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Viral Hepatitis
 
Liver is the largest gland in the human body performing a variety of important functions. These include synthesis of serum proteins, production of bile, regulation of nutrients and various metabolic and excretory functions. Any inflammation of liver is termed Hepatitis. This is most commonly caused by viral infections. But there are other causes also like Alcohol, Drugs, metabolic, Auto immune disorder and Non alchoholic fatty liver.

There are different viruses that can cause Hepatitis. The common ones include Hepatitis A, B, C and E. The course of illness differ for different viral hepatitis. Hepatitis A is always an acute and short term disease. This type of hepatitis is most commonly transmitted by consuming contaiminated food or water. Similarly Hepatitis E is also transmitted by feco-oral route and has a beningn course except in pregnant women where it can produce serious illness.

Hepatitis B and C infections are transmitted through contact with infectious body fluids such as blood, vaginal secreations or semen. These two infections can remain in the body for long and can produce permanent liver damage- Cirrhosis. In this condition, the liver is shrunken and its functions may be severely compromised. Hepatitis D is a rare form of hepatitis that occurs only in conjunction with Hepatitis B infection.

Signs and symptoms of acute hepatitis appears quickly. These include fatigability, flu like symptoms, yellowish discoloration of eyes and urine, pale stools etc. The liver is usually enlarged. Rarely acute hepatitis can progress to fulminant liver failure. Chronicle hepatitis develop slowly. So the condition may go unnoticed.. Disease manifestation occur only in the advanced stage of cirrhosis.

Hepatitis can be diagonised by simple blood tests. Liver function test is a blood test to determine how effectively our liver works. In acute viral hepatitis the liver enzymes- SGOT/SGPT are grossly elevated. There are specific blood tests to determine the exact cause of hepatitis. Ultrasound scan of abdomen allows your doctor to have a close look at your liver and nearby organs. Liver bopsy is done only in special circumstances to help in diagnosis.

Treatment options depends on the type od hepatitis. Acute hepatitis A usually requires only supportive treatment. Adequate rest is advised during the period of illness. Hepatitis A vaccine is
available to prevent infections for both children and adults. Acute Heapatitis E also requires only supportive treatment. However pregnant women who develop this infection requires close monotoring and care.

The treatment of Hepatitis B and C is more complex as they become chronic and can produce long term sequelae. Acute Hepatitis B which usually presents as jaundice is self limiting. The presence of Hepatitits B positive (Hbs Ag+) alone is not an indication of treatment. But when the virus is actively multiplying antiviral treatment should be started. Hepatitis B infection can be prevented by vaccination. A series of three vaccines needs to be taken for complete protection.

In the treatment of Chronic Hepatitis C, previously only injections were available. But now a variety of oral medications are used very effectively and complete cure from this disease can be achieved. Unfortunately there is no vaccine for Hepatitits C till now.

The most dreaded complication of Hepatitis B and C infection is the development of Cirrhosis. Our aim should be to prevent thos complication form developing. This can be achieved by treating these infections quiet early.

Dr Ajith K Nair MD DM
Senior Consultant and Chief Coordinator
Dept. Of Gastroenterology
KIMS Hospital, Trivandrum.


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