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You are in Home > Medicentre News and Features > Hepatitis Explained

Hepatitis is the Greek term for 'liver inflammation' – and the Greeks got it absolutely right. It is characterised both by the presence of inflammatory cells and the destruction of cells in the liver. It is usually caused by viruses, but can also be caused by toxins (especially alcohol), by certain medications and some industrial products and solvents. It is sometimes also caused by other infections and diseases such as glandular fever.

It is divided into two groups, according to its duration.

Acute hepatitis last less than six months, and Chronic hepatitis lasts longer than six months and is often a life-long condition.

ACUTE HEPATITIS

The onset of acute hepatitis is usually marked with flu-like symptoms which may include general tiredness and malaise, muscle and joint aches, fever, nausea and diarrhoea. It is also often marked with a major loss of appetite, dark urine and a yellowing of the skin and eyes.

It is likely to be asymptomatic (no symptoms) in younger people, but symptomatic individuals start showing symptoms around 8-10 days after infection, with the illness lasting up to six weeks.

It may lead to acute liver failure in a small number of people. This could be life-threatening and may occasionally require a transplant.

CHRONIC HEPATITIS

Chronic hepatitis presents symptoms such as tiredness and weakness, but it often displays no symptoms at all and because of this, it is usually identified through a blood test for something else altogether, or through health screening. A great many people are continuing their lives with chronic hepatitis with no idea at all.

However it is a very serious condition which will eventually manifest itself with enlargement of the liver, yellowing of the eyes and skin, easy bruising and bleeding, acne, abnormal menstruation, scarring of the lungs, inflammation of the thyroid glands and kidneys and eventual cirrhosis.

Viral hepatitis falls into five classes, from A to E.

HEPATITIS A

'HAV' (Hepatitis A Virus) causes the acute form and is transmitted by the ingestion of contaminated food or water, or from person to person by direct contact.  Tens of millions of people are infected in the developing world, although infection in the young is seldom serious and leads to lifelong immunity. It is estimated that 100% of children in some regions have been infected with HAV. Young people travelling from the West are susceptible. Though highly unpleasant, it is seldom life – threatening. Vaccination is both effective and recommended.  

HEPATITIS B

It is estimated that around a quarter of the world's population have been infected with the hepatitis B virus, and that there are some 350 million people who are chronic carriers.  Infection results from exposure of infected blood or body fluids such as semen and vaginal fluid, and it has been detected in the saliva , tears and urine of carriers. Although it rarely causes death directly, it causes liver inflammation, abdominal pain, vomiting and jaundice. Hep B can lead to a vastly increased risk of cirrhosis and liver cancer. It is preventable though vaccination.

HEPATITIS C

HCV often displays no symptoms, but once established as a chronic infection it can progress to fibrosis and cirrhosis, and to cause liver failure or cancer. It is difficult to treat: success rates are currently at around 50%, and there is no vaccine.

It is transmitted from person to person by blood contact, and it is estimated that as many as 300 million people have the disease. In the west, intravenous recreational drug users are at particular risk. In the USA it is estimated that 60-80% of such users have been infected.

HEPATITIS D

This is essentially a 'child' of the hepatitis B virus, since it can only be found in its presence. It is a 'complication' of HBV which increases the severity of symptoms and the chances of liver failure, cirrhosis and cancer. Because of this, it has the highest mortality rate of all hepatitides. Since it is dependant on the B virus, vaccination is highly effective.

HEPATITIS E

Hepatitis E is similar to HAV in that it is an acute, 'self limiting' infection which is often asymptomatic in younger people. Mortality rates are low, but it does develop into severe liver disease in about 2% of cases. The mortality rates for pregnant women however are much higher at 20%. It is most prevalent in developing countries and is transmitted via the faecal contamination of food and water supplies. Person to person contamination is rare. it was not fully identified as a human disease until 1980.  A promising vaccine has been developed recently, but it is still subject to evaluation and is not yet available.

SUMMARY AND ADVICE

Hepatitis is not a disease that can be viewed lightly and care should be taken when in an environment or situation where infection is likely – namely when travelling or during sexual encounters.

Sanitation, food and water should all be taken into account when abroad in the developing world. Even if staying in a top hotel, the appetising locally-caught shellfish may appear perfectly safe, but could well have been caught in a bay into which flows a river carrying with it human waste. Take great care with water supplies and any produce washed in using the local water supply.

Intravenous drug users are another high-risk group, and fastidious cleanliness is essential. Sharing of needles and paraphernalia is inviting infection. Hepatitis B is considered a sexually transmitted infection (STI) and is covered in some detail in our sexual health section, which can be found here.

The message is: get tested, get vaccinated and take care.

The Liver, the heaviest organ of our body is the storehouse of many vitamins, minerals, carbohydrates, proteins, fats many other nutrients. It also takes part actively in production of different hormones and enzymes besides playing important role in several metabolic reactions. Being the storehouse, it has to suffer the pangs of storing some toxins and harmful chemical elements. A suboptimal liver can bring about chronic fatigue, headache, allergic reactions, bad breath and jaundice. There are various ways to protect the liver; but the easiest way to take care of this vital organ is to take foods good for the liver.

A normal, healthy liver (top) and a liver infected by hepatitis B.

These fall into two categories - foods high in antioxidants and foods which encourage and assist the detoxification process.

They include blueberries, broccoli, cabbage, carrots, cauliflower, garlic, apples, beets, brown rice, dandelion, grapefruit, onion, pears, parsley, raisins, soy beans and tomatoes.

Foods to avoid include any kind of fried food, processed meats and processed convenience foods.