Until recently only two major types were recognised; hepatitis A and hepatitis B. Other types were often called non-A non-B hepatitis. New viruses such as hepatitis C and E and the delta agent (hepatitis D) have now been discovered and as research continues more viruses which can cause this infection may be identified. Viruses such as Epstein-Barr virus, cytomegalovirus and yellow fever virus can also infect the liver and produce a hepatitis-like illness.
Contracting Viral Hepatitis
The disease can be caught in different ways depending on the type of virus causing the infection. Hepatitis A and E are spread by the consumption of food and drinking water contaminated with infected faeces; faecal-oral spread. Hepatitis B, C and D are spread by contact with blood or other body fluids from an infected person; blood-borne spread.
The Symptoms of Viral Hepatitis
These are very variable. Many patients have no symptoms at all, others just feel 'off colour' for a few days. The first symptoms noticed by most patients are often tiredness, weakness, muscle pains and headaches followed shortly by loss of appetite, nausea, vomiting and discomfort on the right side of the upper abdomen. These symptoms usually last for about three to ten days. They are followed by jaundice (a yellowing of the eyes and skin) and often dark urine with pale stools and a mild fever. The jaundice can last for up to six weeks during which the patient generally begins to feel better. Tiredness is usually the last symptom to disappear. Some patients also have painful joints and those with severe jaundice often complain of intense itching of the skin.
Diagnosing the Virus
The diagnosis is usually confirmed by laboratory tests on blood samples. The blood levels of liver enzymes are raised, particularly when the patient is jaundiced. These usually return to normal several weeks after the jaundice and other symptoms have subsided. Additional blood tests can be performed which will help to identify the virus causing the acute illness. This is important as hepatitis B and C can persist in the body to cause a chronic infection. Blood samples collected six months or more after the acute illness will show either raised serum liver enzymes or persistence of the virus if chronic hepatitis has occurred.
Available Treatments
Most patients can be cared for at home. Ample bed-rest together with a light diet and non-alcoholic fluids during the early part of the illness are recommended. Occasionally admission to hospital is advised because of persistent vomiting or development of suspected liver failure. There is no specific anti-viral treatment for acute viral hepatitis. Depending on the cause, certain forms of chronic hepatitis may be treated with steroids, interferon or other anti-viral agents. A liver transplant may be considered in cases of fulminant acute hepatitis or if liver failure develops.
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