What are the different types of hepatitis. How is hepatitis diagnosed. What are the common symptoms of hepatitis. How is hepatitis treated. Can hepatitis be prevented. What causes hepatitis. When should you seek medical help for hepatitis.

What is Hepatitis and Its Various Forms?

Hepatitis is a general term used to describe inflammation of the liver. This condition can be caused by various factors, including viruses, chemicals, drugs, alcohol, certain genetic disorders, or an overactive immune system that mistakenly attacks the liver (autoimmune hepatitis). Hepatitis can manifest in two primary forms:

• Acute hepatitis: This form flares up suddenly and then goes away
• Chronic hepatitis: A long-term condition that typically produces more subtle symptoms and progressive liver damage

There are five main types of viral hepatitis, each caused by a different virus:

1. Hepatitis A
2. Hepatitis B
3. Hepatitis C
4. Hepatitis D
5. Hepatitis E

Hepatitis A: The Food-Borne Illness

Hepatitis A is primarily a food-borne illness that can be spread through contaminated water and unwashed food. It is the easiest to transmit, especially in children, but is also the least likely to cause severe liver damage. In most cases, hepatitis A is mild and resolves completely within six months.

Hepatitis B: A Potentially Chronic Condition

Hepatitis B can be transmitted through exposure to contaminated blood, needles, syringes, or bodily fluids, as well as from mother to baby. It is a chronic disorder that may lead to long-term liver damage, liver cancer, and cirrhosis of the liver after many years of carrying the virus.

Hepatitis C: Blood-Borne Transmission

Hepatitis C is only transmitted through infected blood or from mother to newborn during childbirth. Like hepatitis B, it can lead to liver cancer and cirrhosis in the long term.

Hepatitis D: A Co-Infection

Hepatitis D is unique in that it is only found in people who are also infected with hepatitis B. This co-infection can complicate the treatment and prognosis of hepatitis B.

Hepatitis E: Geographically Limited

Hepatitis E is predominantly found in Africa, Asia, and South America. It is less common in developed countries but can be a serious concern for travelers to endemic regions.

What Are the Common Symptoms of Hepatitis?

Hepatitis can present with a range of symptoms, which may vary depending on the type and severity of the infection. Some common symptoms include:

• Malaise (general feeling of discomfort or illness)
• Abdominal tenderness, especially in the upper right corner
• Fatigue
• Jaundice (yellowing of the skin and the white portion of the eyes)
• Dark-colored urine
• Lightly colored stools
• Abdominal pain
• Nausea with or without vomiting
• Abdominal swelling due to fluid retention

Do these symptoms always indicate hepatitis? While these symptoms can be indicative of hepatitis, they may also be associated with other liver or gastrointestinal conditions. It’s essential to consult a healthcare professional for an accurate diagnosis.

How is Hepatitis Diagnosed?

Diagnosing hepatitis typically involves a combination of physical examination, laboratory tests, and imaging studies. The diagnostic process may include:

1. Physical exam: This may reveal a swollen, enlarged liver, although it’s not always detectable through physical examination alone.
2. Blood tests: These are crucial for checking liver enzymes, which are typically elevated when the liver is damaged or infected. Blood tests can also detect the presence of any of the five viruses causing hepatitis.
3. Ultrasound of the liver: This imaging technique can help detect any changes in the liver’s structure or size.
4. Liver biopsy: In some cases, a liver biopsy may be necessary to confirm suspected inflammation when other tests are inconclusive and to determine the exact degree of liver damage.

Is a liver biopsy always necessary for diagnosing hepatitis? Not always. While a liver biopsy can provide definitive information about the extent of liver damage, it’s often reserved for cases where other diagnostic methods have been inconclusive or when more detailed information about liver health is needed.

What Are the Treatment Options for Hepatitis?

Currently, there is no cure for hepatitis once it occurs. However, treatment options focus on several key areas:

• Preventing further damage to the liver
• Reversing existing damage if possible
• Providing symptom relief

Most cases of acute hepatitis will resolve over time with supportive care. For chronic forms of hepatitis, treatment approaches may vary:

Antiviral Medications

For viral hepatitis B and C, antiviral medications may be prescribed to suppress viral replication and reduce liver inflammation.

Immune System Modulation

In autoimmune hepatitis, certain medications may be used to help keep the overactive immune system in check and prevent further attacks on the liver.

Lifestyle Changes

Regardless of the type of hepatitis, patients are often advised to make lifestyle changes to support liver health, such as:

• Avoiding alcohol
• Maintaining a healthy diet
• Getting regular exercise
• Avoiding medications that may be toxic to the liver

Can hepatitis be cured completely? While some forms of acute hepatitis can resolve on their own, chronic hepatitis often requires long-term management. In some cases, particularly with hepatitis C, new antiviral treatments have shown high cure rates.

How Can Hepatitis Be Prevented?

Prevention strategies for hepatitis vary depending on the type:

Vaccination

Vaccines are available for hepatitis A and B. Children, or anyone who has not been previously vaccinated, should be vaccinated against these types of hepatitis.

Safe Practices

For types without vaccines (hepatitis C, D, and E), prevention focuses on:

• Practicing safe sex
• Avoiding sharing needles or personal care items
• Ensuring safe food and water when traveling to regions with high hepatitis E prevalence

Are hepatitis vaccines 100% effective? While hepatitis A and B vaccines are highly effective, they don’t provide absolute protection. It’s still important to practice safe behaviors to minimize the risk of infection.

What Are the Potential Complications of Untreated Hepatitis?

If left untreated, hepatitis can lead to several serious complications:

• Cirrhosis: Scarring of the liver that can impair its function
• Liver failure: When the liver can no longer perform its vital functions
• Liver cancer: Particularly associated with chronic hepatitis B and C
• Portal hypertension: Increased blood pressure in the portal vein system

Can these complications be reversed? Some liver damage can be reversed with treatment, especially if caught early. However, advanced cirrhosis and liver cancer are often irreversible, emphasizing the importance of early detection and treatment.

When Should You Seek Medical Help for Hepatitis?

It’s crucial to seek medical attention if you or your child develop symptoms suggestive of liver inflammation, such as:

• Persistent fatigue
• Jaundice
• Abdominal pain or swelling
• Unexplained weight loss
• Dark urine or pale stools

Early diagnosis and treatment can significantly improve outcomes and prevent serious complications.

Is it possible to have hepatitis without noticeable symptoms? Yes, particularly in the early stages or with some chronic forms of hepatitis. This is why regular check-ups and liver function tests are important, especially for those at higher risk.

Hepatitis | Johns Hopkins Medicine

Hepatitis | Johns Hopkins Medicine

Overview

Hepatitis is a general term used to describe inflammation of the liver. Liver inflammation can be caused by several viruses (viral hepatitis), chemicals, drugs, alcohol, certain genetic disorders or by an overactive immune system that mistakenly attacks the liver, called autoimmune hepatitis. Depending on its course, hepatitis can be acute, which flares up suddenly and then goes away, or chronic, which is a long-term condition usually producing more subtle symptoms and progressive liver damage.

Types of Hepatitis

There are five viruses that cause the different forms of viral hepatitis: hepatitis A, B, C, D and E. Hepatitis A is mostly a food-borne illness and can be spread through contaminated water and unwashed food. It is the easiest to transmit, especially in children, but is also the least likely to damage the liver and is usually mild and is completely resolved within six months. Hepatitis B can be transmitted through exposure to contaminated blood, needles, syringes or bodily fluids and from mother to baby. It is a chronic disorder and in some cases may lead to long-term liver damage, liver cancer and cirrhosis of the liver after many years of carrying the virus. Hepatitis C is only transmitted through infected blood or from mother to newborn during childbirth. It too can lead to liver cancer and cirrhosis in the long term. Hepatitis D is only found in people who are also infected with hepatitis B. Hepatitis E is predominantly found in Africa, Asia and South America. Certain generally safe medications can be toxic to the liver and cause hepatitis (drug-induced hepatitis) when taken in excess or in very high doses. These include acetaminophen (Tylenol) and even vitamin A. Check with your pediatrician about appropriate dosing for your child.

• Autoimmune hepatitis

• Hepatitis A

• Hepatitis B

• Hepatitis C

• Hepatitis D

• Hepatitis E

• Neonatal hepatitis

Symptoms

• Malaise

• Abdominal tenderness, especially in the upper right corner

• Fatigue

• Jaundice (yellowing of the skin and the white portion of the eyes)

• Dark-colored urine

• Lightly colored stools

• Abdominal pain

• Nausea with or without vomiting

• Abdominal swelling due to fluid retention

Diagnosis

The following are required to diagnose hepatitis:

• Physical exam, which may or may not reveal a swollen, enlarged liver

• Blood tests to check liver enzymes that are elevated when the liver is damaged or infected, as well as blood tests to check for the presence of any of the five viruses causing hepatitis

• Ultrasound of the liver to detect any changes

• Liver biopsy to confirm suspected inflammation when other tests are inconclusive and to determine the exact degree of liver damage

Treatment

To prevent infection, children — or anyone who has not been previously vaccinated — should be vaccinated against hepatitis B and hepatitis A. There are no vaccines against hepatitis types C, D and E. There is no cure for hepatitis once it occurs. Treatment focuses on preventing further damage to the liver, reversing existing damage if possible and symptom relief. Most cases of acute hepatitis will resolve over time. In autoimmune hepatitis, certain medications may be used to help keep the overactive immune system in check and prevent further attacks on the liver.

When to Call for Help?

If your child develops symptoms suggestive of liver inflammation, as listed above, call your pediatrician.

Basics

• 
  Alcoholic Hepatitis
• 
  Autoimmune Hepatitis
• 
  Drug-Induced Hepatitis
• 
  Hepatitis A and E
• 
  Hepatitis B
• 
  Hepatitis C
• 
  Hepatitis D
• 
  Hepatitis in Children
• 
  Neonatal Hepatitis


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Yes, Hepatitis C Is Curable.

Here’s How.

Hepatitis is an inflammatory liver disease often caused by a virus. While there are many types of hepatitis, the most common in the United States are hepatitis A virus, hepatitis B virus, and hepatitis C virus. While there are vaccinations for the A and B viruses, no such vaccine exists for hepatitis C.

The good news is that while hepatitis C cannot be entirely prevented through a vaccination, the infection is now curable! (More on that in a bit.) Let’s begin by taking a closer look at this illness…

Hepatitis C is a liver infection; severity can range from a mild illness to a serious, chronic illness. Of those who contract hepatitis C, more than three in four will develop a chronic hepatitis C infection. Some individuals (fewer than one in four) will clear hepatitis C from their body without any treatment; researchers do not fully understand why this happens.

Acute v. Chronic Hepatitis C

Acute hepatitis C is used to describe a new infection; it typically occurs within six months of exposure to the virus.

Chronic hepatitis C may last throughout a patient’s entire lifetime. This infection could result in scarring, cancer, or damage of the liver. In some cases, chronic hepatitis C may even result in death.

The Prevalence of Hepatitis C

2,967 cases of acute hepatitis C were reported to the Centers for Disease Control and Prevention in 2016. However, many people with hepatitis C do not experience symptoms; others experience symptoms, but do not know the cause of their illness. In reality, the CDC estimates there were as many as 41,200 cases of hepatitis C in 2016 – nearly 14x the number of cases actually reported.

A Cure for Hepatitis C

As stated, above there is now a cure for hepatitis C. Treatments have improved markedly over the last few years. Now, more than 90% of people with hepatitis C can be successfully treated with an 8-12 week round of oral therapy. A list of FDA-approved drugs (many of which have few or mild side effects) can be reviewed here. Talk to your doctor to learn more about these hepatitis C drugs. In addition to undergoing a clinical treatment, patients with hepatitis C should focus on caring for their liver.

What You Need to Know About Sustained Virologic Response (SVR)

If you’ve been researching hepatitis C, you may have heard about “sustained virologic response (SVR).” A virologic response refers to the presence of the hepatitis C virus being detected in the blood. If the virus cannot be detected in the blood after at least 12 weeks post-treatment, then a sustained virologic response has been achieved.

Having an SVR is essentially what it means to be “cured” of hepatitis C! Approximately 99% of people who experience a sustained virologic response live without the virus. Hepatitis C only returns in fewer than one percent of patients who achieve SVR. And, in many cases, that virus is actually the result of a new infection (i.e. being reintroduced to hepatitis C through a new exposure).

Once you achieve SVR you are no longer contagious, additional liver damage ceases, and liver function may improve. Not only does achieving SVR mean the virus is gone, but it also stops the progression of liver disease and other risks and complications associated with liver damage.

If you have been diagnosed with hepatitis C, help is available! Take action with your doctor today.

Get Care for Hepatitis C In Nashville

The care you need may be available at St. Thomas Medical Group. To learn more, schedule an appointment with a physician by calling +1 (615) 297-2700. You can also make an appointment online.

Is it possible to cure hepatitis B. How to treat. – “HEPATIT.RU”

Hepatitis B is an incurable chronic lifelong disease. The course of the disease is not accompanied by severe symptoms. It is possible for many years not to suspect the presence of a virus in oneself and only to detect it during a random examination. Sometimes with a long-term illness, there may be joint pain, fatigue, decreased performance, and insomnia. Often patients complain of heaviness in the right hypochondrium.

For the diagnosis of chronic viral hepatitis B, one marker is sufficient – HBsAg positive. It is usually done at any visit to a medical institution, for example, in preparation for surgery, pregnancy, IVF, etc. This indicator means that the hepatitis B virus is present in the liver. It will remain there forever.

However, this does not mean at all that nothing can be done about the virus and irreversible changes in the liver (cirrhosis and primary liver cancer) are inevitable. Viral hepatitis B is a controlled disease , which means if you keep it under control, you can live a long life with a normal healthy liver. Moreover, viral hepatitis B does not always need to be treated with antiviral drugs !

If the virus is detected for the first time, it is necessary to undergo a complete examination in order to obtain complete information about your virus and the state of the liver. Hepatitis B virological markers allow determining the activity and aggressiveness of the virus, the presence of drug resistance mutations in it, counting the amount of the virus in the blood, and determining its genotype.

In addition, it is extremely important to do an analysis for hepatitis D, which can enter the body along with the B virus. This virus is highly aggressive and quickly causes fibrosis in the liver with an outcome in cirrhosis. Treatment of the hepatitis D virus is prescribed immediately upon its detection – with interferon preparations.

The state of the liver is assessed by different methods: Ultrasound, biochemical parameters, elastometry (FibroMax, FibroTest) – degree liver fibrosis according to the METAVIR scale – F0 healthy liver, F4 cirrhosis.
Depending on the results of this survey, different decisions are made:

1. if the virus is not active and does not pose a threat to life, the liver is in good condition, then antiviral treatment is NOT PRESENTED;

2. if the virus is active and the liver is already affected by the virus, the doctor must prescribe antiviral drugs in order to stop the destructive processes in the liver and return it to a healthy state.

In all cases, the patient should be informed about how to control viral hepatitis throughout his life. The main control parameters are the state of the liver according to elastometry data (FibroTest, FibroMax) – that is, the degree of fibrosis, as well as the activity of the virus – its amount in the blood. It is advisable to be under the supervision of a qualified hepatologist who will be able to make the right decisions in time if the situation changes.

Unfortunately, for viral hepatitis B there is no single standard of treatment and decision-making on its appointment. That is why it is so important to be examined in a timely manner and consult a specialist who knows how to treat viral hepatitis B.

Purpose of hepatitis B treatment

Complete removal of the hepatitis B virus from the body is impossible, since the DNA of the virus is integrated into the host genome. At the same time, the virus is not always dangerous and does not always require treatment. Treatment is necessary only if the virus is active and there are changes in the liver that can lead to cirrhosis.

The goal of therapy for chronic hepatitis B (CHB) is to prevent the progression of the disease to cirrhosis, thereby improving the quality and duration of life.

In the presence of cirrhosis, the goal of treatment is to prevent decompensation of cirrhosis and the development of end-stage liver disease, primary liver cancer, and death.

This goal can be achieved with persistent suppression of HBV replication. Parallel suppression of viral replication and reduction of the inflammatory process in the liver reduces the risk of liver cirrhosis and liver cancer.

Treatment regimens and antivirals for the treatment of CHB

There is no single standard treatment for viral hepatitis B. Decisions are made individually depending on the virological parameters and the degree of liver damage.

Currently, there are two different treatment strategies: course use of alpha interferons, including pegylated ones, or nucleoside/nucleotide analogues (ANs).

Nucleoside analogues: lamivudine, telbivudine, entecavir.

Nucleotide analogues: adefovir and tenofovir.

The advantage of treatment with interferons is that the course of treatment is limited to 1 year. In addition, the resistance of the virus to interferon does not develop, and a persistent virological response persists for a long time even after a course of therapy. It is also possible to completely eliminate the virus with the formation of immunity (formation of anti-HBsAg), although this occurs in about 20-30% of cases.

At the same time, a significant drawback of this tactic is serious side effects, as well as the need for subcutaneous administration, which significantly reduce the patient’s tolerance and motivation for treatment.

Interferon preparations are contraindicated in decompensated cirrhosis due to HBV infection, autoimmune disease, as well as in patients with uncontrolled severe depression and psychosis, and during pregnancy.

Entecavir and tenofovir have potent antiviral properties and are characterized by a high genetic barrier to the development of resistance. Their long-term use does not cause the development of resistance mutations (resistance) to the drug in the virus. Therefore, they can be confidently used as first-line monotherapy.

Lamivudine, telbivudine, and adefovir are recommended for the treatment of CHB only when more potent ANs are unavailable or if intolerance to more active drugs develops.

Lamivudine is an inexpensive drug, but long-term monotherapy is very often accompanied by virus mutation and the development of resistance. Adefovir is less effective and more expensive than tenofovir. Resistance to it occurs more often.

Telbivudine is a potent inhibitor of HBV replication, but resistance develops rapidly in patients with high baseline HBV DNA or detectable HBV DNA after 6 months. treatment. The incidence of telbivudine resistance is relatively low in patients with low baseline viremia (< 2 x 108 IU/mL in HBeAg-positive and < 2 x 106 IU/mL in HBeAg-negative patients) who do not have HBV DNA detected after 6 months. therapy.

Course therapy with pegylated interferon

A 48-week course of PEG-IFN therapy is recommended in HBeAg-positive patients. This provides the greatest likelihood of seroconversion with anti-HBe. This strategy can also be applied in HBeAg-negative patients, since this is practically the only way to obtain a stable virological response after completion of antiviral therapy.

The patient should be given full information about the advantages, adverse events, and disadvantages of interferon therapy compared with NA, so that he can participate in the decision on the choice of drug.

Long-term treatment with nucleoside/nucleotide analogues

This strategy is required in HBeAg-positive patients without HBe seroconversion and in HBeAg-negative patients. The same strategy is recommended in patients with cirrhosis, regardless of HBeAg status or HBe seroconversion during treatment. The most potent drugs with an optimal resistance profile, i. e. tenofovir and entecavir, should be used as first-line monotherapy.

With monotherapy with tenofovir and entecavir for 3 years or more, it is possible to maintain virological remission in most patients.

When taking any drug, it is necessary to achieve and maintain a negative level of HBV DNA, confirmed by real-time PCR. In addition, it is necessary to monitor the condition of the liver during treatment0007 FibroTest ).

Since complete elimination of the virus cannot be achieved, lifelong monitoring of virus activity and liver condition is recommended.

Hepatitis C is a dangerous but curable disease

Chronic viral hepatitis C is a widespread disease The number of cases of hepatitis C is increasing every year around the world. The danger of chronic hepatitis C lies in the fact that the disease is asymptomatic and in most cases ends with cirrhosis and liver cancer .

Tests for suspected hepatitis C

Hepatitis C is most often detected during a random examination for hospitalization, when antibodies to the hepatitis C virus are found in the patient’s blood. In this case, antibodies in the blood indicate only a suspicion of an active viral process.

To confirm the diagnosis, it is necessary to pass a test for virus activity by PCR. Only if a virus is detected can antiviral treatment be planned. The goal of treatment is to completely remove the virus from the liver, and not just from the blood, that is, to get sustained virologic response .

Treatment of hepatitis C

Modern antiviral therapy with direct antiviral drugs is very effective. Manufacturers claim a 99% chance of recovery.

However, in actual clinical practice, the chance of recovery may be lower, as the virus is prone to mutations and genetic changes that make it resistant to drugs. Such mutations often occur in long-term illness or in failure of previous antiviral treatment.

The main goal of hepatitis C treatment is to prevent the formation of cirrhosis. At the same time, it should be taken into account that not only viral hepatitis C, but also other concomitant liver diseases can lead to cirrhosis. Therefore, in the presence of concomitant liver diseases, the hepatologist is obliged to treat them before starting antiviral therapy or at the same time.

The course of treatment is only three months, but in case of cirrhosis it can be extended up to six months.

Treatment of hepatitis C without a complete examination and, if necessary, treatment of concomitant liver diseases can only worsen the patient’s health!

Contraindications in the treatment of hepatitis C

To prescribe treatment, it is necessary to undergo an examination to determine the characteristics of the virus and the condition of the liver.

The characteristics of the virus – genotype and viral load – allow you to choose the most effective treatment regimen. An assessment of the state of the liver is necessary to take into account contraindications in therapy.

Contraindications are decompensated class B and C cirrhosis, concomitant liver disease (most often fatty liver and viral hepatitis B), as well as heart and kidney disease when using certain antiviral drugs. The hepatologist must take into account the patient’s individual contraindications to select the safest treatment regimen and control therapy.

We remind you that in our hepatology center you can get the first hepatologist consultation free of charge.

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• from 9:00 to 15:30 on weekdays

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Self-treatment of hepatitis C – dangerous for your life

Modern antiviral therapy with direct-acting antiviral drugs is well tolerated and does not impair the quality of life during therapy. In many patients, this creates the illusion that the disease can be cured on its own without the supervision of a hepatologist.

Without a doctor’s prescription for individual therapy , side effects from taking drugs, up to severe damage to the kidneys and heart, may occur. Also, self-treatment in general may be unsuccessful due to an incorrectly selected therapy regimen.

Clinical experience of treating several thousand patients in our Hepatocenter shows that complications and failures most often occur when:

• the patient refuses to visit a hepatologist
• self-treatment of a patient on the advice of sellers of generics not registered in Russia.

Generics are copies of original drugs, which are often of dubious origin and quality, both of the active substance and excipients. This is dangerous not only because of the lack of treatment results, but also due to the mutation of the virus, which makes the curable disease hepatitis C – incurable due to the formation of drug resistance in the virus.

So, despite the apparent simplicity of the treatment of hepatitis C with direct antiviral drugs, the treatment of the disease is always ambiguous on a number of issues: Whom to treat? How to treat? When to start therapy? What to check before starting therapy? How to control the safety of treatment and take into account all the individual contraindications of the patient? How to announce a complete recovery to a patient after a course of AVT?

Only a qualified specialist, a hepatologist, can give you answers to these questions.