Hepatitis explains about inflammation of liver.Viral type of hepatitis is the most dangerous one and has a more fast outbreak. The bacterial form of hepatitis is not an easily transmitable disease.
Symptoms of hepatitis
Stomach pain, weakness and tiredness Flue like sickness, pruritus (itching), muscle and joint pains, Nausea and vomiting, jaundice
Complications of hepatitis
Acute liver failure, acute renal failure, pancreatitis, cholestasis, cryoglobulinemia, coagulopathy.
There are five types of viral hepatitis given below.
1. Hepatitis A ( HAV)
27 nanometer picornavirus (hepatovirus) with single stranded RNA genome.Hav is transmitted by faecal – oral route usually in infected water or food. It can cause Cholestasis which can lead to pruritus, jaundice, dark urine and pale stools.
Investigation of HAV can be done through liver function test in which raised alanine aminotransferese (ALT) and aspartate amino transferese are found especially ALT is found higher
Serological test
The basis for the diagnosis is the detection of igm antibodies to HAV Using Elisa. It usually settle without treatment.
Prevention
Before exposure inactivated HAV vaccine 1ml by intramuscular route is given to prevent HAV. After exposure to HAV immunoglobulin 0.02 ml/kg by intramuscular route withing two weeks.
2. Hepatitis B (HBV)
42 nanometer hepadnavirus with partiality double stranded DNA genome of 3200 nucleotide. It is transferred by direct contact with blood or bodily liquids, such as during intercourse or sharing needle. It can also be transmitted by sharing toothbrushes, razors or contact with open cuts. It can also be passed from mother to child during pregnancy.
Diagnosis
Screening for hepatitis B include HBV antigen HBsAg and anti-Hbc igm antibody in serum for active infection.
Prevention
After exposure in unvaccinated persons : hepatitis immunoglobulin (HBIG) 0.06 ml/kg intramuscular immediately after needle piercing to within 14 days of sexual contact in fusion with vaccine series.
3. Hepatitis C (HCV)
Induced by flavi like virus in the genus Hepacivirus with RNA genome of 9600 nucleotides.It is transmitted by blood and body fluids. Hapatitis C is now curable with direct acting antiviral medications like sofosbuvir and daclatasvir. Without treatment 75 % develop chronic hepatitis C and 25 % fight off the virus and make a full recovery. Complications of hepatitis C without treatment may include liver cirrhosis and hepatocellular carcinoma.
Testing
Anti-HCV antibodies can be found 4 to 10 weeks from infection. The most sensitive indicator of HCV infection is HCV RNA.
4. Hepatitis D ( HDV)
Faulty 37 nanometer RNA virus that needs HBV for its reproduction.It can only survive in patients who also have hepatitis B. It links itself to the HBsAg and can’t remain alive without this protein.
Diagnosis
Presence of Anti-HCV in the serum.
Prevention
Hepatitis B vaccine (for non carriers only)
Management
There are no recommendations for the treatment of acute HDV infections. In patients with chronic infection, the benchmark treatment is pegylated interferon alpha-2a over at least 48 weeks. However this treatment is not very impactful and has remarkable side-effects.
5. Hepatitis E (HEV)
Induced by 29 to 32 nanometer agent looks like calicivirus but pondered within its own genus.it is responsible for waterborne epidemics of hepatitis in India.
Diagnosis
Diagnosis is based on the identification of serum anti-HEV antibodies.
Management
HEV usually produces only mild sickness. The virus is disappeard within a month and its no treatment is required. In patient with severe acute HEV or acute on chronic liver failure, ribavirin may be taken for 3 month.
Complications
Arthritis, anemia pancreatitis, bell’s palsy, ataxia and guillain barre syndrome
To prevent HEV, hygiene standards should be maintained, including water supply.
Acute hepatic failure is rare in HAV infection, but HAV infection in chronic hepatitis B or C may be life threatening.
Drugs for liver diseases
Ursidiol
Metadoxine
Acamprosate
Lactulose
Polybion injection and tablets
Liv 52 Ds
Silymarin/limarin
Aldactone
Lasilactone
Human albumin
L-ornithine ; L-aspartate
Peginterferone