HEPATITIS, VIRAL

General Information

DEFINITION--Inflammation of the liver caused by a virus. Hepatitis has several forms. The most common are type A (infectious hepatitis) and type B (serum hepatitis). Other types include hepatitis C, D and E.

BODY PARTS INVOLVED--Liver.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Early stages:

• Flulike symptoms, such as fever, fatigue, nausea, vomiting, diarrhea and loss of appetite.

Several days later:

• Jaundice (yellow eyes and skin) caused by a buildup of bile in the blood.
• Dark urine from bile spilling into the urine.
• Light, "clay-colored" or whitish stools.

CAUSES

> Types A and E: The virus usually enters the body through water or food, especially raw shellfish, that has been contaminated by sewage (fecal-oral contact). This type can occur in epidemics.

> Type B: Usually sexually transmitted (contact with body fluids of an infected person), through blood transfusions contaminated with the virus, or from injections with non-sterile needles or syringes. An infected mother can pass it to her newborn.

Some cases appear sporadically.

> Type C: Usually transmitted through intravenous drug use, blood transfusions and other exposures from contaminated blood or its products. In 40% of the cases, mode of transmission is unknown.

> Type D: Always associated with an infection of hepatitis type B.

RISK INCREASES WITH

• Travel to areas with poor sanitation.
• Oral-anal sexual practices.
• Use of intravenous, mind-altering drugs.
• Alcoholism; blood transfusions.
• Hospital workers; day-care centers or residential programs; kidney-dialysis treatment; poor nutrition; illness that has lowered resistance.

HOW TO PREVENT

• If you are exposed to someone with hepatitis, consult your doctor about receiving gamma-globulin injections to prevent or decrease risk.
• If you are in a high-risk group, such as hospital workers, dentists, dental workers, male homosexuals, sexually promiscuous men and women, or intravenous drug abusers, consider vaccination for Type-B hepatitis. Vaccines are under development for other forms.
• Routine hepatitis B vaccination for all newborn infants.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood tests to identify infection, liver function studies, liver biopsy in severe or chronic cases.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization in severe cases to prevent dehydration.

POSSIBLE COMPLICATIONS

• Liver failure, cirrhosis of the liver, liver cancer, even death.
• Chronic hepatitis. These patients are carriers and potentially infectious to household and sexual contacts.These people may look and feel well and not know they are infected.

PROBABLE OUTCOME--Jaundice and other symptoms peak and then gradually disappear over 3 to 16 weeks. Most people in good general health recover fully in 1 to 4 months. A small percentage proceed to chronic hepatitis. Recovery from viral hepatitis usually provides permanent immunity against it.

How To Treat

GENERAL MEASURES--

• Most persons with hepatitis can be cared for at home without undue risk. Strict isolation is not necessary, but the ill person should have separate eating and drinking utensils, or use disposable ones.
• If you have hepatitis or are caring for someone with it, wash your hands carefully.

MEDICATION--There is no specific medicine to treat hepatitis. Cortisone drugs may be prescribed for severe cases to reduce liver inflammation. Chronic hepatitis C may be treated with alpha-interferon.

ACTIVITY--Bed rest is necessary until jaundice disappears and appetite returns.

DIET--Despite poor appetite, small well-balanced meals help promote recovery. At least 8 glasses of water are necessary each day. Don't drink alcohol.

Call Your Doctor If

• You have symptoms of hepatitis, or have been exposed to someone who has it.
• The following occurs during treatment: Increasing loss of appetite. Excessive drowsiness or mental confusion. Vomiting, diarrhea or abdominal pain. Deepening jaundice; skin rash or itching.