Lexically, hepatitis means inflammation and liver swelling and is divided into acute and chronic forms, the chronic type of which may lead to permanent liver damage and destruction if left undiagnosed and treated. The main cause of hepatitis is the virus, but some other factors such as drugs, alcohol, fatty liver, autoimmune deficiency and drug use can also cause hepatitis. Transmission of the disease is done through direct contact with the patient in the acute stage, blood transfusion, use of common injectables, contaminated food and water, and contact with virus-infected secretions.
Hepatitis has different types in terms of causative agent, including hepatitis (A), (B), (C), (D), (E). The cause of each viral hepatitis is a different virus. Hepatitis A is always an acute and short-term disease, while hepatitis B, C and D are generally progressive and chronic. Hepatitis E is usually acute and can be dangerous, especially in pregnant women.

Symptoms of Acute Hepatitis

Acute hepatitis is usually caused by a viral infection and has certain phases:

• At first the symptoms are not specific and are similar to the flu that appears to be common in many acute infections such as excessive fatigue, nausea, vomiting, decreased appetite, joint pain and headaches. Fever is common in hepatitis A and hepatitis E. In the final stages of this phase, the patient is faced with signs of liver problems such as darkening of urine and red stools.

• 1 to 2 weeks after the beginning of the previous stage, jaundice of the skin and white parts of the eye develop and continue for about 4 weeks. Non-specific symptoms of the first stage usually disappear over time, but the liver enlarges and the person feels pain and discomfort in the upper right side of the abdomen. 10 to 20 percent of people also experience spleen magnitude and weight loss.

• The healing phase is associated with a reduction in clinical symptoms of hepatitis, stability of liver enlargement symptoms and high levels of liver enzymes. All cases with hepatitis A and E are expected to recover after 1 to 2 months. Most people with hepatitis B are also spontaneously restricted and recover within 3 to 4 months. Few cases of complete hepatitis C are treated.

Symptoms of Chronic Hepatitis

Acute cases of hepatitis often improve within 6 months, and if symptoms last longer than this time, the disease has become chronic. Chronic hepatitis usually has no symptoms in the early phase and is only diagnosed with liver photographs or ultrasound. As inflammation progresses, patients will have severe symptoms similar to acute hepatitis, such as:

• Excessive fatigue
• Nausea
• Vomiting
• Decreased appetite
• Joint pain

Jaundice is also likely, but it occurs in the final phases of the disease and the symptom of hepatitis is advanced. Chronic hepatitis leads to hormonal dysfunction of the liver and causes acne, increased thickness and growth of unwanted hair, and menstruation. Severe damage and liver scarring, which are symptoms of cirrhosis, occur over time and with the progression of the disease. At this stage, the liver tissue is dead and has no activity, and as a result, the person suffers the following complications:

• Severe jaundice
• Weight loss
• Blood coagulation disorder
• Fluid in the abdomen
• Swelling of the legs

Diagnosis of hepatitis

If the patient’s clinical symptoms indicate that he or she is infected, the doctor will prescribe a clinical examination and then diagnostic tests for definitive diagnosis of the disease. The first step in diagnosis is to evaluate history and clinical symptoms. During the clinical examination, the doctor presses the abdomen gently to determine any possible pain and swelling in the liver area. Also, symptoms such as yellowing of the eyes and skin are also warning signs, and then liver enzyme level tests are measured to evaluate any abnormal changes in liver function. The rise of some enzymes indicates inflammation in the liver. If the disease is confirmed in blood tests, a tissue sample may be taken from the liver to find out the health of the cells. Liver biopsies do not require surgery and can be performed through a needle-like device that enters the liver through the skin. Finally, in ultrasound, all parts of the liver and its adjacent organs are checked to reveal the extent of inflammation and possible damage.

Hepatitis Vaccine

Among all types of hepatitis, hepatitis B is one of the most serious viral liver problems. The virus, called the HBV virus, can cause lifelong infection, cirrhosis, cancer, and liver failure. The hepatitis B vaccine is available for all age groups and is recommended for all infants, children, adolescents and adults. The hepatitis B vaccine does not contain live virus, so it is permitted to be administered during pregnancy and during breastfeeding.

Treatment of Hepatitis

Acute cases of hepatitis such as A and E are often treated with medication after a short time. But most people with chronic infections, especially chronic hepatitis B infections, need to take medication for the rest of their lives. Treatment helps reduce the risk of liver complications and prevents transmission of infection to others. Treatment of hepatitis includes:

• Antiviral drugs: Several oral antiviral drugs such as tenofovir and adfuvir are able to help the immune system fight the virus and reduce liver complications.
• Interferon injection: Interferon alpha-2-B is a synthetic version of a natural antiviral substance in the body. Interferon injections help the immune system fight hepatitis virus.
• Liver transplantation: If the liver is severely damaged transplantation may be considered as an option.