Hepatitis

Inflammation of the liver, which can be caused by various agents.

• Hepatitis A (HAV): Primarily spread through faecal-oral route.
• Hepatitis B (HBV): Transmitted through blood and bodily fluids.
• Hepatitis C (HCV): Primarily bloodborne transmission.
• Hepatitis D (HDV): Requires HBV for replication; co-infection or superinfection with HBV.
• Hepatitis E (HEV): Primarily spread through faecal-oral route, similar to HAV.

• Alcoholic hepatitis: Due to excessive alcohol consumption.
• Drug-induced hepatitis: Certain medications (e.g., paracetamol overdose, isoniazid).
• Autoimmune hepatitis: Immune system attacks liver cells.
• Non-alcoholic fatty liver disease (NAFLD): Fat accumulation in liver cells.
• Toxic hepatitis: Caused by chemicals or toxins.

• Jaundice (yellowing of skin and eyes).
• Fatigue.
• Abdominal pain.
• Nausea and vomiting.
• Dark urine.
• Pale stools.
• Joint pain.

• Liver function tests (LFTs): Elevated liver enzymes (ALT, AST) indicate liver inflammation.
• Serology tests: Detect specific viral hepatitis antibodies and antigens.
• PCR: Detects and quantifies viral RNA/DNA.
• Liver biopsy: In certain cases to assess severity.

• Supportive care: Rest, hydration, and nutrition.
• Antivirals: For HBV (e.g., entecavir, tenofovir) and HCV (e.g., sofosbuvir).
• Vaccinations available for HAV and HBV.
• Avoid alcohol if alcohol-related or drug-related.
• Immunosuppressants for autoimmune hepatitis.

• Vaccination against HAV and HBV.
• Safe practices:
  • Hand hygiene.
  • Safe food and water.
  • Safe sex.
  • No sharing of needles.
  • Limited alcohol intake.
  • Regular monitoring of medications affecting the liver.
• Screen blood donors.

• Chronic hepatitis: Persistent inflammation can lead to cirrhosis and liver cancer.
• Fulminant hepatitis: Severe, rapid deterioration of liver function.
• Extrahepatic manifestations: Including arthralgia, vasculitis, and glomerulonephritis.

• Hepatitis is categorised as a viral cause (A-E) or non-viral cause (e.g., alcoholic, drug-induced, autoimmune).
• Prevention through vaccination, safe practices and screening of blood donors is crucial.
• Patients often present with jaundice, abdominal pain, dark urine and pale stools.
• Investigations primarily include LFTs, serology and PCR.
• Management involves supportive care, but specific treatment varies depending on the underlying cause.