hepatitis Hepatitis is a collective term for liver inflammation caused by various pathogenic factors such as bacteria, viruses, parasites, alcohol, drugs, chemicals, and autoimmunity. Both children and adults can be affected, with viral hepatitis being more common, caused by viral infections. The contagiousness of hepatitis depends primarily on its etiology. Hepatitis A and E, caused by viral infection, are highly contagious and can be transmitted through the digestive tract, while hepatitis B, C, and D are transmitted through blood and other routes. Other non-viral hepatitis is non-infectious.

Hepatitis is a general term for liver inflammation caused by various pathogenic factors such as bacteria, viruses, parasites, alcohol, drugs, chemicals, and autoimmune responses. Both children and adults can be affected, with viral infections being a common cause of viral hepatitis. The contagiousness of hepatitis depends mainly on the causative factor. Hepatitis A and E are highly contagious and can be transmitted through the digestive tract, while hepatitis B, C, and D are transmitted through blood and other routes. Other non-viral hepatitis types are non-contagious.

Hepatitis is caused by various pathogenic factors that invade the human body and cause damage to liver cells, triggering an inflammatory response in the liver.

Causes of Viral Hepatitis

Viral hepatitis occurs when hepatitis viruses infect the body, causing viremia. The hepatitis viruses enter the liver, replicate, and release more viruses, leading to immune activation, destruction of virus-infected liver cells, induction of cell death or apoptosis, resulting in liver inflammation, necrosis, and further development of liver fibrosis, cirrhosis, and liver cancer.

Causes of Alcoholic Hepatitis

Alcoholic hepatitis occurs when the body ingests alcohol (ethanol) and its metabolites, leading to hemodynamic changes, hepatic cell steatosis, hypoxia, and immune-mediated damage, resulting in hepatitis.

Causes of Fatty Liver Disease

Fatty liver disease is mainly caused by overweight and obesity, with a small portion possibly being caused by drugs, metabolism, and other factors. Fatty liver disease is closely related to high-calorie diets, intake of sugary beverages, and a sedentary lifestyle.

Autoimmune Hepatitis Causes

Autoimmune hepatitis results from immune dysregulation, leading to the body launching an immune attack against liver cells, causing hepatitis. It is characterized by elevated transaminases, positive autoantibodies, and increased immunoglobulins.

Drug-Induced Hepatitis Causes

Drug-induced hepatitis occurs due to the direct or indirect hepatotoxicity of drugs and their metabolites, and can also lead to liver cell damage through immune activation. Manifestations can include non-jaundiced hepatitis, jaundiced hepatitis, severe hepatitis (liver failure), as well as cirrhosis and liver cancer.

Skin

Patients may exhibit a "hepatic facies," with itchy and dull skin, and may develop brownish pigmentation on the cheeks. Jaundiced patients may experience skin and scleral yellowing, as well as yellow urine. Chronic hepatitis can lead to the appearance of spider nevi on the neck, chest, hands, and arms.

Additionally, patients may develop redness at the base of their nails, which fades upon pressure, known as "liver palms." Patients with alcoholic hepatitis may also exhibit signs such as an "alcoholic facies" and a "whiskey nose." Those with autoimmune hepatitis may occasionally develop rashes.

Digestive System

Patients may experience varying degrees of nausea, loss of appetite, bloating, diarrhea, or constipation. Acute hepatitis often presents with a marked aversion to fatty foods, and due to liver enlargement, patients may experience tenderness in the right upper abdomen, with palpable liver tenderness.

Severe hepatitis can lead to abnormal coagulation function, potentially causing gastric mucosal erosion and bleeding, resulting in upper abdominal pain, black stools, or hematemesis.

Nervous System

Fatigue, lethargy, and mental fatigue can occur, along with peripheral nerve damage symptoms such as numbness in the extremities. Patients with alcoholic hepatitis may experience memory impairment and tremors. Severe hepatitis or alcohol intoxication can lead to confusion, and even stupor or coma.

The possibility of curing hepatitis depends on the underlying cause:

In viral hepatitis, acute hepatitis such as hepatitis A, except for those who die from severe hepatitis, can generally be cured. Most cases of acute hepatitis B that do not progress to chronic hepatitis can also be cured. Although chronic hepatitis C is more common, there are now specific drugs available, and the vast majority of patients can be cured. Hepatitis D cannot occur independently and needs to be associated with hepatitis B, making it difficult to cure.

Alcoholic hepatitis and non-alcoholic fatty liver disease, if not accompanied by significant fibrosis, can be cured through strict lifestyle control and standardized drug treatment.

Some types of autoimmune hepatitis cannot be cured and may progress to cirrhosis, while others can be cured through standardized treatment.

For drug-induced hepatitis patients, stopping the medication in a timely manner can halt liver damage and lead to a cure.

Rest

During the course of hepatitis, patients should rest in bed and reduce physical activity.

Diet

Patients should pay attention to dietary hygiene to avoid various infections.

Dietary Recommendations

The diet should primarily consist of easily digestible and light foods such as millet congee and oatmeal, while ensuring adequate intake of energy and fluids.

Dietary Restrictions

During the acute phase, it is advisable to avoid heavy, spicy, and cold foods, as well as alcohol consumption.

Alcohol consumption should be prohibited.

Prevention of Viral Hepatitis

Managing the source of infection

Due to the transmission of hepatitis A and E through the digestive tract, patients in the acute phase need to be isolated to reduce the risk of transmission. Healthcare providers should pay attention to personal hygiene to prevent infection through the oral route.

Patients with hepatitis B, C, and D do not need to be isolated, but timely antiviral treatment to reduce viral levels is necessary to minimize the risk of transmission. Strict screening of blood donors should be implemented to avoid bloodborne transmission.

Cut off transmission routes

Use disposable syringes, strictly disinfect medical equipment, and prevent iatrogenic transmission. Excreta, blood, and body fluids from patients should be disinfected. Improving personal hygiene and strengthening feces and water management can prevent hepatitis A and E.

Protect susceptible populations

Avoid contact with patients in the acute phase of hepatitis. Newborns and children should receive planned immunizations for hepatitis B and A. Adults, especially high-risk individuals, should be encouraged to receive hepatitis B and A vaccinations. In China, a vaccine for hepatitis E has been developed and is available, and it is recommended that patients with liver disease, pregnant women, and the elderly be vaccinated if conditions permit.

For patients with other causes of hepatitis, there are no special care requirements.

Prevention of Non-viral Hepatitis

Control alcohol consumption and avoid heavy drinking.

Maintain weight and control overweight and obesity.

Regular exercise helps control weight, increase insulin sensitivity, and prevent fatty liver, diabetes, and cardiovascular diseases.

Avoid indiscriminate use of drugs to reduce the risk of drug-induced hepatitis.