Q: What causes hepatitis disease?

A: Hepatitis refers to inflammation (a situation that causes swelling, redness, heat and pain of affected area) of the liver cells caused by a viral infection or damage to the liver as a result of drinking too much alcohol.

The liver is an organ in the body which is usually found on the right side of your abdomen, just under the rib cage. Its job is to ensure that toxins taken into the body are rendered harmless, food is digested properly and the nutrients available in it, properly absorbed.

There are different types of hepatitis and some of them will not cause serious problems while others will cause long lasting damage to the liver and could lead to cancer.

The symptoms of liver disease include yellowness of the eyes and/or skin, dark urine, pale (light coloured) stool, itching, abdominal pain, abdominal swelling etc. You are more at risk of this if you work in a center where you handle body fluids (so this list includes healthcare workers). Other people who are more at risk include diabetics, obese people, people who take a lot of alcohol, drug abusers (this includes people who use illicit drugs and those who abuse prescription drugs), people who are in the habit of indiscriminate and unsafe sex etc

Hepatitis A: This is caused by eating food or drinking water contaminated by the faeces of someone who already has the infection. This is usually common in areas with poor sanitation. This infection would usually resolve after a couple of months but sometimes it could be very serious and life-threatening. Treatment is focused on symptoms like pain, itching etc

Prevention is vaccination with the Hepatitis A vaccine.

Hepatitis B: Hepatitis B infection is caused by the Hepatitis B virus (HBV) and it can cause very serious symptoms in people or it could very well pass unnoticed and be discovered by chance as in this question. The infections that occur in adults are usually acute and the body is able to clear the infection within 6 months. However, in a small proportion of adults and in a lot of infections occurring in children, the infection remains the body for a long time (chronic) leading to complications like liver failure and cirrhosis (long term liver disease in which there is scarring of the liver due to different types of liver disease) of the liver.

The symptoms include yellowness of the skin and eyes, dark urine, fatigue, body and joint aches etc. These symptoms vary in severity and appear about 3 months after infection.

Causes of HBV infections include contact with infected sharps like needles, sexual contact with an infected person, having multiple seal partners, sharing needles used for intravenous drug use.

If one suspects exposure to HBV infection, an immunoglobulin injection if taken within 24 hours can prevent the infection. Treatment depends on the type of HBV infection…whether acute or chronic. To confirm whether the infection is acute or chronic, the doctor runs a couple of tests.

The Hepatitis B surface antigen. A positive test result confirms that an infection is present but does not tell us if it is acute or chronic.

The Hepatitis B surface antibody. A positive test confirms that an infection had occurred but the body had developed antibodies to fight off the infection. This person is no longer contagious.

The Hepatitis B core antibody. A positive result tells us that a past or present infection exists. This is mainly interpreted in conjunction with the other two tests.

If the core antibody is positive and the surface antibody is positive, it means that the body had encountered this infection and fought it off in the past. This is likely to be an acute infection.

If the core antibody is positive and the surface antigen positive, it is more likely to be a chronic infection.

Treatment for acute infections focus on alleviating the symptoms noted above. Treatment for chronic infections focus on use of antiviral drugs and other medications that improve liver function. If liver function Is badly affected, transplant might be an option.

So, the first focus for you is to confirm if this is an acute or a chronic infection. That will determine the way forward. Remember that you can improve liver function by staying off alcohol, exercising, eating a lot of fruits and vegetables and not self-prescribing.

To avoid this infection, reduce your risk factors: Know the Hepatitis status of partner and be faithful to that person, where necessary, use condoms, stop the use of illicit drugs, do not share needles and other sharps, be careful with tatooing et al.

Vaccines are available for this virus and is now listed on the National Program on Immunization schedule. All adults who also have risk factors as noted above should also take this vaccine.

Hepatitis C: This is spread through blood to blood contact eg sharing needles. In a few cases, people can fight off the infection, but in most people, the virus survives and causes chronic (long standing) infection which can lead to cirrhosis and liver failure. There is no vaccine for this infection.

Hepatitis D: This is caused by Heaptitis D virus and only occurs in people already infected by the Heaptitis B virus as it requires the latter to survive in the body.

It is spread through blood to blood and sexual contact. Long term infection with this can put one at risk of liver failure and cirrhosis. There is no vaccine against this but given its relationship with Hepatitis B, vaccination against Hepatitis B can provide some protection against this as well.

Hepatitis E: This is caused by eating food or drinking water contaminated by the faeces of someone who already has the infection. This infection is usually mild and would usually resolve without treatment but sometimes it could be very serious and life-threatening. It can also become long term especially in people with suppressed immune systems.

There is no vaccine for this infection. Focus is on ensuring good hygiene.

Other types of hepatitis include:

Alcoholic hepatitis due to taking excessive amounts of alcohol over years. This can lead to liver failure, cirrhosis or liver cancer. Prevention is reducing your alcohol intake or stopping completely J

Auto-immune hepatitis is is a situation in which the body begins to attack its own liver cells for no reason. Treatment is the use of drugs to suppress the body’s immune system.

What foods should a hepatitis patient take? A healthy balanced diet, really. Stay off alcohol though as this causes further damage to the liver. Be sure to drink sufficient amounts of water daily and discuss all drugs you’re taking with your doctor.

I hope this helps.