Health: Viral Hepatitis

Viral hepatitis is an infection affecting the liver and causing chronic long term damage to the organ. Greater awareness needs to be generated among masses regarding this preventable disease. Viral hepatitis is a chronic infection of the liver by viruses which are of 5 types characterized as A, B, C, D and E. Hepatitis means inflammation of liver cells, and being caused by a virus it is named viral hepatitis. The illness is manifested by jaundice (yellow discoloration of eyes) which is a characteristic sign of infection of the liver. The patient also has complaints of passing yellow colored urine. There is also loss of appetite, nausea, vomiting, low grade fever, malaise, e.t.c. in variable degrees. At times there may be obstruction to flow of bile due to swelling of liver cells which causes intense itching. As the disease progresses, there is further damage to liver cells, leading to cirrhosis, where liver tissue is replaced by fibrous tissue, causing further derangement of liver function. There can be swelling all over the body including the stomach, due to retention of water and salt. The person may have vomiting of blood or pass blood in stools. With further damage to liver cells, liver failure sets in, which is invariably fatal. Kidney failure can also occur thus causing the patient to die due to many causes. Cancer of the liver is a long term complication of cirrhosis which can occur if the patient survives the extensive injury of the liver cells. The liver is a vital organ of the body. Proteins, factors needed for clotting of blood and glucose are produced in the liver. It also helps in metabolism of fats and many other substances. Therefore damage to the liver leads to derangement in many functions of the body. With the pandemic of AIDS worldwide, it is important to know about viral hepatitis, because except for Hepatitis A and E, all other types of hepatitis are caused by the same behavior pattern and risk factors as AIDS. Sexual promiscuity, pricks by unsterlised needles and razors, accidental contamination with blood, all these are the underlying causes for hepatitis as well as AIDS. Presence of one facilitates the acquisition of the other. Hepatitis A is acquired by ingestion of food or water contaminated with the faeces of an infected person. Outbreaks can occur due to contaminated water. The illness caused is benign and good recovery mostly occurs. But if there is extensive liver cell injury, it can lead to acute liver failure. Hepatitis B and C are spread by use of contaminated syringes and needles and also through sexual intercourse. Hepatitis D or delta virus is acquired by the same routes as Hepatitis B. A person suffering from both Hepatitis B and D infections is at the risk of developing more serious form of disease. Hepatitis E infection occurs by the faeco- oral route like Hepatitis A but tends to cause more severe and chronic form of liver disease. Use of hepatotoxic substances (those that damage the liver) like alcohol or pain killer drugs make one more prone to develop severe illness and complications due to viral hepatitis. Diagnosis of hepatitis is established by serological tests. Once diagnosis is confirmed, antiviral drugs can be used, but are useful only when used early, ideally within 2 to 3 days of illness. Other drugs used for treatment only provide some symptomatic relief, but do little to minimize the damage done. Once part of the liver is injured, complications invariably follow in more or less amount. Sometimes the patient may apparently recover after the attack but complications like chronic hepatitis may develop after many years. Preventive vaccines are currently available only for Hepatitis A and B infections. Therefore it is prudent to prevent the disease. Good food hygiene if maintained while cooking, serving and eating minimizes the chances of infection with Hepatitis A and E. Avoiding promiscuous and premarital sex is a good measure to avoid viral hepatitis B, C and D. One should be vigilant while taking haircuts, pedicures, injections e.t.c. to avoid acquiring hepatitis B. The author is a specialist in Internal Medicine. She’s based in Musanze, Northern Province. E-mail – rachna212002@yahoo.co.uk