Hepatitis: causes, symptoms, diagnosis and treatment

The liver is the most important metabolic organ and has many tasks. The liver can become inflamed: hepatitis. Liver inflammation can be acute or chronic. What are the causes and symptoms of the different forms of viral hepatitis (A, B, C, D and E)? How is the diagnosis made and what options are there to treat liver inflammation?

Article content

  • Liver
  • Acute and chronic hepatitis
  • Acute hepatitis and the different viruses
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis D
  • Hepatitis E
  • The symptoms/signs
  • Diagnosis
  • The treatment
  • The prognosis
  • Prevent

 

Liver

The liver is the most important metabolic organ. The organ is located in the upper right part of the abdomen, under the diaphragm and behind the ribs. The liver has several tasks. Almost all substances absorbed through the intestinal wall reach the liver via the portal vein. The liver also plays a central role in carbohydrate, protein and fat metabolism. Furthermore, the liver has a detoxification function. Various foreign and endogenous substances, such as medicines and alcohol, are broken down in the liver. The liver delivers waste products to the gallbladder through the bile ducts. The liver also makes all kinds of substances such as blood proteins and stores substances such as glucose in the form of glycogen. A common condition is liver inflammation or hepatitis.

Acute and chronic hepatitis

Liver inflammation can be acute or chronic. Acute hepatitis is a sudden, short-term inflammation of the liver with various causes. The most common cause is infection with one of the different hepatitis viruses. Chronic hepatitis is an inflammation of the liver due to various causes that lasts longer than six months.

Acute hepatitis and the different viruses

Until the late 1980s (last century), two of these viruses were known: hepatitis A and hepatitis B. Now hepatitis C, D and E are also known. They can all cause acute hepatitis and also have many common symptoms. The differences lie in the method of spread and the long-term consequences. In addition to these viruses, acute hepatitis can also be caused by infection with some bacteria, some parasites and other (non-hepatitis) viruses (such as the Epstein-Barr virus). The condition can also be caused by some medications or by alcohol, poisonous mushrooms. Sometimes hepatitis occurs during pregnancy, the cause of this is still unknown.

Hepatitis A

Sometimes there are no symptoms at all with hepatitis A. Or they are so minimal that a doctor does not suspect hepatitis A. The hepatitis A virus can be detected in the urine and feces of people who are infected. It can be passed on to others through contaminated food or water. The time between infection and the appearance of symptoms is a maximum of six weeks for hepatitis A.

Hepatitis B

If someone has the hepatitis B virus, they can spread it through body fluids. It can be caused by sexual intercourse, several people using the same injection needle, in developing countries it happens that mothers pass it on to the newborns at birth. Previously, blood transfusions were a source of contamination, but now the blood is tested.

Hepatitis C

The virus is usually spread through the blood. Often among drug users who share their needles. Spread can also occur through sexual intercourse. The blood used for blood transfusions is tested for the virus.

Hepatitis D

Infection with the hepatitis D virus can only occur in people who have hepatitis B. Spread takes place via body fluids. Hepatitis D is rare in the Netherlands, in contrast to Italy, the Middle East, Africa and South America.

Hepatitis E

Infection with hepatitis E is rare in developed countries. It is released in the feces of persons who are infected. The method of spread is similar to that of the hepatitis A virus.

The symptoms/signs

Some people have no complaints at all or they are so mild that they are not noticed. If a viral infection is the cause of acute hepatitis, the time between infection and the appearance of symptoms can vary considerably. A maximum of six weeks for hepatitis A and up to six months for hepatitis B. Someone who has no symptoms may be a carrier!

Symptoms

  • A tired feeling;
  • Not feeling hungry;
  • A feeling of nausea, vomiting;
  • An increased body temperature;
  • Abdominal pain (upper right).
  • Sometimes a few days after these symptoms: the whites of the eyes and the skin turn yellow (jaundice);
  • After the jaundice breaks, the other complaints usually diminish;
  • The stool may change color slightly: a lighter color;
  • Itching may occur all over the body;
  • Hepatitis B can be associated with painful joints;
  • Liver failure can occur with severe hepatitis, a person can become confused or sometimes fall into a coma.

 

Diagnosis

If the doctor thinks there is hepatitis, blood tests will be done. The liver function is determined and an attempt will be made to determine the cause. To see whether healing has started, another blood test can be done. If a diagnosis is not possible, an ultrasound scan and sometimes a liver biopsy can be performed. A piece of liver is then removed and examined under a microscope.

The treatment

There is usually no treatment for acute hepatitis; you will be advised to rest. Always consult with a doctor before taking any painkillers, as there is a risk of side effects. Furthermore, it is important that if you have a viral infection, you must take measures to prevent the spread. Consider safe sex, for example. Do not consume alcohol during the illness and at least three months (consult your GP) after recovery. If excessive alcohol consumption is the cause, you will be advised not to drink alcohol at all.

The prognosis

About three out of four people with hepatitis C and one out of twenty people with hepatitis B or D will have chronic hepatitis. If acute hepatitis is not caused by a virus but by another microorganism, a person usually recovers completely. If hepatitis is caused by alcohol, medications or other harmful substances, recovery depends on the severity of the damage to the liver. If hepatitis leads to liver failure, which fortunately is rare, a liver transplant may be necessary.

Prevent

You can prevent hepatitis in various ways.

  • Hepatitis A and hepatitis E can be prevented by good hygiene.
  • The risk of hepatitis A, B, C and D can be reduced by having safe sex and not sharing needles or other items that may contain contaminated bodily fluid
  • Babies are vaccinated against hepatitis B (injection programme).
  • Vaccination against hepatitis A is recommended for people who are at risk of the disease, for example if someone goes to a developing country or goes on holiday to a country where the virus is common such as Egypt and Turkey.
  • Blood at the blood bank is tested for hepatitis viruses B and C to prevent the transmission of hepatitis through blood transfusion.
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