Hepatitis is essentially an inflammatory disease of the liver. Infections and medications can cause hepatitis, and autoimmune events can also cause hepatitis. The most common causes are infections. Many viruses or microorganisms called bacteria can cause hepatitis. For example, hepatitis may develop during a flu infection, a pharyngitis, or even due to herpes viruses, which we call herpes. In such cases, hepatitis develops as a component of a systemic disease. However, some hepatotrophic viruses are particularly fond of the liver and rarely cause disease in other organs. These are called hepatitis viruses. These are known as hepatitis A, B, C, D and E viruses. There are 2 types of hepatitis (acute and chronic) caused by these 5 main viruses. While A and E do not become chronic, the others do.
What are the symptoms of hepatitis?
Hepatitis can range from asymptomatic to cirrhosis and liver failure. Jaundice, weakness, fatigue, nausea and vomiting, abdominal pain and diarrhea are common signs and symptoms. Hepatitis infections can have life-threatening or deteriorating quality of life consequences in the short and long term. What is feared in the long term is the development of cirrhosis and liver cancer. This mostly happens with hepatitis B, C and D viruses that cause chronic infection. A life-threatening complication in the short term is the development of liver failure. In this case, the patient may experience impaired consciousness, bruising and bleeding throughout the body. While the risk of developing liver failure is high in acute hepatitis caused by hepatitis A and E, it is lower in hepatitis B infection. However, not all A and E hepatitis occur. Some personal, constitutional factors are also important here.
What is the course of hepatitis?
Hepatitis A and E cause acute hepatitis and are often self-limiting. Hepatitis B and C can become chronic after the acute hepatitis phase. For example, if a newborn baby acquires the B virus, there is a 95% chance that it will become chronic (unless vaccinated and immunoglobulin is not given). Hepatitis D alone cannot cause infection without hepatitis B virus.
Is hepatitis contagious? How is it transmitted?
Unfortunately, all hepatitis cases are contagious. But the modes of transmission are different. What causes acute hepatitis The most common is hepatitis A. It is transmitted from person to person by oral-fecal route, that is, by eating or drinking an infected substance. After people ingest this microbe, they excrete it with their feces. In cases where hygiene rules are not followed, the virus is transmitted first from feces to food or drink items, and then to the person who consumes them if these items are not cleaned well. The incubation period is 3 weeks. Towards the end of the incubation period, the virus is excreted in the feces 2 weeks before jaundice occurs, thus starting the transmission phase. In other words, the person is contagious before jaundice begins. Therefore, it can easily cause epidemics. Contagiousness continues until 1 week after jaundice occurs. Hand washing and isolation are very important during infections to prevent transmission. Children with hepatitis A or E should not be sent to school and should be separated from other individuals, siblings, especially pregnant women or people with compromised immune systems. Hepatitis A is not transmitted to the baby unless the mother is infected during birth.
The primary mode of transmission of hepatitis B and C is body fluids (blood, blood product, sexual contact, etc.) and birth. The incubation period of Hepatitis B virus is 45-160 days, and the incubation period of Hepatitis C virus is 7-9 weeks. There is no epidemic in this type of hepatitis. These children do not need to be removed from school or isolated from other individuals.
Is it possible to be protected from hepatitis?
It is possible to be protected from some hepatitis. It is possible to be protected with a vaccine before contact and with blood products called Immunoglobulin after contact. In our country, vaccination against A and B hepatitis virus infection is included in the routine vaccination program. For hepatitis A, 2 doses of vaccination are given with an interval of 6 months starting from the age of 12 months. For hepatitis B infection, 3 doses of vaccine are given immediately after birth, at the 1st month and at the 6th month. These vaccines generally provide lifelong protection. There is no vaccine for Hepatitis C and D viruses.
In case of contact with the Hepatitis virus without vaccination, temporary protection is provided with the application of Immunoglobulin in addition to vaccination until the vaccine effectiveness begins. Therefore, a baby born to a mother with Hepatitis B infection should be administered both the vaccine and Hepatitis B Immunoglobulin within the first 24-48 hours.
How is hepatitis treated?
There is no special treatment for acute hepatitis, except for immunodeficiency or the use of drugs that suppress the immune system. General treatment principles applied to all diseases are followed. Infection is often self-limiting. Therefore, general supportive treatments that are not specific to the disease, such as rest, relaxation, and plenty of fluid support if there is nausea and vomiting, are given. If liver failure has developed, specific treatment is applied and liver transplantation is required in cases that do not respond.
In chronic hepatitis B and C, various antiviral or immunomodulatory treatments are applied to patients who meet appropriate criteria. The patient is treated specifically when it comes to choosing which medication to use.
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