Hepatitis is the term used to describe inflammation of the liver. It’s usually the result of a viral infection or liver damage caused by drinking alcohol.
Causes/Factors
Hepatitis A
- More common in countries with poor sanitation (transmitted via oro-faecal route)
- Usually passes after a few months
- No chronic infection
Hepatitis B
- Spread via blood
- Usually spread via vertical transmission, rarely via unprotected sex and drug injection
- Uncommon in UK
Hepatitis C
- Most common Viral hepatitis in UK
- Often causes no symptoms
- 25% will fight of the infection the rest will have a chronic infection
- Good drug treatment options
Hepatitis D
- Only affects people who are already infected with hep B
- Spread via blood
- Chronic infection of hep B and D can increase risk of Cirrhosis and liver cancer
Hepatitis E
- Most common acute hepatitis
- Consumption of raw/undercooked pork, boar, venison and shellfish
- Mild and short term
Alcoholic hepatitis
Paracetamol Overdose
Autoimmune hepatitis
- Rare long term
- Associated with the presence of anti-nuclear and/or anti-smooth muscle antibodies.
- Immunosuppressants
Symptoms
- muscle and joint pain
- nausea and vomiting
- fatigue
- loss of appetite
- pain in abdomen
- dark urine
- pale grey stools
- itchy skin
Signs
- Jaundice
- pyrexia
Diagnostic Tests
- Blood tests to confirm virus + LFT
- Imaging (ultrasound, etc) to assess liver damage
- MRI/CT to look for cancer
- Liver biopsy if imaging not enough to assess damage
Management
Mostly symptomatic relief
Complications/red Flags
- Acute liver injury should result in regeneration of the liver
- Chronic liver injury results in Liver Cirrhosis (fibrous/scarring)