Definition of viral hepatitis
Viral hepatitis is an infection that mainly affects the liver and causing inflammatory lesions.
Six viruses cause hepatitis: viruses A, B, C, D, E and G. There is talk of hepatitis "acute" during the invasion phase of the organism by the virus; we speak of "chronic" hepatitis as the disease persists beyond six months after infection. Hepatitis B, C and D can become chronic hepatitis, which makes dangerousness.
Risks and health challenges of viral hepatitis
The three most common viral hepatitis are Hepatitis A, B and C. Hepatitis A is usually mild and heal in 10 to 15 days. However, hepatitis B and C are more serious as they can become chronic and develop into cirrhosis and liver cancer.
280,000 people (0.65% of the adult population) are chronic carriers of hepatitis B. For hepatitis C, 180 million people are infected with the virus worldwide, of which 500 000 a 650 000.
Causes and Symptoms of viral hepatitis
Hepatitis is transmitted by viruses. The hepatitis A virus (HAV) is transmitted through the digestive tract (fecal-oral) and primarily affects young adult or child. It is eliminated by the stool and do not persist chronically in the body.
Viral hepatitis B is consecutive in turn to infection by the hepatitis B virus (HBV); its transmission is through contact with bodily fluids of infected persons (unprotected sex, prick or cut with blood transmission during pregnancy ...).
The infection heals spontaneously in most cases but can sometimes remain in the body: People are then carry the virus without showing symptoms, while others have a progressive chronic hepatitis.
The Hepatitis C virus (HCV) is transmitted by blood, primarily by use of intravenous drugs. Spontaneous cure of hepatitis C is rare (20% of cases) and the infection becomes chronic in most patients.
How manifest viral hepatitis?
Acute hepatitis manifested by symptoms that are common to all hepatitis. They may first be asymptomatic; their diagnosis will be made after the event on serology. Otherwise fatigue, nausea, abdominal pain (under the right ribs in the liver) dominate. The appearance of dark urine and jaundice are characteristic of hepatitis. Very severe cases may even lead to liver transplant exist: it is fulminant hepatitis with rapid destruction of the liver.
In hepatitis A, the illness resolves spontaneously without the risk of chronicity. In hepatitis B and C, the change can be made to chronicity that will be diagnosed by blood tests. Cirrhosis and liver cancer are then two formidable complications.
With what should we be confused?
It initially be confused hepatitis viruses among themselves. Hepatitis A is a mild disease which does not have the risk of becoming chronic.
All hepatitis are not infectious and viral; certain liver injury has a drug issue, alcoholic or immune.
Finally, it should not be confused jaundice and hepatitis. Jaundice reflects the poor liver function. Other diseases are responsible as gallstones, Gilbert's disease (hereditary anomaly) or anemia.
Will it possible prevention?
Prevention is essential and differs between the relevant virus.
For hepatitis A, it is based primarily on hygiene: hand washing, food washing, not sharing cutlery and utensils ... A vaccination is recommended for the traveler who had no history of hepatitis A (unimmunized) and traveling in heavily contaminated areas.
For hepatitis B, the preventive measures are many. The condom use is essential during sex with a partner or unknown HIV status; gloves for health professionals is essential. Screening for hepatitis B is also mandatory in case of pregnancy or when giving blood.
Vaccination is widely proposed, for professional or non-professional. Only a history of neurological disease like multiple sclerosis indicate that vaccination-against.
Hepatitis C finally the sharing of injection equipment among drug users is prohibited. The posttransfusionnelles contamination have now become exceptional because all blood donations are screened and treated.
When to consult?
Any fatigue, jaundice or unexplained persistent symptoms should motivate a medical consultation to make a diagnosis. Some forms of hepatitis may represent genuine emergencies: the liver is destroyed and can not perform its functions. Coagulation disorders and impaired consciousness (encephalopathy) lead to death within hours if no treatment is established.
Screening for hepatitis B and C, even in the absence of symptoms, is in any way significant.
What is the doctor?
The doctor can only suspect hepatitis. It will look for arguments in favor of a mode of transmission (drug use, sex ...) The clinical examination is not specific for hepatitis. In case of abdominal pain, palpation find a pain in the right upper quadrant abdomen; haemorrhagic signs are detected and are a sign of seriousness.
The diagnosis is often made after a blood test reveals elevated liver enzymes, transaminases (up to 20 to 40 times normal). Coagulation is also tested and can be collapsed in severe hepatitis. The key consideration is the serology of hepatitis. Antibodies against viruses A, B and C are most often requested. These antibodies require a delay before they appear; several blood tests are sometimes necessary.
In cases of hepatitis A, no further action is usually required. However, in the case of hepatitis B or C, regular blood tests or examinations as the liver biopsy will be proposed to ensure that hepatitis does not become chronic and active. In this case, the treatments involved in interferon as antiviral for example.
How to prepare my next appointment?
Even in the absence of symptoms after acute hepatitis B or C, it is essential to respect the prescribed blood tests. Only early detection and treatment will prevent the dreaded complications.
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