Hepatitis

Hepatitis

Hepatitis is a condition that leads to the inflammation of the liver. It is mainly caused due to a viral infection. However, it can be caused by many other reasons too, like autoimmune hepatitis and hepatitis caused as a result of the intake of medicines, drugs and alcohol.

The 5 viral types of Hepatitis include: Hepatitis A, B, C, D and E. Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to be chronic. Hepatitis E is usually acute but can be dangerous in pregnant women.

According to the Center for Disease Control and Prevention (CDC), nearly 4.4 million Americans are currently living with chronic hepatitis B and C. Many more people don’t even know that they have hepatitis. In the United States (U.S.), the incidence of hepatitis A has been falling for the last 20 years, but acute hepatitis C has seen an increase of 44 percent between 2011 and 2012.

Treatment options depend on the type of hepatitis you have. You can prevent some forms of hepatitis through immunizations and lifestyle precautions.

Causes:

Cause of Hepatitis

  • Excessive intake of alcohol leads to the inflammation and damage of the liver. It can also cause permanent damage like the failure of scarring of the liver.
  • Overdose of certain medication.
  • Exposure to poisons.
  • Autoimmune hepatitis, a condition that occurs when your body makes antibodies against your liver tissue. It’s three timesmore common in women than in men.

 

Symptoms:

Symptoms of Hepatitis

  • Jaundice or yellowing of eyes.
  • Internal bleeding.
  • Loss of weight and appetite.
  • A condition of stupor (mental change) or coma.
  • Pain in the abdomen.
  • Pain in muscle and joints.
  • Urine is dark in colour.
  • Stools are light-coloured.

Diagnosis:

Diagnosis of Hepatitis

  • Physical examination: In this test, the doctors press the abdomen slightly, to see if there is any pain or sensitivity. He might also try to feel the liver to check if it has enlarged. Eyes and skin are checked to look for the yellowness.
  • Blood test: Blood tests are conducted to look for the functioning of the liver. High levels of enzymes indicate improper functioning of the liver. It is also used to detect the virus that causes hepatitis. They are also used to check for antibodies.
  • Ultrasound: An Ultrasound is recommended to check the fluid in your abdomen, enlargement or damage of the liver, liver tumors and abnormalities in the gallbladder.
  • Liver biopsy: Liver biopsy is recommended by the doctors to detect the effect on inflammation and infection on the liver.
  • Nucleic acid tests: This test is recommended for hepatitis B and C, an HBV DNA or HCV RNA test can confirm the speed at which the virus is reproducing in the liver, and this will show how active the disease is.
  • Paracentesis: This process involves the extraction and testing of the fluids of the abdomen to detect the cause of fluid accumulation.
  • Elastography: This process helps to measure the liver’s stiffness by emitting sound waves.
  • Surrogate markers: A type of blood test to assess the development of cirrhosis and fibrosis.

Treatment:

Treatment of Hepatitis

  • Treatment for Hepatitis A: There is no specific treatment for HAV. The doctor will usually advise the patient to avoid alcohol and drugs during the recovery. Most patients with hepatitis A will recover without intervention.
  • Treatment for HBV: A patient with HBV requires adequate amount of rest and completely avoid alcohol. The doctor may prescribe an antiviral agent called interferon, or other antiviral suppressive therapies.
  • Treatment for HCV: A patient with hepatitis C is recommended to take antiviral agents, with or without ribavirin.

●       Treatment for autoimmune hepatitis: Patients are recommended to take corticosteroids, like prednisone or budesonide. Azothioprine ( Imuran ), a drug that suppresses the immune system, is often included in treatment. It can be used with or without steroids. Other immune suppressing drugs like mycophenolate (CellCept), tacrolimus (Prograf) and cyclosporine (Neoral) can also be used.

●       Liver transplant: If the liver is damaged beyond repair, a liver transplant is conducted.

Life after surgery:

Life after Surgery

  • Liver transplants are usually a great success. According to the most recent year computed UNOS/OPTN (2004) national average one-year graft survival at 83%, and patient survival at 87% for patients receiving a deceased donor liver and 92% for those transplanted with an organ from a living donor.
  • After a liver transplant, a patient is recommended to stay in the I.C.U for a few days and then later shifted to the transplant recovery area for 5-10 days. The patient can then go back to normal day-to-day activities. Regular follow-ups are advised and patients have to take the medicines for lifetime.

Risks involved:

Risk Involved in Hepatitis

Patients with chronic hepatitis B or C are at risk for Chronic liver disease, cirrhosis and live cancer.

If the liver stops functioning, liver failure can occur. Patients with chronic hepatitis B and C are asked to avoid alcohol because it can accelerate liver disease and failure. Certain medications can also affect the functioning of the liver.

Risks involved in a liver transplant include:

  • Organ rejection.
  • Failure of the donated liver.
  • Clots of blood.
  • Bile duct leaks.
  • Shrinking of bile ducts.
  • Long-term complications may also include recurrence of liver disease in the transplanted liver.

 

Prognosis:

Hepatitis - prognosis

Hepatitis A & B, hepatitis C has higher risk of progressing to chronic hepatitis, approaching 85–90%. Cirrhosis has been reported to develop in 20–50% of patients with chronic hepatitis C. Series of patients with compensated cirrhosis due to HCV have shown up to 3,5, and 10-year survival rates of 96, 91, and 79% respectively. The 5-year survival rate drops to 50% upon if the cirrhosis becomes decompensated.

Cost:

Hepatitis Treatment Cost

The estimated 1997 cost of hepatitis A among adolescents and adults is $488.8 million. Only 26% of this sum is represented by treatment costs, with larger shares comprised of morbidity (36%) and mortality (38%) costs.

HBV can cost $36 per person for full treatment for a year.

Gilead Sciences priced the treatment at $1000 per pill, making the total cost of the treatment $84,000. Gilead then combined sofosbuvir with a new drug, ledipasvir, to create the even more effective combination treatment, Harvoni. Harvoni’s total treatment cost is $94,500 for a 12-week regimen.

In the late 90s, when the first successful liver transplants were done in India, the procedure cost Rs.20 lakh. Now, a resection costs between Rs.3 and 4 lakh and a transplant Rs.20-25 lakh in a private hospital.

New Life Clinics offers a low-risk way to treat Hepatitis. Our team of experienced and skilled doctors make life at hospital a painless one and guarantee a speedy recovery. 

 New Life Doctors

 

References: