The Vital Role of the Liver

The liver plays a crucial role in maintaining our body's well-being. Its functions include:

  1. Nutrient Metabolisation: Transforming nutrients into more accessible forms for the body.
  2. Detoxification: Eliminating toxic substances and foreign bodies.
  3. Nutrient Storage: Preserving vitamins, minerals, glucose, and iron.
  4. Fat and Cholesterol Management: Overseeing fat storage and cholesterol utilisation.
  5. Blood Clot Regulation: Contributing to blood clotting processes.
  6. Energy Production: Generating energy, immune factors, hormones, and blood plasma proteins.

When hepatitis infects the liver, it can significantly impair these vital functions.

Common Causes of Hepatitis

Hepatitis, a condition characterised by liver inflammation, can stem from various sources:

  • Viral Infections: A leading cause of hepatitis.
  • Lifestyle Factors: Excessive alcohol consumption.
  • Infections: Bacterial, protozoan, and leptospirosis infections.
  • Parasites: Contributing to liver inflammation.
  • Medications and Chemicals: Certain types can damage liver cells.

Types of Hepatitis Viruses and Their Characteristics

Hepatitis viruses vary in their nature and impact:

  1. Hepatitis A (HAV): Common in older children and adults, usually resolving without leading to chronic liver disease. A vaccine is available.
  2. Hepatitis B (HBV): Often symptom-free, with potential to become chronic or turn the person into a carrier. Vaccination is available.
  3. Hepatitis C (HCV): Typically asymptomatic, but can lead to cirrhosis and liver cancer. No vaccine is currently available.
  4. Hepatitis D (HDV): Co-occurs with HBV and can cause severe hepatitis.
  5. Hepatitis E (HEV): Not prevalent in Thailand, but common in neighbouring regions.
  6. Hepatitis G (HGV): Transmitted through blood and sexual contact.

Identifying Common Symptoms of Hepatitis

Hepatitis can present a range of symptoms, often similar to the flu, including:

  • General Discomfort: Fatigue, body and muscle aches, joint pain.
  • Digestive Issues: Nausea, vomiting, loss of appetite.
  • Fever and Headaches: Reflecting the body's response to infection.
  • Specific Signs: Abdominal tenderness, right rib pain, pale stools, dark urine.
  • Jaundice: Yellowing of skin and eyes, possibly accompanied by itching.

While most patients recover, hepatitis B can lead to chronic conditions in some cases.

Approach to Hepatitis Diagnosis

Diagnosis typically involves a combination of clinical assessment and specific tests:

  • Symptom Evaluation: Recognising the signs mentioned above.
  • Physical Examination: Checking for physical indicators of liver issues.
  • Blood Tests: Including Liver Function Test (LFT) and specific hepatitis virus tests, detecting markers like SGOT, SGPT, and bilirubin levels.
  • Virus-Specific Tests: Differentiating between various hepatitis viruses through immunoglobulin and antigen tests.

Handling Acute Hepatitis Symptoms

While specific treatment for hepatitis is limited, symptom management is crucial:

  • Rest: Essential for combating fatigue.
  • Dietary Adjustments: Light, low-fat meals to ease digestion.
  • Medical Intervention: Medications for severe symptoms like vomiting or itching.
  • Avoiding Liver Stressors: Staying clear of alcohol and certain medications.

Chronic Hepatitis Treatment and Effective Prevention

Addressing Chronic Hepatitis

Chronic hepatitis, particularly from HBV and HCV, requires careful management:

  • Treatment for HBV: Tailored medication plans by gastroenterologists or hepatologists, considering the patient's condition and medical history.
  • Handling HCV: Determining the virus strain and treatment duration is vital, alongside tests like FibroScan or liver biopsy, to assess infection status before treatment initiation.

Preventive Measures Against Hepatitis

Prevention plays a key role in reducing hepatitis risk:

  • Hygiene Practices: Regular hand washing and consuming well-cooked food and clean water.
  • Safe Practices: Avoiding contact with others' bodily fluids, not sharing personal items, and practising safe sex.
  • Vaccination: Vaccines are available for Hepatitis A and Hepatitis B.

Recurrence Patterns in Different Hepatitis Types

  • Hepatitis A and Hepatitis E: Typically resolve on their own without recurrence.
  • Hepatitis B: Over 90% of patients recover with immunity against recurrence.
  • Hepatitis C and Hepatitis D: Recurrence possibilities are less clear due to limited information.

Persistent Infection Risk

While symptoms may improve or disappear, the virus can remain, posing a risk of future liver damage. This risk is mitigated by the body's antibody response, which becomes more robust once symptoms improve.