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Hepatitis & Cirrhosis (more information)

THE LIVER

The liver is a vital part of the human body. The liver helps to keep the body clean, by filtering out impurities that we put into our body.

Hepatitis

Overview

Hepatitis is the inflammation of the liver. The effects on the liver and symptoms they produce may be similar but the ways of contraction are different. The organism that causes the disease determines how severe the disease will be. Hepatitis is often caused by a virus other possible causes include alcohol, medications that have a harmful effect on the liver toxins or autoimmune disorders. There are at least seven known viral hepatitis strains: A, B, C, D, E, F, and G. There is also non-viral hepatitis diagnosis, which include alcoholic hepatitis, and toxic/drug-induced hepatitis. Hepatitis A-E causes acute or short-term viral hepatitis. The hepatitis B, C, and D can also cause chronic hepatitis in which the infection is prolonged sometimes lasting the rest of someone's life.

Symptoms

Symptoms of Viral Hepatitis include the following:

• Jaundice (yellowing of the skin and eyes)
• Fatigue
• Loss of Appetite
• Nausea
• Vomiting
• Diarrhea
• Low Grade Fever
• Headache

The risk factors, prevention measures, and treatments vary from strain to strain therefore; each strain will be listed with its ways of transmission, risk factors, prevention methods, and treatments.

Hepatitis A

Hepatitis A is considered to be the least dangerous of the Hepatitis strains because it does not lead to chronic inflammation of the liver.

Ways of Transmission

Hepatitis A is primarily spread through food or water that has been contaminated by feces from an infected person. Rarely does it spread through contact with infected blood.

Risk Factors

People at risk of contracting Hepatitis A include:

• International travelers
• People living where hepatitis A outbreaks are common
• People who live with or have a sex with an infected person
• Day care children and employees
• Men who have sex with men
• Injection drug users

Prevention

There are several ways in which Hepatitis A can be prevented. These prevention measures include:

• The hepatitis A vaccine
• Avoid tap water when traveling internationally
• Practice good Hygiene and Sanitation

Treatment

There is no listed treatment for hepatitis A. The disease usually cures itself.

Hepatitis B

Hepatitis B is the most widespread of the hepatitis viruses it infects an estimated 300,000 people every year in the United States alone. In 1/3 of all Hepatitis B cases the exact cause is undetermined.

Ways of Transmission

Hepatitis B is primarily spread through contact with infected blood, through sex with an infected person, and from mother to child during childbirth.

Risk Factors

People at risk of contracting Hepatitis B include:

• People who have sex with an infected person
• Men having sex with other men
• Injection drug users
• Children of immigrants from disease-endemic areas
• Infants born to infected mothers
• People who live with an infected person
• Hemodialysis patients
• People who received a blood transfusion or blood products prior to July 1992 or clotting factors made before 1987
• International travelers

Prevention

There is a vaccine available for Hepatitis B prevention

Treatment

For chronic Hepatitis B drug treatment with alpha-interferon, peginterferon, lamivudine, or adefouir dipixoxil. For acute Hepatitis B the disease usually resolves itself on its own.

Hepatitis C

People with Hepatitis C may show mild symptoms or show no symptoms at all. 20% to 30% of chronic Hepatitis C carries develop cirrhosis of the liver within 20 years.

Ways of Transmission

Hepatitis C is primarily spread through contact with infected blood. Hepatitis C is less commonly contracted through sexual contact and childbirth.

Risk Factors

People at risk of contracting Hepatitis C include:

• Injection drug users
• People who have sex with an infected person
• People with multiple sex partners
• Infants born to infected women
• Hemodialysis patients
• People who received a blood transfusion and blood products before July 1992 or clotting factors made before 1987.

Prevention

There is no vaccine for Hepatitis C. The only way to prevent the disease is to reduce the risk of exposure to the virus. One should not share drug needles, and personal items such as razors, toothbrushes, and nail clippers these items may be contaminated with infected blood.

Treatment

Chronic Hepatitis C can be treated with peg interferon alone or combination treatment with peg interferon and the ribavierin. Acute Hepatitis C should be treated if the symptoms do not disappear within 2 or 3 weeks.

Hepatitis D

Hepatitis D is the rarest form of Hepatitis and the most dangerous because it is two diseases working at the same time.

Ways of Transmission

Hepatitis D is primarily spread through contact with infected blood. This disease occurs only in people who are already infected with Hepatitis B.

Risk Factors

People at risk if contracting Hepatitis D include:

• Anyone infected with Hepatitis B
• Injection drug users with Hepatitis B
• People who received a blood transfusion prior to July 1992 or clotting before 1987

Prevention

To prevent Hepatitis D, one should get immunized for Hepatitis B. Avoid exposure to infected blood that may exist in needles, razors, and toothbrushes.

Treatment

There is treatment available from the drug alpha interferon.

Hepatitis E

Hepatitis E is mainly found in Asia, Mexico, India, and Africa. Hepatitis E is more dangerous than Hepatitis A, especially in pregnant women, if contracted it can kill them.

Ways of Transmission

Hepatitis E is primarily spread through food and water contamination by feces and infected person. This disease is uncommon in the United States.

Risk Factors

People at risk of contracting Hepatitis E include:

• International travelers
• People living in areas where Hepatitis E outbreaks are common
• People who live or have sex with an infected person

Prevention

There is no vaccine available for Hepatitis E. The only way to prevent the disease is to reduce the risk of exposure to the virus. This means avoiding tap water when traveling internationally and practicing good hygiene.

Treatment

Hepatitis E usually resolves itself on its own in one to two weeks

Hepatitis F

Hepatitis F is a newly discovered strain of Hepatitis. Currently, research has proven that Hepatitis F is a mutation of Hepatitis B. Therefore, the ways of transmission and risk factors will be the same.

Ways of Transmission

The method of transmission of Hepatitis F is the same as Hepatitis B. Hepatitis B is primarily spread through contact with infected blood, through sex with an infected person, and from mother to child during childbirth.

Risk Factors

Since Hepatitis F is a replica of Hepatitis B then the risk factors for Hepatitis F will be the same as Hepatitis B. People at risk of contracting Hepatitis B include:

• People who have sex with an infected person
• Men having sex with other men
• Injection drug users
• Children of immigrants from disease-endemic areas
• Infants born to infected mothers
• People who live with an infected person
• Hemodialysis patients
• People who received a blood transfusion or blood products prior to July 1992 or clotting factors made before 1987
• International travelers

Prevention

There is a vaccine available for Hepatitis B prevention

Treatment

For chronic Hepatitis B drug treatment with alpha-interferon, peg interferon, lamivudine, or adefouir dipixoxil.

For acute Hepatitis B the disease usually resolves itself on its own.

Hepatitis G

Like Hepatitis F, Hepatitis G is a mutation of an already existing strain of hepatitis. Hepatitis G is a mutation of Hepatitis C. Therefore, the ways of transmission and the risk factors for the disease will be the same.

Ways of Transmission

Since Hepatitis G is a mutation of Hepatitis C the way of transmission for Hepatitis G will be the same as those for Hepatitis C. Hepatitis C is primarily spread through contact with infected blood. Hepatitis C is less commonly contracted through sexual contact and childbirth.

Risk Factors

Since Hepatitis G is a replica of Hepatitis C, the risk factors for Hepatitis G will be the same as that for Hepatitis C. Research has shown that those persons with HIV are especially venerable to Hepatitis G. People at risk of contracting Hepatitis G include:

• Injection drug users
• People who have sex with an infected person
• People with multiple sex partners
• Infants born to infected mothers
• Hemodialysis patients
• People who received a blood transfusion blood products before July 1992 or clotting factors made before 1987

Prevention

There is no vaccine for Hepatitis C. The only way to prevent the disease is to reduce the risk of exposure to the virus. One should not share drug needles, and personal items such razors, toothbrushes, or clippers with a person who is infected.

Alcoholic, Toxic, and Drug Related Hepatitis

Alcoholic, toxic, and Drug related hepatitis, is caused by excessive and chronic consumption of alcohol, ingestion of environmental toxins, or misuse of certain of certain prescription drugs and over-the -counter medications.

Prevention

The only way to stop this type of Hepatitis is to stop drinking or stop using whatever it is that caused the hepatitis. In general kick the drug habit and/ or stop abusing alcohol.

Cirrhosis of the Liver

Overview

Cirrhosis is the condition that occurs when the liver is damaged due to scarring or fibrosis. Fibrosis replaces healthy tissue and prevents the liver from working properly. Cirrhosis occurs when substantial amounts of scar tissue replace normal tissue in the liver. Once scar tissue forms it can not be replaced. As cirrhosis develops scar tissue surrounds normal liver cells, making the tissue form nodules. These nodules in the tissue can block bile ducts or make them swollen which can back up bile in the liver and bloodstream. Scar tissue also may block blood flow through the liver. Obstruction of blood flow can cause the veins that bring blood to the liver to become larger and may lead to high blood pressure in the veins that flow from the intestine to the liver. In the United States cirrhosis is usually caused by either by alcoholism or from one of the viral hepatitis B or C.

Risk Factors

Cirrhosis can be caused by a number of factors. The most common is due to alcohol abuse. At least 10% to 15% of people who drink alcohol excessively will develop cirrhosis. Of the 26, 000 people who die from cirrhosis annually, at least 40% have a history of alcohol abuse.

• Alcoholic cirrhosis can develop in a man who consumes 5 or more alcoholic beverages every day for at least 10 to 15 years. Women may develop the disease after 3 or more drinks over the same period or time.
• Cirrhosis caused by viral hepatitis develops in 40% or people with chronic viral hepatitis. The development is often times slow, taking up to 20 years or longer. For those people who have chronic hepatitis and drink the length of time is much shorter.
• Autoimmune hepatitis in some people their immune system may attack their liver, causing cirrhosis.
• Inherited diseases- cirrhosis is also inherited by diseases such as Wilson's disease, cystic fibrosis, or hemochromatosis.

In rare cases, cirrhosis can be caused by reactions to prescribed medications, prolonged exposure to poisons in the environment, having too much fat stored in the liver, and having a long-term biliary tract disease.

Symptoms

Symptoms of cirrhosis may not develop early in the disease. Symptoms usually don't become visible until the disease has progressed. Symptoms may include the following:

• Fluid build- up in the legs(edema) and the abdomen(ascites)
• Fatigue
• Yellowing of the skin (jaundice)
• Itching (pruritus)
• Profuse nosebleeds (epistaxis)
• Redness of the palms (palmar erythema)
• Bleeding from enlarged veins in the intestinal tract (variceal bleeding)
• Bruising easily
• Weight loss and muscle wasting
• Abdominal pain
• Frequent infections
• Confusion

Prevention

Steps to prevent the development of cirrhosis

• drink alcohol in moderation
• don't put oneself in risk of developing hepatitis
• maintain a well-balance diet

Treatment

Treatment for cirrhosis lies with the person who developed the disease. One should correct whatever is causing the cirrhosis. If alcohol is the cause, stop drinking. If Wilson's disease is the cause there are medications that are available from a doctor's prescription. If hepatitis is the cause of the cirrhosis, seek treatment for the stain of hepatitis that you have contracted. If the cirrhosis is extremely severe, a liver transplant may be an option.

Complications of Cirrhosis and other Liver Diseases

The blockage of blood flow is particularly dangerous when it comes to cirrhosis because it can lead to portal hypertension. Portal hypertension occurs when there is an increase in blood pressure in the veins that flow to the liver. Portal hypertension can lead to other complications. These complications include:

• Fluid build- up in the abdominal cavity
• Bleeding from enlarged veins in the intestinal tract
• Infection of the fluid in the abdomen
• Altered brain function
• Hepatorenal syndrome (kidney failure caused by cirrhosis of the liver)
• Hepatopulmonary syndrome (complications of the lungs)
• Hepatic hydrothorax (the build of fluid between the lungs and the chest)

Cirrhosis can also lead to the formation of gallstones. Gallstones are formations of cholesterol that develop in the gallbladder. These deposits are about the size of a grain of sand and may form in the bile duct. The development of gallstones depends greatly on the severity of the liver disease that one has.

Liver cancer is also a possibility for someone who has developed cirrhosis of the liver. For anyone with cirrhosis the chances of developing liver cancer are increased. Liver cancer involves the rapid uncontrolled growth of cells in the tissue surrounding the liver, as the cells grow they form a tumor. As the tumor grows, the size may begin to cause complications. Liver cancer is one of the world's leading causes of death in North America. Liver cancer is found four times more often in men than in women. There is no cure for cancer. There are two treatment options available for liver cancer. The first is the removal of the tissue surrounding the liver that is infected. The second is the removal of part of the liver that is infected and liver replacement.

OTHER LIVER DISEASES INCLUDE:

Polycystic Liver Disease- is an inherited disease that causes the formation of too many cysts in the liver. This may cause abdominal discomfort from the swelling of the liver. The exact cause of the disease is unknown.

Caroli Disease- is an inherited disease that causes the abnormal widening of the ducts that carry bile from the liver. The will cause inflammation of the bile duct and the formation of pus in the liver. It may also cause the formation of bands of fibrosis tissue in the portal area of the liver. This disease is associated with portal hypertension.

Primary Sclerosing Cholangitis- is a rare progressive disorder that results in the inflammation of the liver, thickening and abnormal formation of fibrosis tissue within the passages that carry bile from the liver. Symptoms often include fatigue, itching, yellowing of the skin (jaundice), dark-colored urine, and light-colored stool, abdominal pain, and nausea. The liver may also become enlarged as a result of this disease. The exact cause of the disease is unknown.

Congenital Hepatic Fibrosis- is a rare disease that affects both the liver and the kidney. It is an inherited disease. The disease may cause enlarged liver, increased blood flow to organs, the growth of fiber-like connective tissue that spreads over the liver and bleeding from the stomach and intestines.

Hers Disease- is a hereditary disease that results in the deficiency of the enzyme, liver phosphorylase. This may cause the enlargement of the liver, moderately low blood sugar, elevated levels of acetone, and ketone in the blood and possible moderate growth retardation.

TESTING

If you think you may have one these diseases please consult you physician immediately. The testing procedure for diseases of the liver involves the drawing and examination of blood.

Frequently asked questions

Q: Is the liver important?

A: Yes, the liver is a major part of the human body. It filters out impurities that enter our body.

Q: What is Hepatitis?

A: Hepatitis is the inflammation of the liver. There are seven viral strains of the disease. They are labeled A- G. There are also two non-viral strains of hepatitis. Alcoholic Hepatitis and Toxic/Drug-Induced Hepatitis.

Q: What does viral mean?

A: Viral means that the disease is transmitted through the body from person to person for example through blood exchange.

Q: What is the most deadly strain?

A: The most deadly strain of Hepatitis is Hepatitis D. Hepatitis D is the most deadly because it is two strains of Hepatitis working together on the liver.

Q: Is there testing available to see if I have Hepatitis?

A: There is testing available for Hepatitis. Blood must be drawn to determine if you are infected with the virus.

Q: What is Cirrhosis?

A: Cirrhosis is the condition that results from substantial amounts of scar tissue replaces normal tissue in the liver.

Q: What is the most common way that someone contracts cirrhosis?

A: Cirrhosis is developed based on the habits of the individual that contracts it. Alcohol abuse is one of the ways in which cirrhosis is developed. The other most common method is through the prolong exposure to viral hepatitis.

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