Hepatitis
Hepatitis is a disease that has symptoms in the form of inflammation of the liver. This condition can occur due to viral infections, alcohol consumption, exposure to toxic substances or certain drugs.
The types are divided into two based on their nature, namely acute and chronic. The acute type can occur suddenly in a relatively short period of time.
While chronic develops slowly and is a long-term condition. Unfortunately, both disrupt various body functions, especially those related to metabolism.
This happens because the liver plays an important role in the body’s metabolism, such as producing bile, breaking down various substances, neutralizing toxins, activating enzymes and so on.
What Are the First Symptoms of Hepatitis?
This disease does not always show symptoms. Symptoms only appear after the body has suffered damage that can affect liver function.
If it is acute, signs and symptoms can appear quickly.
There are a number of symptoms that generally occur in sufferers of this disease, namely:
- Experiencing flu-like symptoms, nausea, vomiting, fever, and weakness.
- Pale colored stools.
- Eyes and skin turn yellowish.
- Pain in the stomach.
- Lose weight.
- Urine becomes dark like tea.
- Loss of appetite.
Important Facts About Hepatitis
1. Hepatitis can be spread in various ways.
2. Hepatitis B can become a chronic disease.
3. Hepatitis E is common in developing countries due to poor sanitation and is spread through water contamination.
4. Hepatitis A can be cured without special treatment.
5. Hepatitis D can only occur in people who are infected with hepatitis B.
What Causes Hepatitis?
The cause of hepatitis can occur due to infection or not due to infection. There are types of viruses that you should be aware of, such as:
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Hepatitis A
This type is caused by the hepatitis A virus (HAV). It can be transmitted through food or drinking water contaminated with feces from sufferers.
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Hepatitis B
The cause of hepatitis B is the hepatitis B virus (HBV). This type is generally transmitted through bodily fluids from sufferers, such as blood, vaginal fluid, and semen.
Transmission of this disease can also occur through the birth process.
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Hepatitis C
This type occurs due to infection with the hepatitis C virus (HCV). Body fluids, especially through sharing needles and unprotected sex, can transmit this disease.
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Hepatitis D
The cause of hepatitis D is infection with the hepatitis D virus (HDV). The virus cannot reproduce in the human body without the presence of hepatitis B.
Diseases can be transmitted through blood and other bodily fluids.
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Hepatitis E
The cause of this type is the hepatitis E virus (HEV). This type often occurs in environments that do not have good sanitation, due to virus contamination in water sources.
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Autoimmune hepatitis
In some cases, the immune system can mistake the liver for a dangerous organ and attack it.
This causes ongoing inflammation that can range from mild to severe, and often inhibits liver function.
This disease is more likely to occur in women than men.
The cause of this disease is not clear. However, the condition is more likely to occur in people with other autoimmune conditions, such as thyroiditis, type 1 diabetes, hemolytic anemia, celiac disease, and ulcerative colitis.
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Neonatal hepatitis
Neonatal hepatitis is an inflammation of the liver that occurs only in early infancy, usually between one and two months after birth.
Quoting Johns Hopkins Medicine, around 20 percent of babies with this condition are infected by a virus that causes inflammation before birth that is transmitted from their mother.
Conditions that can occur after a baby is born also include cytomegalovirus, rubella (measles), and hepatitis A, B, or C viruses.
Meanwhile, in most other cases, the virus cannot be specifically identified as the cause.
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Alcoholic hepatitis
Excessive alcohol consumption can cause liver damage and inflammation.
This condition is also called alcoholic hepatitis. You need to know that alcohol can directly injure liver cells.
Over time, the damage can become permanent, leading to thickening or scarring of the liver tissue (cirrhosis) and liver failure.
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Toxic hepatitis
The cause of this disease is the use of certain drugs in excess of the dose.
As a result, the liver becomes inflamed or damaged due to working too hard to break down the drugs you take.
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Hepatitis due to liver flukes
This disease can also occur due to liver fluke infection, namely opisthorchiidae and fasciolidae.
Liver fluke infection can infect someone if they frequently consume raw or undercooked food, as well as consuming food contaminated with liver fluke larvae.
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Mysterious acute hepatitis
The cause of this disease is not clear, so another name is mysterious acute hepatitis.
However, experts suspect that this disease is related to Adenovirus and SARS-CoV-2. Children aged 1 month to 16 years are a vulnerable group to experience it.
Hepatitis Risk Factors
There are several factors that can increase a person’s risk of experiencing hepatitis symptoms, namely:
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Environmental Factors
Examples of environmental factors that can cause or trigger this disease include:
- Water that is not suitable for drinking or for washing eating utensils.
- Lack of sanitation facilities; Bathrooms or hand washing facilities.
- Contact with used needles, syringes, or other objects contaminated with infected blood.
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Lifestyle
There are several behaviors or activities that have the potential to expose you to viruses, toxic chemicals, or substances that cause this disease, namely:
- Sharing needles or other objects.
- Having unsafe sex; Not using condoms during sex or having multiple partners.
- Working around toxic chemicals. Janitors, painters, health care providers, or farm workers are all at risk of contracting the disease.
- Drinking unboiled water or eating food that has not been safely and properly prepared.
- Excessive alcohol consumption over a long period of time.
- Take medications associated with this condition.
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Health History
A person’s medical history can also affect whether they develop the disease. Here are some things that can increase the risk of this condition:
- Not yet vaccinated.
- Having an acute or chronic infection with one or more viruses.
- Have an autoimmune disorder.
- Born to a mother infected with the hepatitis B virus.
What Do Studies Say About Hepatitis?
According to a study in StatPearls titled Hepatitis (2024), general management of acute viral hepatitis is supportive and most individuals can be safely monitored in an outpatient setting.
The most important thing is to prevent transmission of hepatitis to those who have close contact with the patient. For patients who experience significant nausea or vomiting, and patients who are at high risk of dehydration, should be treated with intravenous hydration.
Since hepatitis can develop into serious complications such as liver abscess or acute liver failure, hospitalization and proper management of the disease are necessary. For patients diagnosed with hepatitis, immediate referral to specialist services such as gastroenterology or hepatology is needed.
Diagnosis of Hepatitis
The first step in diagnosing this condition is to ask about the history of the onset of hepatitis symptoms and look for risk factors in the sufferer.
After that, a physical examination is necessary to find signs or physical abnormalities that appear in the sufferer.
For example, by pressing on the abdomen to look for an enlarged liver or examining the skin and eyes for yellow discoloration.
Some other tests you can do to diagnose this condition include:
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Liver function test
This test uses a blood sample to determine how efficiently the liver is performing its functions.
The results of this liver function test can be an indication of a problem.
Especially if there are no symptoms during a physical exam. When liver enzyme levels are high, it means the organ is under stress, damaged, or problematic.
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Blood test
If the liver is not working as it should, the doctor may perform blood tests to detect the source of the problem.
This method can check for viruses in the blood. It can also detect the body’s antibody conditions that can cause autoimmune hepatitis.
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USG
Ultrasonography examination uses ultrasonic waves to see the condition of the liver through images.
This test allows the doctor to examine the liver and surrounding organs, such as liver damage, liver tumors, and gallbladder abnormalities.
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Liver biopsy
This procedure involves taking a tissue sample from the liver. The sample determines whether there is any infection or inflammation in the liver.
This can also be used to sample abnormal or problematic areas of the liver.
Hepatitis Treatment
In general, acute hepatitis A, B, and E rarely require specific treatment.
If done, treatment will focus on relieving the symptoms of hepatitis that appear (such as nausea, vomiting and abdominal pain).
Administration of medication must also be done with caution, because the sufferer’s liver function is impaired.
Here are some treatment options according to the type and condition:
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Antiviral drugs
If the disease is chronic, the doctor will prescribe antiviral drugs with the aim of inhibiting the growth of the virus.
In addition, antiviral drugs can prevent further liver damage.
Doctors will usually prescribe antiviral drugs such as entecavir, ribavirin, or tenofovir.
These drugs are useful for people with chronic hepatitis B or C.
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Immunosuppressant drugs
If the disease occurs due to an autoimmune condition, then treatment can use immunosuppressant drugs.
Especially those in the corticosteroid group, such as prednisone and budesonide.
In addition, the doctor may prescribe the drugs azathioprine, mycophenolate, tacrolimus, and cyclosporin.
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Interferon drugs
This drug also aims to stop the spread of the virus and prevent liver damage from getting worse.
Doctors usually prescribe interferon medication by injection every week for 6 months.
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Liver worm medicine
If this disease occurs due to liver flukes, then the medication the doctor prescribes will be according to the type of worm that is infecting.
for example, the drugs praziquantel or albendazole to kill clonorchiasis worms.
Meanwhile, if the infection occurs due to fasciolosis worms, the doctor will prescribe the drugs triclabendazole and possibly nitazoxanide.
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Liver transplant
If liver damage is very severe, the doctor may recommend a liver transplant procedure.
This procedure will replace the sufferer’s liver with a healthy liver from a donor.
Hepatitis Prevention
There are several ways you can do to prevent or reduce the risk of contracting this disease.
However, all of this depends on the type of disease that attacks.
For example, make sure not to consume too much or reduce your alcohol consumption.
Here are some ways you can prevent this condition:
- Get vaccinated. There are now vaccines that can prevent hepatitis A and B, but there is no vaccine for hepatitis C.
- Reduce alcohol consumption.
- Maintain cleanliness of water sources.
- Wash the food you consume, especially shellfish and oysters, vegetables, and fruits.
- Do not share toothbrushes, razors, or needles with others.
- Do not touch blood without protective gloves.
- Having safe sex. For example, using condoms or not changing partners (being faithful to one partner).
Complications of Hepatitis
Each type has a different level of severity. However, whatever the type, if you leave it untreated, hepatitis symptoms can trigger various complications, including:
- Liver fibrosis, a condition where the liver is filled with scar tissue so that it can no longer function properly.
- Cirrhosis of the liver, is an advanced stage of fibrosis.
- Liver cancer, can occur as a complication of cirrhosis.
- Liver failure. Although this complication is rare, liver failure is a serious condition that can be fatal.
- Glomerulonephritis, a kidney disorder that occurs due to inflammation that is often related to an immune response.
- Cryoglobulinemia, a rare disease that occurs when a group of abnormal proteins clog small blood vessels.
- Hepatic Encephalopathy. Severe loss of liver function, such as liver failure, can cause inflammation of the brain, called encephalopathy.
- Portal hypertension occurs when the liver’s portal circulation system becomes blocked due to cirrhosis and other problems.
- Porphyria, is a rare complication of chronic hepatitis C infection.
- Viral coinfection, which is when there are two viral infections at the same time.
