Hepatitis

Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. Etymologically from ancient Greek "hepar" or "hepato-"  meaning 'liver' and suffix "-itis" denoting 'inflammation'. The condition can be self limiting, healing on its own or can progress to scarring of liver. Acute hepatitis is when it lasts less then 6 months and chronic hepatitis is when it persists longer. It may run a subclinical course when the affected person may not feel ill. The patient becomes unwell and symptomatic when the disease impairs liver functions.

HEPATITIS

Causes

Acute hepatitis Viral Hepatitis: Hepatitis A to E (more than 95% of viral cause), Herpes simplex, Cytomegalovirus, Epstein-Barr, yellow fever virus, adenoviruses. Non viral infection: toxoplasma, Leptospira, Q fever, rocky mountain spotted fever Alcohol Toxins: Amanita toxin in mushrooms, Carbon tetrachloride, asafetida Drugs: Paracetamol, amoxycillin, anti tuberculosis medicines, minocycline and many others Circulatory insufficiency pregnancy Auto immune conditions e.g. SLE Metabolic diseases e.g. Wilson's disease Chronic hepatitis Viral Hepatitis: Hepatitis B with or without hepatitis D, Hepatitis C (Hepatitis A and E do not lead to chronic disease) Autoimmune: Autoimmune hepatitis Alcohol Drugs: methyl-dopa, nitrofurantoin, isoniazide, ketoconazole Non-alcoholic steatohepatitis Heredity: Wilson's disease, alpha 1-antitrypsin deficiency Primary biliary cirrhosis and primary sclerosing cholangitis occasionally mimic chronic hepatitis

Signs and symptoms

Acute Hepatitis acute viral hepatitis are more likely to be asymptomatic in younger people nonspecific flu-like symptoms and may include: malaise, muscle and joint aches, fever, feeling sick or vomiting, diarrhea and headache. profound loss of appetite, aversion of smoking among smokers, dark urine, yellowing of the eyes and skin i.e. jaundice and abdominal discomfort Chronic Hepatitis asymptomatic or mildly symptomatic jaundice abdominal fullness from enlarged liver or spleen, low grade fever and fluid retention (ascites extensive damage and scarring of liver i.e. cirrhosis leads to weight loss, easy bruising and bleeding tendencies acne, abnormal menstruation, lung scarring, inflammation of the thyroid gland and kidneys may be present in women with autoimmune hepatitis

TYPES OF HEPATITIS

Hepatitis A	or infectious jaundice caused by a picornavirus transmitted by the orofecal route, and can be spread through personal contact, consumption of raw sea food or drinking contaminated water it causes an acute form of hepatitis and does not have a chronic stage people with hepatitis A are advised to rest, stay hydrated and avoid alcohol the time between the infection and the start of the illness can run from 15 to 45 days vaccine is available
Hepatitis B	caused by a hepadnavirus can be both acute or chronic identified methods of transmission include blood (blood transfusion, now rare), tattoos (both amateur and professionally done), sexually (through sexual intercourse or through contact with blood or bodily fluids), or in utero (from mother to her unborn child, as the virus can cross the placenta) vaccine is available
Hepatitis C	aka originally "non-A non-B hepatitis" caused by a Flavivirus it can be transmitted through contact with blood (including through sexual contact where the two parties' blood is mixed) may lead to a chronic form of hepatitis, culminating in cirrhosis it can remain asymptomatic for 10-20 years can cause cirrhosis of the liver no vaccine is available
Hepatitis B with D	caused by a small circular RNA virus (Hepatitis delta virus or hepatitis D virus, HDV). a subviral satellite because it can propagate only in the presence of another virus, the hepatitis B virus (HBV) transmission can occur either via simultaneous infection with HBV (coinfection) or via infection of an individual previously infected with HBV (superinfection) results in more severe complications compared to infection with HBV alone complications include a greater likelihood of experiencing liver failure in acute infections and a greater likelihood of developing liver cancer in chronic infection
Hepatitis E	produces symptoms similar to hepatitis A it can take a fulminant course in some patients, particularly pregnant women
Hepatitis F (existence unknown)	it is a hypothetical virus linked to hepatiti
Hepatitis G	probably spread by blood and sexual contact
Other viruses	mumps virus rubella virus cytomegalovirus Epstein-Barr virus other herpes viruses
Alcoholic Hepatitis	usually alcoholic hepatitis comes after a period of increased alcohol consumption feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis
Other toxins	drugs amatoxin-containing mushrooms white phosphorus, an industrial toxin paracetamol can cause hepatitis when taken in an overdose carbon tetrachloride, chloroform, and trichloroethylene, all chlorinated hydrocarbons cylindrospermopsin
Metabolic disorders	Hemochromatosis (due to iron accumulation) Wilson's disease (copper accumulation)
Obstructive	jaundice due to obstruction of the bile duct (by gallstones or external obstruction by cancer) If longstanding it leads to destruction and inflammation of liver tissue
Autoimmune	anomalous presentation of human leukocyte antigen (HLA) class II on the surface of hepatocyte causes a cell-mediated immune response against the body's own liver
Alpha 1-antitrypsin deficiency	In severe cases of alpha 1-antitrypsin deficiency (A1AD), the accumulated protein in the endoplasmic reticulum causes liver cell damage and inflammation
Nonalcoholic steatohepatitis	resembles alcoholic hepatitis on liver biopsy (fat droplets, inflammatory cells, but usually no Mallory's hyalin) but occurs in patients who have no known history of alcohol abuse more common in women and the most common cause is obesity or the metabolic syndrome a related but less serious condition is called "fatty liver" (steatosis hepatis)

Several are the herbal nutritional supplements adjuvant to traditional treatments of hepatitis, including:

• chanca piedra
• jergon sacha
• mullaca
• anamu
• macela
• sangre de grado
• clavillia
• fedegoso
• bitter melon
• vassourinha
• mutamba
• erva tostão
• gervâo
• carqueja
• picão preto
• mulungu

                                                                                             Articles form Wikipedia





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