LIVER CONDITIONS

Viral hepatitis (A, B, C & D)


Viral hepatitis refers to any viral infection that affects the liver cells. The most commonly known ones are hepatitis A, B, C and D.

Hepatitis A Virus (HAV):

With Hepatitis A we know that it is usually caught by contaminated foods and contact with someone who has the virus and if you catch it without being immunised you may feel nauseous and unwell for a few days and then very tired for a few weeks but the overall full recovery rate is about 99%. As with all liver injuries we would tell you not to drink alcohol whilst your liver was recovering and to be careful with the use of medications whilst you are getting better.

Hepatitis B virus (HBV):

Hepatitis B is a virus that multiplies in the liver cells and it is thought that 2 billion people worldwide have evidence that they either have had the infection or are currently infected. This means that there are around 367 million world wide carriers of HBV(WHO,2003). However less than 5% of those infected will go on to develop chronic liver disease (CLD) and the problems associated with progressive damage being done to the liver over time. Some people have no symptoms of infection; however others may get symptoms such as:

  • tiredness
  • fever
  • malaise
  • flu-like feelings
  • nausea and/or vomiting
  • loss of appetite
  • abdominal pain or bloating
  • indigestion
  • headaches
  • itching
  • muscle or joint aches
  • jaundice

Hepatitis B is best prevented by immunisation but if you have been infected treatments with anti-viral therapy (dependent upon viral activity) can be worthwhile. If you have had the infection for many years and have liver damage as a result of hepatitis B then you need to have the symptoms of that damage monitored and treated and you may eventually require a liver transplant. However, not everyone who gets hepatitis B will go on to get liver disease and treatment is therefore based on blood test analysis and your health history.

Delta virus is the name given to Hepatitis D (HDV). This is a separate virus to HBV but it is carried on it so therefore you cannot be positive to HDV unless you are already infected with Hepatitis B.

Hepatitis C :

Identified in 1989 with the antibody test only widely available since 1992 to screen for its presence, Hepatitis C (HCV) is becoming one of the major causes of liver disease world wide. Over 170 million people world wide are thought to be currently affected and this number is growing yearly. There are certain areas of the world where the proportion of people who have HCV is more common for instance in Egypt and Rawanda where up to 18% of the entire population is infected. This is important as different geographical areas tend to have different forms of HCV which are medically referred to as 'genotypes'. There are 6 genotypes of HCV and it is important to know what the genotype is as this tells us about treatment options and helps us to predict response to treatments.

The ways of becoming infected with HCV vary but here are the most common forms of how it is passed:

  • injection drug use
  • blood products
  • therapeutic injection
  • ritual scarification
  • sexual contact
  • body piercing
  • sharing toothbrushes
  • 5% unknown

With hepatitis C it can be hard to find out if you have the virus as you may have no symptoms. However if you have a family member with the virus it is important to be tested and if you have a combination of the following symptoms and fall into a risk group then you may wish to get tested:

Symptoms:

  • fatigue
  • jaundice
  • poor appetite
  • nausea
  • right upper abdominal pain
  • fever
  • flu-like symptoms
  • headaches
  • muscle or joint pain
  • dark urine

Treatment for HCV varies according to genotype, the stage at which you present and whether you have been treated before. The aim is for early treatment with antiviral therapy to stop the virus multiplying and thus stop it causing liver damage. However, with progressive 'chronic' liver disease caused by hepatitis C, the aim is to decide whether you require control of the symptoms of liver disease or assessment of the need for liver transplantation. To discuss the options or to find out the cost of therapy fro HCV then please contact the CNS for the liver unit whose number is on the contacts page.

For further information see www.hepcuk.info or www.britishlivertrust.org.uk