the history of the patient and does a physical assessment.
• Specialized radiological (ultrasound, computed tomography, magnetic resonance imaging) tests and blood investigations (liver function test, serum electrolytes).
• Liver biopsy.

The treatment of viral hepatitis depends on its cause. All patients with hepatitis should stop alcohol, recreational drug use, and liver toxic medication.

• Hepatitis A
  • It is a short-term illness.
  • Hospitalization is required.
  • Treatment is recommended to reduce symptoms and discomfort.
  • Adequate hydration.
  • There is no anti-viral therapy available.
• Hepatitis B
  • Supportive treatment to reduce symptoms and discomfort.
  • Anti-viral medication can be used.
• Hepatitis C
  • Anti-viral medication can be used along with supportive treatment.
• Hepatitis D
  • A drug called interferon may help in some situations.
• Hepatitis E
  • Usually resolves on its own.
  • Supportive treatment to reduce discomfort.
  • Adequate rest, fluid and nutrition.
  • No anti-viral medication is available.
• Autoimmune hepatitis
  • Medication to suppress or modulate the immune system, such as steroids.

Hepatitis B, C, D can progress to chronic (long-term) hepatitis disease. Early diagnosis, treatment and lifestyle modification can slow or inhibit the progression of the disease and reduce complications. Complications include:

• Chronic damage that leads to scarring (liver cirrhosis).
• Bleeding disorders (prolonged or easy bleeding).
• Fluid accumulation in the abdomen (ascites).
• Portal hypertension: Increased blood pressure in portal veins (veins that enter the liver).
• Failure of the kidneys and brain.
• Liver cancer.
• Death.

Acute hepatitis can be cured. Chronic hepatitis can be treated to prevent progression and complications. Some types of hepatitis can be prevented.

• A vaccine is available for hepatitis B. Because hepatitis E only occurs in the presence of hepatitis B, the vaccine prevents hepatitis E as well.
• Good personal hygiene.
• Avoid sharing needles, razors, toothbrush, and other personal items.
• Avoid touching blood.
• Avoid unprotected sexual intercourse.
• Avoid excessive consumption of alcohol.
• Avoid using recreational drugs.