Hepatitis

Hepatitis refers to inflammation of liver and is commonly due to viral infection.

Currently five viruses are known to primarily affect the liver. They are named from A to E.

Of them D is an incomplete virus and can cause significant disease only in association with B virus.

Both B and C viruses are known to cause chronic liver disease, cirrhosis and even cancer of the liver.

Hepatitis A

Viral infection of liver caused by A virus is a common liver disease. The virus is transmitted by fecal oral route and can cause epidemics. The disease is more prevalent in developing countries.

Symptoms and signs: There may be history of contact with an infected individual. The incubation period varies from 15-40 days. The initial manifestations are nonspecific and consist of fever, abdominal pain, vomiting and loss of appetite.

Jaundice may not be detected clinically at this stage (Anicteric stage). The urine turns dark yellow in color. Later jaundice appears (yellowish discoloration of the sclera of the eye). Jaundice reaches its peak in 1-2 weeks and then starts subsiding.

At the height of jaundice the stools become pale in color because obstruction within the liver decreases the amount of bilirubin in intestine which is responsible for the normal color of stool. The liver is enlarged and is tender to touch.

Laboratory investigations: Liver enzymes are elevated. Serum bilirubin is raised. Antibody to Hepatitis A virus can be detected usually after the first week of onset of symptoms.

Treatment: There is no specific treatment. It is imperative to minimize the use of drugs as most are metabolized in liver.

Paracetamol which is used to treat fever is a relatively safe drug. But if given to a patient having liver problems it can cause considerable damage. Sedatives and corticosteroids can also be harmful. Fat intake should be reduced.

Herbal remedies have been used for liver disorders for a very long time. Recent studies have shown that they are helpful is treating liver disease, both viral and drug induced.

Prognosis: In general prognosis is excellent. Complete recovery can be expected without any long term problems.

Rarely the damage to liver can be extensive resulting in a condition called massive hepatic necrosis. This can lead to coma and death. Liver transplant has been tried in this situation.

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