What is Hepatitis? Hepatitis is the Latin word for liver inflammation. It is characterised by the destruction of a number of liver cells and the presence of inflammatory cells in the liver tissue. Hepatitis can be caused by diseases that primarily attack the liver cells. It can also arise as a result of a disease such as mononucleosis. Hepatitis can be divided into two subgroups according to its duration:

acute hepatitis - lasting less than six months
chronic hepatitis - lasting longer than six months.

Acute hepatitis has a number of possible causes:

- Infectious viral hepatitis such as hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E.

- Other viral diseases such as: mononucleosis and cytomegalovirus.

- Severe bacterial infections.

- Amoebic infections.

- Medicines, eg paracetamol poisoning and halothane (an anaesthetic).

- Toxins: alcohol and fungal toxins, eg toadstool poisoning.

Chronic hepatitis also has a number of different causes:

- Contagious viral hepatitis such as hepatitis B, hepatitis C and hepatitis D.
Medicines.

- Toxins such as alcohol.

- Autoimmune hepatitis. This is a disease in which a number of liver cells are destroyed by the patient's own immune system. Autoimmune hepatitis can also sometimes occur as acute hepatitis. The cause is unknown.

- Inborn metabolic disorders, such as Wilson's disease (disorder of the body's copper metabolism) and haemochromatosis (disorder of the body's iron metabolism)

People can develop hepatitis if they contract one of the viruses that can cause liver inflammation, or as a result of exposure to substances that can cause hepatitis - alcohol, fungal toxins and certain medicines. There are two ways in which medicines can lead to hepatitis: it can either occur as a result of medicine poisoning through overdoses of a medicine (eg paracetamol), or it can occur as a result of an abnormal reaction of the liver to a normal dose (eg halothane, the anaesthetic). The latter type of hepatitis is rare.

Acute hepatitis
The symptoms of acute hepatitis very considerably from person to person. Some patients have no symptoms at all, and in most cases, children only show mild symptoms.
In the early stages:
- tiredness, general malaise, slight fever
- nausea, poor appetite, changes in taste perception
- pressure or pain below the right ribs caused by an enlarged liver
- aching muscles and joints, headache, skin rash.

The jaundice phase:
- yellowing of sclera (the white portions of the eyes), skin and mucous membranes
- dark urine
- light-coloured stools

around this time, the other symptoms subside.

The recovery phase: tiredness that can last for weeks.

Many patients have no symptoms.
Tiredness, an increased need for sleep, aching muscles and joints.
Periodic light pressure or pain below the right ribs - liver enlargement.
Jaundice is a very late symptom of chronic hepatitis. It is a sign that the disease has become serious.

The risk of hepatitis?

Patients with jaundice or other symptoms of hepatitis.
People who are very likely to have contracted the hepatitis B or the hepatitis C virus.
People who are at increased risk due to a hereditary type of hepatitis in their families.

The prevention of hepatitis:

By avoiding exposure to the infectious hepatitis viruses.
By taking enough rest or sleep.
By refraining from drinking large amounts of alcohol.

Do's
- Avoid drinking alcohol if you have symptoms of hepatitis or if a blood sample has shown that the disease is active.
- If alcoholism is the cause, you must stop drinking completely and see your doctor. Eat a well-balanced diet.
- If you have symptoms of acute hepatitis, you may need to slow down. However, if you feel fine, there is no reason why you should not go to work and keep up your other activities.
- If you have chronic hepatitis, try to lead a normal life as far as possible.
- People with hepatitis B must inform their family and their sexual partners about it. They will need to protect themselves by being vaccinated against it. Condoms should be used until the vaccine has begun to work.
- If you have hepatitis A, you must inform your family, so that they can protect themselves against it by practicing good hygiene .

Hepatitis- The diagnosis is confirmed by blood samples, and, in some cases, by a tissue sample from the liver (biopsy). Some of the blood samples are used for establishing the cause of the disease and excluding other known causes.

Other blood samples will reveal the degree of activity of the inflammation at the time when the samples are taken.
In cases of chronic hepatitis, the extent of the damage to the liver can only be established via a tissue sample from the liver.

Future prospects:
- Acute infectious viral hepatitis usually improves on its own. Less than 1 in 300 patients develop liver failure and risk dying. Hepatitis B and hepatitis C can become chronic. Hepatitis A never does.
- Hepatitis caused by mononucleosis always improves on its own.
- Acute hepatitis caused by medicines or alcohol usually improves once the liver is no longer exposed to these substances.
- About one fifth of the patients with chronic hepatitis B and C are at risk of developing cirrhosis or cancer of the liver.
- Cirrhosis can also be caused by other types of chronic hepatitis.