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Hepatitis

Hepatitis occurs when the liver becomes inflamed. This is due to a variety of factors, but in the case of hepatitis A, B, C, D, and E, it is caused by viral infections, and is known as viral hepatitis. Although hepatitis A and hepatitis B are both preventable with a vaccine in most countries, 1.9 million people are infected with long-term cases of hepatitis B in South Africa.

Viral hepatitis can be sexually transmitted. However, hepatitis A is also transmitted by contaminated water or food, hepatitis B and C are also transmitted through infected blood and hepatitis E is transmitted through contaminated water and undercooked meat.

Symptoms

Symptoms of viral hepatitis can be similar between hepatitis A, B, C, D, and E.  There are some common symptoms between all viral forms of hepatitis, acute and chronic, including weakness and fatigue, lack of appetite, dark urine, and yellowing of the eyes and skin.

Symptoms of hepatitis A include:

  • Nausea, vomiting, and diarrhoea
  • Abdominal pain, especially on the upper right side of the stomach – this is where your liver is
  • Light-coloured stool
  • Fever
  • Itching
  • Joint pain

Symptoms of hepatitis B include:

  • Abdominal pain
  • Fever
  • Joint pain
  • Nausea and vomiting

Symptoms of long-term hepatitis B include:

  • Muscle pain
  • Nausea, diarrhoea, and vomiting
  • Cough
  • Fever
  • Abdominal pain
  • Light-coloured stool
  • Itchy skin

Symptoms of hepatitis C include:

  • Bleeding and bruising easily
  • Itching
  • Build-up of fluid in the abdomen
  • Weight loss
  • Leg swelling
  • Sleepiness, confusion, and slurred speech
  • Webbing of blood vessels

Symptoms of acute hepatitis D include:

  • Pain in the upper right part of the stomach
  • Light-coloured stool

Symptoms of long-term hepatitis D include:

  • Swelling of the abdomen and ankles
  • Weight loss
  • Itchy skin

Symptoms of hepatitis E include:

  • Nausea and vomiting
  • Pain in the upper right part of the stomach
  • Light-coloured stool

Causes & Risk Factors

The cause of hepatitis A, B, C, D, or E is the corresponding virus. For example, the hepatitis A virus causes hepatitis A, and the hepatitis B virus causes hepatitis B.

A risk factors for every form of viral hepatitis is being a man who has sex with men and/or having sex with someone who is positive for viral hepatitis. Other risk factors for hepatitis A include:

  • Travel or work in parts of the world where hepatitis A is common
  • Living with someone who has hepatitis A
  • Experiencing homelessness
  • HIV positive diagnosis
  • Use of recreational drugs

Other risk factors for hepatitis B include:

  • Sharing needles
  • Being born to a mother with the disease
  • Working in a healthcare setting
  • Travel to regions with high rates of hepatitis B

Other risk factors for hepatitis C include:

  • Working in healthcare
  • Inhaling or injecting illegal drugs
  • Blood transfusion & organ transplants before 1992
  • Diagnosis of HIV
  • Unclean piercing
  • Being in prison
  • Being the biological child of a woman with hepatitis C
  • Born between 1945 and 1965

Other risk factors for hepatitis D include:

  • Injecting drugs
  • Haemophilia
  • Healthcare workers
  • Having a biological mother with hepatitis D
  • Being a haemodialysis patient

Other risk factors for hepatitis E include:

  • Older age
  • Living or travelling in countries with poor sanitation

Diagnosis & Complications

A doctor will diagnose all forms of viral hepatitis with a medical history, physical examination, and blood tests. Blood tests can provide a definitive diagnosis of one of the types of viral hepatitis.

Common complications from viral hepatitis include liver damage, liver failure, cirrhosis (scarring of the liver that reduces its ability to function), and increased risk of liver cancer.

Treatment & Management

Treatment is different for every form of viral hepatitis. Hepatitis A usually requires rest and no other additional treatments. Hepatitis B is treated with antiviral medications and in severe cases a liver transplant. Treatment for hepatitis B and C are the same.

There is promising new immunotherapy treatment for hepatitis B that may eliminate the need for long term medication. Hepatitis D is treated with medication to control the symptoms of the infection and potentially a liver transplant depending on the severity of the case. Hepatitis E is treated with rest. The virus is expected to clear the body on its own. If it doesn’t, and develops into a long-term infection, then doctors will use immunotherapy treatments or medications to treat the symptoms.

 
 
 

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