Hepatitis: understand what it is, causes and how is the treatment

What is Hepatitis?

Hepatitis is any inflammation in the liver, acute or chronic, which can be caused by viral or bacterial infections, alcohol abuse, medication, drugs, hereditary diseases and autoimmune diseases . In the case of viral hepatitis, the symptoms of the disease may appear a few days after contact with the virus and are manifested mainly through the yellowish color in the eyes and skin, whitish stools and darkened urine.

According to the World Health Organization (WHO), viral hepatitis leads to the death of about 1.4 million people each year and affects hundreds of others worldwide. The types of hepatitis vary by location, with the highest number of cases of hepatitis B in China and hepatitis C in Egypt. In Brazil, the most common types are hepatitis A, B and C, with an estimate that, in 2005 alone, about 120 thousand people contracted the disease.

Hepatitis can be cured by carrying out treatments and using appropriate medications. If the patient does not respect the doctor’s instructions, the disease can lead to complications and lead to death.

Types and causes of Hepatitis

Hepatitis can present in the acute condition, which allows the patient to recover completely after eliminating the virus from his body, or to maintain the inflammation for a period of more than 6 months, thus becoming chronic.

The causes of hepatitis vary according to the type, they are:

Viral hepatitis

Viral hepatitis are infectious diseases that affect the liver through six different viruses known to date: A (HAV), B (HBV), C (HCV), D (HDV), E (HEV) and G (VHG).

The evolution of hepatitis varies according to the virus, but only B, C and D have the potential for chronic forms.

Hepatite A (HAV)

Also known as “traveler hepatitis”, hepatitis caused by virus A (HAV) is the most common type of the disease. Its contamination occurs through the digestive tract, through water and undercooked food or contaminated by feces and by the consumption of seafood. It is more widespread in areas with poor conditions, poor basic sanitation and poor hygiene.

Its symptoms appear around 15 to 45 days and are more discreet, so they can be confused with the flu , especially in children. Hepatitis A does not evolve to a chronic form, but severe cases can occur, such as complete disruption of kidney function, a condition called fulminant hepatitis.

Hepatite B (HBV)

Hepatitis caused by the B virus (HBV) is transmitted through saliva, semen or blood. Unprotected sex, blood transfusion or sharing contaminated needles, as in tattoos, piercings and acupuncture, can trigger the disease. The virus takes around 30 to 180 days to develop.

In many cases, hepatitis B is acquired at the time of delivery, passing from the mother to the newborn. The disease can be asymptomatic, but it has a high chance of becoming chronic, which, in the long run, causes cirrhosis , liver failure and liver cancer .

Hepatite C (HCV)

Hepatitis caused by virus C (HCV) has transmission routes similar to hepatitis B, that is, through blood, sexual intercourse or contaminated secretions and artifacts. However, the main means of transmission is intravenously, unlike hepatitis B which is sexual.

Hepatitis C is usually not very symptomatic, it takes around 30 to 100 days for the virus to develop and evolves to a chronic form in most patients who do not receive an early diagnosis of the disease.

Hepatitis D (HDV)

Also called Delta hepatitis, hepatitis caused by the D virus (HDV) has the form of transmission similar to hepatitis B: through contaminated blood. The presence of the hepatitis B virus is necessary for the D to develop, either from a coinfection – infected simultaneously by both viruses – or a superinfection – carriers of the B virus that contract the D virus.

The disease takes about 45 to 180 days for the virus to develop and affects, in most cases, injecting drug users. This form of hepatitis is uncommon in Brazil.

Hepatitis E (HEV)

Transmitted in a manner similar to Hepatitis A, hepatitis caused by the E virus (HEV) occurs from the ingestion of contaminated water or food. It is common in regions with poor hygiene or lack of basic sanitation, especially after floods.

Hepatitis E is uncommon in Brazil and does not evolve to a chronic form, but, in its severe forms, it has a higher mortality in pregnant women.

Hepatite G (VHG)

Hepatitis discovered in 1995, responsible for 0.3% of cases of patients with the disease. Because it is a recent discovery, there is not much information about the virus, such as symptoms or the consequence of the infection, but it is known that the disease is transmitted by blood contact.

Inflammation in the liver caused by the VHG virus does not cause serious damage to the body, as it is usually acute and transient. It has not yet been possible to prove whether the evolution to the chronic condition leads to cases of cirrhosis or cancer in the liver.

Other types of Hepatitis

In addition to hepatitis caused by viruses, there are non-infectious hepatitis that are not transmitted by contact with other people.

Hepatitis Guide

Alcoholic Hepatitis

Alcoholic hepatitis is induced by prolonged, abusive drinking, which makes the liver swollen and inflamed. Like all chronic hepatitis, it can also progress to cirrhosis and liver failure. The chance of reaching women is higher than men, especially if you have a viral hepatitis.

Medicinal Hepatitis

Medicated hepatitis is caused by excessive or inadequate intake of medications, which makes the liver unable to metabolize toxins and inflame, causing the disease. Patients who have other liver diseases are at greater risk of contracting, so it is recommended to stop taking the drugs or to switch to others that are less aggressive.

The most common medications for the cause of this type of disease are:

  • Paracetamol;
  • Ibuprofen ;
  • Amiodarone ;
  • Isoniazid ;
  • Cholesterol-lowering drugs;
  • Erythromycin ;
  • Tetracycline ;
  • Sulfas;
  • Ketoconazole ;
  • Nitrofurantoin ;
  • Clorpromazina;
  • Methyldopa ;
  • Contraceptives;
  • Allopurinol ;
  • Optional acid ;
  • Anabolic steroids.

Autoimmune hepatitis

Autoimmune hepatitis is a genetic disease caused by the malfunction of antibodies, which attack liver cells instead of acting as a defense system against viruses, bacteria and other invaders. If left untreated, the disease can progress to chronic hepatitis and lead the patient to death in about 5 to 10 years. Women are the most affected by the disease, which can be triggered after cases of viral hepatitis.

Hepatic steatose

Liver steatosis is the accumulation of fat in the liver, as in the case of excessive alcohol consumption, diabetes , obesity , malnutrition, prolonged intravenous nutrition, high cholesterol and triglycerides and abdominal surgeries.

Certain medications can favor the development of fatty liver, such as:

  • Corticosteroids;
  • Estrogen;
  • Amiodarone;
  • Antiretrovirals;
  • Diltiazen;
  • Tamoxifen .

Ischemic hepatitis

Ischemic hepatitis occurs due to a low blood flow to the liver, such as after severe sepsis or states of advanced heart failure. The use of cocaine can also trigger this type of hepatitis, through spasms in the hepatic arteries.

Illnesses

Hepatitis can also occur due to some inherited diseases that lead to the accumulation of iron and copper in the liver, such as:

  • Hemocromatosa;
  • Wilson’s disease.

Other diseases that can trigger hepatitis:

  • Lupus;
  • Sjogren’s syndrome;
  • Cystic fibrosis ;
  • Inflammatory bowel disease;
  • Hemolytic anemia ;
  • Rheumatoid arthritis;
  • Scleroderma;
  • Glomerulonefrite.

Transmission: Is Hepatitis Contagious?

In the case of contagious hepatitis, such as hepatitis A, B, C, D and E, transmission occurs in the following ways:

  • Hygiene (hepatitis B, C and D): sharing or making use of non-sterile materials (such as razors and needles for piercings and tattoos), unprotected sex (mainly B), sharing syringes (mainly C and D);
  • Hygiene (hepatitis A and E): use of public toilets, poor hygiene, contact with feces or urine infected by the virus.
  • Food (Hepatitis A and E): ingestion of contaminated food or drink, ingestion of raw food or rare meat (mainly A).
  • Blood (Hepatitis B and, in a few cases, Hepatitis C): contact with contaminated blood. If prenatal care is not performed properly and the woman has the disease, the baby may acquire hepatitis at birth by normal delivery or by breastfeeding.

Medicinal hepatitis and autoimmune hepatitis arise with alcohol or drug abuse, autoimmune diseases or genetic predisposition, but they are not contagious.

Groups of risk

Hepatitis can affect people of both sexes and of all ages and ethnicities. There are certain situations that can weaken the organism and leave the individual exposed to acquiring the disease, such as:

  • Travelers, prone to consuming water and food from places with poor hygiene and that may be contaminated;
  • Alcoholics;
  • Individuals with an active sex life who have unprotected sex;
  • Patients who need blood transfusion or hemodialysis;
  • People with low immunity, such as patients with HIV, cancer, among others;
  • Close people, such as family and friends, with the disease;
  • Health professionals, prone to being victims of accidents with cuts;
  • Individuals who live in precarious situations and with insufficient basic sanitation;
  • Injecting drug users who share needles.

Symptoms of Hepatitis

Hepatitis can appear quickly with more intense symptoms, called acute hepatitis, or slow and less symptomatic, called chronic hepatitis.

Acute hepatitis

In acute hepatitis, symptoms may vary according to the type of disease, but initially they have similar conditions that can be mistaken for the flu , such as:

  • Fever;
  • Pain in muscles and joints;
  • Headache;
  • Sickness;
  • Vomiting;
  • Lack of appetite;
  • Weakness;
  • General ill-being;
  • Hypersensitivity to light;
  • Constant cough;
  • Coryza;

These discomforts are more frequent in cases of hepatitis A, B, D and E, and are not common in patients with hepatitis C.

In the improvement of these complaints, it is common for specific symptoms of hepatitis to arise, they are:

  • Jaundice: yellow skin and eyes;
  • Coluria: mate-colored urine;
  • Fecal acholia: clear stools.

In severe cases, the liver increases in size by making more effort to work, which leads to swelling on the right side of the belly.

The evolution of this form of the disease will depend on the following factors:

  • Alcohol consumption;
  • Consumption of some medications, so do not use any that is not indicated by your doctor.

Chronic hepatitis

Most chronic hepatitis is asymptomatic, that is, the patient has the disease, but does not show symptoms. At this stage of hepatitis, the destruction of liver cells occurs slowly, so many people take a long time to diagnose the disease. In a few cases, the individual may experience the same symptoms as acute hepatitis.

Diagnosis

When the patient has one or more symptoms, it is important to consult a hepatologist or gastroenterologist. To confirm the diagnosis, the professional will order blood tests, abdominal ultrasound, computed tomography, among others.

Physical exam

During the physical examination, it will be analyzed if there are typical symptoms, such as skin or yellow eyes. The doctor gently presses below the abdomen to see if there is pain, tenderness or if the liver is swollen.

Bloodtests

They are used to detect the presence of antibodies and antigens of the hepatitis virus in the blood. For the identification of the disease, the following exams are usually used:

  • AST.
  • ALT.

Viral antibody testing

It may be necessary for the patient to perform further viral antibody tests to determine the specific type of viral hepatitis.

Liver biopsy

Characterized by the removal of a small fragment of the liver with a needle, the test allows the doctor to determine if there is infection or inflammation present in the organ. It is performed mainly to observe the situation of liver damage in patients with chronic hepatitis, that is, those who have been suffering from the disease for more than six months.

Liver function tests

Liver function tests use blood samples to determine the efficiency of the liver in its basic functions, such as cleaning up waste of blood, proteins and enzymes. Elevated levels of liver enzymes can indicate that the liver is damaged.

Abdominal ultrasound

The test uses ultrasound waves to view the organs inside the abdomen and check for fluid buildup or liver damage.

Hepatitis treatment and cure

Some hepatitis can show similar causes and symptoms, but they differ in the form of contagion, therefore, they present different treatments. However, in all cases it is recommended to rest, hydrate, only use medications under medical prescription, interrupt alcohol consumption and eat a balanced and low-fat diet. Treatment should not be interrupted without the professional’s instruction.

Hepatitis A

This type of viral hepatitis does not evolve and does not consist of a specific treatment other than rest and hydration. Following these guidelines, the disease will heal within a few weeks. There are vaccines for the prevention of virus A, which is available for both children and adults.

Hepatite B

In its acute type, it does not require specific treatment and will heal in a few weeks. However, chronic hepatitis B can drag on for months or years, so it is treated with antiviral drugs, especially interferon alfa. The vaccine for the prevention of virus B is indicated for all newborns and recommended for health professionals who deal directly with the virus. Treatment will require prolonged medical monitoring to ensure that the disease does not progress.

Hepatitis C

Antiviral drugs are used to treat both acute and chronic forms of hepatitis C. Treatment is usually prolonged with the combination of alpha interferon and ribavirin . Hepatitis C does not have a vaccine available, but patients can achieve a cure by following the instructions of doctors.

Hepatitis D

So far, there are no specific treatments for hepatitis D, but some patients have shown results when being medicated with alpha interferon. There are chances of the disease coming back even after treatment.

Hepatitis E

There are no specific treatments, but patients are advised to perform rest, hydration, nutrient diets and avoid alcoholic beverages. The virus does not evolve and will heal itself within a few weeks.

Autoimmune hepatitis

Treatment is done with corticosteroids and azathioprine .

Alcoholic and medication hepatitis

Stopping the use of harmful substances until the disease is completely cured is the best way to treat it. Treatment is also composed of other measures, such as nutrition and hydration, for withdrawal symptoms.

Phytotherapy

Phytotherapy is a complementary measure that can help improve the state of the liver, using the following medicinal plants with a positive effect in cases of hepatitis:

  • Milk thistle.
  • Artichoke.

Homeopathy

In cases of Hepatitis A, it is possible to associate rest with homeopathic remedies individually prescribed in consultations with homeopaths, which will take into account the symptoms of each patient. Some of the medications used include:

  • Phosphorus triiodatus 7 CH;
  • Phosphorus 200 CH;
  • Phosphorus triidodatus 5 CH + Lycopodium clavatum 5 CH;
  • Nux vomica 5 CH;
  • Bryonia alba 5CH;
  • Berberis vulgaris 4 CH;
  • Papaver compound.

Medicines

In some cases, professionals may prescribe the use of the following medications:

  • Interferon;
  • Lamivudine ;
  • Entecavir;
  • Epocler;
  • Prednisone .

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Complications

If the patient neglects his doctor’s instructions, the disease can lead to complications and make it difficult to cure. Hepatitis is usually acute, but it can become chronic if it lasts more than six months, especially in the case of viral hepatitis B and C. Patients infected with the B virus have a 5% to 10% chance of progressing to chronic diseases, while in virus C the risk is 85%.

Severe cases may require hospitalization to control the disease, so the early diagnosis and treatment of hepatitis can prevent progression to cirrhosis, liver failure or even liver cancer. If the disease progresses, a liver transplant or treatments with radiotherapy and chemotherapy may be necessary.

When there is liver failure, other complications can also occur:

  • Hemorrhagic disorders;
  • Accumulation of fluid in the abdomen;
  • Renal failure;
  • Hepatic encephalopathy, which can lead to fatigue, memory loss and reduced mental abilities due to the accumulation of toxins that affect the brain.

Other complications include glomerulonephritis, a kidney disease caused by the Hepatitis B virus, and cryoglobulinemia, a rare vascular disease caused by the Hepatitis C virus.

Prevention and coexistence

The main guidelines for preventing and living with contagious hepatitis involve hygiene, such as:

  • Wash your hands after going to the bathroom and before eating;
  • Wash food well before eating it;
  • Drink treated or boiled water;
  • Do not swim in places with contaminated water and use disinfectants in swimming pools;
  • Use condoms;
  • Do not share syringes, needles and sharp objects;
  • Health professionals should wear gloves, glasses and masks when contacting patients infected with viral hepatitis;
  • Make use of properly sterilized materials.

In addition to the above guidelines, it is recommended to take vaccines against hepatitis A and B to keep your body protected. High doses of alcohol should also be avoided, preferring moderate consumption. Until then, there are no known ways to prevent autoimmune hepatitis or drugs.


In order not to run the risk of the disease evolving and becoming chronic, it is important to go to the doctor and carry out the necessary vaccines and routine tests that detect hepatitis. Also help your friends and family by sharing this article so they know the risks of the disease and how to prevent it!

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