1.0 Hepatitis, presentation + A

hepatitis

describes inflammation of the liver, usually the result of a viral infection or liver damage caused by drinking alcohol

hepatitis has many causes

• viral infection

• alcohol abuse

• drugs

• autoimmune diseases

• metabolic disorders

the most common cause of hepatitis

viral infeciton

there are different forms of hepatitis

• A

• B

• C

• D

• E

alcoholic hepatitis

excessive alcohol consumption over time can lead to liver inflammation and damage

non alcoholic steatohepatitis (NASH)

conditions like non alcoholic fatty liver disease which is associated with obesity and diabetes can lead to hepatitis

autoimmune hepatitis

a condition where the body’s immune system attacks the liver cells mistaking them for harmful invaders

drug induced hepatitis

certain medications like paracetamol and toxins can cause liver inflammation, like acetaminophen overdose or prolonged use of some antibiotics

viral hepatitis may be asymptomatic or present with non specific symptoms

• abdominal pain

• fatigue

• flu-like symptoms

• pruitus (itching)

• muscle/ joint aches

• nausea and vomiting

• jaundice

hepatitis B and C lead to chronic disease in hundreds of millions of people

both the most common cause of:

liver cirrhosis,

liver cancer

and viral hepatitis related deaths

hep B+C are the main infectious disease killers

causing 1.3 million deaths per year

estimated 304 million people worldwide live with hep B/C

for most testing + treatment remains beyond reach

hepatitis A is the most common viral hepatitis worldwide

but relatively rare in the UK

Hep A is highly endemic in areas like

central + south America

Africa

the middle east

Asia

the western pacific

Hep A is a naked RNA virus of the picornavirus family

transmitted via faecal-oral route, usually in contaminated food/water

vaccination is available

to reduce the chance of developing infection

Hep A causes cholestasis, slows bile flow through the biliary system

with resultant purritus,

significant jaundice

dark urine

pale stool

Hep A diagnosis is based on IgM antibodies

it usually resolves itself without treatment

rarely hep A can lead to acute liver failure

fulminant hepatitis

hep A managment is supportive

basic analgesia