Inflammation of the liver, caused by infectious
or toxic agents is known as hepatitis.
A group of viruses known as the hepatitis viruses cause most cases of
liver damage worldwide. Hepatitis can also be due to toxins (notably
alcohol), other infections or from autoimmune process. It may run a
subclinical course when the affected person may not feel ill. The
patient becomes unwell and symptomatic when the disease impairs liver
functions that include, among other things, removal of harmful
substances, regulation of blood composition, and production of bile to
There are two types-
- Viral hepatitis: Hepatitis A through E (more than 95% of
viral cause), Herpes simplex, Cytomegalovirus, Epstein-Barr, yellow
fever virus, adenoviruses.
- Non viral infection: toxoplasma, Leptospira, Q fever, rocky
mountain spotted fever
- Toxins: Amanita toxin in mushrooms, carbon tetrachloride,
- Drugs: Paracetamol, amoxycillin, antituberculosis
medicines, minocycline and many others.
- Ischemic hepatitis (circulatory insufficiency)
- Auto immune conditions, e.g., Systemic Lupus Erythematosus
- Metabolic diseases, e.g., Wilson's disease
- Viral hepatitis: Hepatitis B with or without hepatitis D,
hepatitis C (neither hepatitis A nor hepatitis E causes chronic
- Autoimmune: Autoimmune hepatitis
- Drugs: methyldopa, nitrofurantoin, isoniazid, ketoconazole
- Non-alcoholic steatohepatitis
- Heredity: Wilson's disease, alpha 1-antitrypsin deficiency
- Primary biliary cirrhosis and primary sclerosing
cholangitis occasionally mimic chronic hepatitis
Many viruses, for example, the virus of mononucleosis and the
cytomegalovirus can inflame the liver. Here are several hepatitis
viruses; they have been named types A, B, C, D, E, F (not confirmed),
and G. The most common hepatitis viruses are types A, B, and C.
This form is caused by the hepatitis A virus (HAV), which lives in the
stools (feces or poop) of infected individuals. Infection with the
hepatitis A virus leads to inflammation of the liver, but complications
are rarely serious.
HAV is spread:
- when someone ingests anything that's contaminated with
HAV-infected stool (this makes it easy for the virus to spread in
overcrowded, unsanitary living conditions)
- in water, milk, and foods, especially in shellfish
It is possible to experience mild or no symptoms. Many people who
become infected with HAV will have symptoms that include:
About 15% of people who have hepatitis
A have symptoms of HAV infection that return or last for 6 to 9 months
after infection first occurred. Symptoms of hepatitis A usually last
less than 2 months.
- A short, mild, flu-like illness.
- Nausea, vomiting and diarrhoea.
- Loss of appetite.
- Weight loss.
- Jaundice (yellow skin and whites of eyes, darker yellow
urine and pale faeces).
- Itchy skin.
- Abdominal pain.
1.Medical history and physical examination
2.Liver Function test.
3.Antibody (antiHAV) test.
There is no specific treatment for HAV and most people fight off the
virus naturally, returning to full health within a couple of months.
The doctor will advise avoiding alcohol and fatty foods as these can be
hard for the liver to process and may exacerbate the inflammation.
Patients should get plenty of rest and eat a nutritious diet. They
should also ensure they do not spread HAV by washing their hands after
using the toilet and before preparing food. Patients with more severe
symptoms may be monitored in hospital for a short period.
Hepatitis B is a serious disease caused by the hepatitis B virus (HBV).
Infection with this virus can cause scarring of the liver, liver
failure, liver cancer, and even death.
HBV spreads through:
- infected body fluids, such as blood, saliva, semen, vaginal
fluids, tears, and urine
- a contaminated blood transfusion (uncommon in the United
- shared contaminated needles or syringes for injecting drugs
- sexual activity with an HBV-infected person
- transmission from HBV-infected mothers to their newborn
Many people who become infected with HBV experience mild symptoms or no
symptoms at all, but they may still carry the infectious virus and pass
it on to others. When symptoms do appear they are similar to those of
1.Complete medical history and physical examination
2.Liver function Test
3.Test to detect hepatitis virus by blood test.
4.In chronic cases- liver biopsies
In most countries a patient with a positive test result will be
referred to a specialist who will carry out further tests to determine
the degree to which hepatitis B may be affecting the liver, and what
may be the best treatment options.
In the majority of patients with active HBV, symptoms will not be
severe and treatment will not be required. The patient will be
monitored and after a few months the patient's immune system should
fight off the virus, giving the patient natural immunity.
Medication is given as treatment to those with chronic symptoms to help
prevent further liver damage.
Immunization is also given to prevent it.
The hepatitis C virus (HCV) is spread by direct contact with an
infected person's blood. However, infection with HCV can lead to
chronic liver disease and is the leading reason for liver transplant.
The hepatitis C virus can be spread by:
- sharing drug needles
- getting a tattoo or body piercing with unsterilized tools
- blood transfusions (especially ones that occurred before
1992; since then the U.S. blood supply has been routinely screened for
- transmission from mother to newborn
- sexual contact (although this is less common)
Many people do not experience any symptoms when they become infected
with hepatitis C. Symptoms may emerge later, taking anywhere between 15
and 150 days to develop. Occasionally a person will not develop any
symptoms and their immune system will successfully clear the virus
without their knowledge. An infected person without symptoms can still
act as a carrier and pass the virus on to others. When symptoms do
appear they are similar to those of hepatitis A.
A doctor can diagnose hepatitis C by carrying out blood tests that
detect HCV antibodies in the blood.
If a patient has been diagnosed with hepatitis C infection, they will
be advised to have regular blood tests and physical check-ups.
The infected person should limit the amount of alcohol they drink as
alcohol puts strain on the liver. The doctor may also advise avoiding
fatty foods and following a low-salt diet with the medications.
Hepatitis D, E, F, G
There also are viral hepatitis types D, E, F (not confirmed yet), and
G. The most important of these at present is the hepatitis D virus
(HDV), also known as the delta virus or agent. It is a small virus that
requires concomitant infection with hepatitis B to survive. HDV cannot
survive on its own because it requires a protein that the hepatitis B
virus makes (the envelope protein, also called surface antigen) to
enable it to infect liver cells. The ways in which hepatitis D is
spread are by shared needles among drug abusers, contaminated blood,
and by sexual contact, essentially the same ways as for hepatitis B.
Patients who already have chronic hepatitis B infection can acquire
delta virus infection at the same time as they acquire the hepatitis B
infection or, alternatively, on top of a chronic hepatitis B infection.
Patients with chronic hepatitis due to hepatitis B and hepatitis D
viruses develop cirrhosis (severe liver scarring) rapidly. Moreover,
the combination of delta and B virus infection is very difficult to
Symptoms of hepatitis
Clinically, the course of acute hepatitis varies widely from mild
symptoms requiring no treatment to fulminant hepatic failure needing
liver transplantation. Acute viral hepatitis is more likely to be
asymptomatic in younger people. Symptomatic individuals may present
after convalescent stage of 7 to 10 days, with the total illness
lasting 2 to 6 weeks.
Initial features are of nonspecific flu-like symptoms, common to almost
all acute viral infections and may include malaise, muscle and joint
aches, fever, nausea or vomiting, diarrhea, and headache. More specific
symptoms, which can be present in acute hepatitis from any cause, are:
profound loss of appetite, aversion to smoking among smokers, dark
urine, yellowing of the eyes and skin (i.e., jaundice) and abdominal
discomfort. Physical findings are usually minimal, apart from jaundice
(33%) and tender hepatomegaly (10%). There can be occasional
lymphadenopathy (5%) or splenomegaly (5%).
Majority of patients will remain asymptomatic or mildly symptomatic,
abnormal blood tests being the only manifestation. Features may be
related to the extent of liver damage or the cause of hepatitis. Many
experience return of symptoms related to acute hepatitis. Jaundice can
be a late feature and may indicate extensive damage. Other features
include abdominal fullness from enlarged liver or spleen, low grade
fever and fluid retention (ascites). Extensive damage and scarring of
liver (i.e., cirrhosis) leads to weight loss, easy bruising and
bleeding tendencies. Acne, abnormal menstruation, lung scarring,
inflammation of the thyroid gland and kidneys may be present in women
with autoimmune hepatitis.
1.Complete blood count.
2.Liver function Test
3.Laboratory test to identify virus in blood
6.Imaging- Ultrasonography, CT- scan, MRI
Treatment of acute and chronic hepatitis is different.
In patients with acute hepatitis, the initial treatment consists of
relieving the symptoms of nausea, vomiting, and abdominal pain. Careful
attention has to be given to prevent complications. Liver functions
should be thoroughly monitored. The patient must abstain from drinking
alcohol since alcohol is toxic to the liver. It occasionally is
necessary to provide intravenous fluids to prevent dehydration caused
by vomiting. Patients with severe nausea and/or vomiting may need to be
hospitalized for treatment and intravenous fluids.
Treatment of chronic infection with hepatitis B and hepatitis C usually
involves medication or combinations of medications to eradicate the
virus. Alcohol aggravates liver damage in chronic hepatitis, and can
cause more rapid progression to cirrhosis. Therefore, patients with
chronic hepatitis should stop drinking alcohol. Smoking cigarettes also
can aggravate liver disease and should be stopped.
Role of homoeopathy
Homeopathic medicines are effective in many functional and pathological
disorders. It also helps in preventing further damage to tissues and
complications. Homoeopathic medicines will help not just in curing hepatitis, but also in correcting the cause/s responsible for it.
A study about successful homeopathic treatment in hepatitis can be seen at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833483
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