In this month’s column I want to highlight the medical condition hepatitis, which often can be difficult to detect but can lead to severe consequences. These consequences include jaundice, anorexia and bodily discomfort. Hepatitis results in the inflammation of the liver and potentially liver cell damage and destruction when not diagnosed quickly.
Hepatitis can be confusing, as it comes in several forms. It can heal on its own with no significant consequences, or it can progress to scarring of the liver. Acute hepatitis lasts under six months, while chronic hepatitis lasts longer. According to the Centers for Disease Control and Prevention (CDC), the three main forms are the following:
• Hepatitis A — This type of hepatitis is usually spread by fecal-oral contact or fecal-infected food and water. It may also be spread by blood-borne infection.
• Hepatitis B (HBV) — Transmission occurs through body fluid exposure such as blood, semen, vaginal secretions or saliva. Needle sticks, sharp instruments, sharing items (razors, toothbrushes) and sexual contact with an infected person are primary modes of transmission. Infants may also develop the disease if they are born to a mother who has the virus. Infected children often spread the virus to other children if there is frequent contact or if a child has many scrapes or cuts.
• Hepatitis C — The symptoms are usually mild and gradual. Children often show no symptoms at all. Transmission occurs primarily from contact with infected blood but can also occur from sexual contact or from an infected mother to her baby.
Hepatitis is very widespread. An estimated 250 million people around the world are thought to be affected by hepatitis C, while 300 million people are thought to be carriers of hepatitis B. While there is not specific treatment for hepatitis A, a vast majority of patients will recover on their own. A vaccine for hepatitis B does exist and is now widely used for routine childhood immunization.
Although hepatitis C has milder symptoms initially, it leads to chronic liver disease in a majority of people who are infected. This form of hepatitis is becoming more common, as we are diagnosing and screening it more often in our health centers. The CDC reports hepatitis C as the leading indication for liver transplantation.
What makes hepatitis C a bit more complicated than the other forms is that there is no vaccine. People who are at risk should be checked regularly for hepatitis C. People who have hepatitis C should be monitored closely for signs of chronic hepatitis and liver failure.
General symptoms of hepatitis include diarrhea, fatigue, loss of appetite, mild fever, nausea, vomiting and weight loss. More severe symptoms include dark urine, dizziness, drowsiness, hives, yellow skin and light colored-feces.
When I am asked by a patient how to prevent hepatitis, I often explain there several general prevention tips. These include washing your hands; cooking food properly; drinking bottled water or boiled water if unsure of sanitation; practicing safe sex; not sharing needles, toothbrushes or razors; and watching alcohol consumption. These tips will greatly reduce the chances of all forms of hepatitis.
As always, if you have any of the symptoms outlined above, please contact your doctor and get a checkup. If you do have hepatitis, it is important to be treated to prevent further liver damage.
Nydia Nunez-Estrada, M.D.
Family Medicine
Eskenazi Health Center