Hepatitis is inflammation of the liver or liver. This condition can be caused by many things, ranging from viral infections, alcohol consumption habits, use of certain drugs, autoimmune diseases, and liver worm infections. If caused by a viral infection, hepatitis can be transmitted to other people.

Hepatitis is characterized by symptoms such as fever, joint pain, abdominal pain, and jaundice . This condition can last for 6 months ( acute ) or more than 6 months (chronic).

If not treated properly, hepatitis can cause complications, such as liver failure , cirrhosis, fulminant hepatitis , or liver cancer ( hepatocellular carcinoma ).

Causes of Hepatitis

There are various things that can cause hepatitis, ranging from viral infections, addiction to alcoholic beverages, use of certain drugs, autoimmune diseases, and liver worm infections.

The following is an explanation of each cause of hepatitis:

1. Hepatitis A

Hepatitis A is caused by infection with the hepatitis A virus (HAV). Transmission of this type of hepatitis can occur through food or drink contaminated with the hepatitis A virus.

2. Hepatitis B

This type of hepatitis is caused by infection with the hepatitis B virus (HBV). Hepatitis B can be transmitted through unprotected sexual intercourse and blood transfusions. In rare cases, pregnant women who are infected with the hepatitis B virus can transmit this virus to their fetuses.

3. Hepatitis C

Hepatitis C is caused by infection with the hepatitis C virus (HCV). Transmission of hepatitis C can be through unprotected sexual intercourse or the use of unsterile needles.

Just like hepatitis B, this virus can be transmitted from a mother infected with hepatitis C to her fetus.

4. Hepatitis D

Hepatitis D is inflammation of the liver due to infection with the hepatitis D virus (HDV). This type of hepatitis is rare, but can cause serious health problems.

A person can be infected with hepatitis D if they have a history of hepatitis B. Transmission of this virus can be through the use of unsterile needles or blood transfusions.

5. Hepatitis E

Hepatitis E is caused by infection with the hepatitis E virus (HEV). Hepatitis E is transmitted through water or food contaminated with this virus. Therefore, hepatitis E is easily transmitted in environments with poor sanitation.

6. Hepatitis due to alcohol addiction

Excessive consumption of alcoholic beverages can cause inflammation in the liver and cause permanent damage to liver cells. This certainly interferes with liver function. If left untreated, this condition can develop into liver failure and cirrhosis.

7. Hepatitis due to certain drugs

This type of hepatitis, which is also called toxic hepatitis , occurs due to the consumption of certain drugs that exceed the dosage. The liver can become inflamed or damaged by working too hard to break down these drugs.

8. Hepatitis due to autoimmune disease

In hepatitis caused by an autoimmune disease , the body's immune system mistakenly attacks liver cells, causing inflammation and liver damage.

9. Hepatitis due to liver worms

Inflammation of the liver can also occur due to infection with liver flukes , namely opisthorchiidae and fasciolidae . One of the opisthorchiidae species of heartworms that most often causes infection is Clonorchis .

A person can get this type of hepatitis if they eat food that is not cooked and is contaminated with the liver worm larvae.

10. Acute hepatitis of unknown cause

Apart from those mentioned above, there is also a type called mysterious acute hepatitis. This hepatitis has no known cause, but there are suspicions that this disease is related to the Adenovirus and SARS-CoV-2.

Mysterious acute hepatitis affects children aged 1 month to 16 years. In Indonesia, as of May 5 2022, it is known that three children have died, allegedly due to this acute and mysterious childhood hepatitis .

Hepatitis risk factors

There are a number of factors that can increase a person's risk of suffering from hepatitis, namely:

  • Not washing hands after using the toilet, before preparing food or before eating
  • Eating food contaminated with the hepatitis virus or food that is not thoroughly processed
  • Sharing personal items, such as razors or nail clippers
  • Having sex with someone with hepatitis, having more than one sexual partner, or having sex with men (MSM)
  • Suffering from HIV disease
  • Work as a health worker or in a water and waste treatment center
  • Frequently receive blood transfusions , especially if the donor's blood does not go through strict examinations or the tools used are unhygienic
  • Taking several types of drugs that contain paracetamol, or taking herbal medicines without first consulting a doctor

Symptoms of Hepatitis

Hepatitis sufferers usually don't feel symptoms until several weeks or there has been impaired liver function. In patients with hepatitis due to viral infection, symptoms will appear after the incubation period, which is around 2 weeks to 6 months.

Common symptoms that appear in people with hepatitis are:

  • Nausea and vomiting
  • Fever
  • Easily tired
  • Pale stools
  • Dark urine
  • Abdominal pain
  • Joint pain
  • Loss of appetite
  • Jaundice
  • Weight loss

When to see a doctor

Immediately do an examination to the doctor if you experience complaints as mentioned above. Examination also needs to be done if you suffer from conditions that increase the risk of developing hepatitis, such as autoimmune diseases, alcoholism, or often taking drugs.

You are advised to seek medical help immediately if you experience the following conditions:

  • Experiencing liver inflammation after taking certain medications
  • Diagnosed with inflammation of the liver due to certain drugs and symptoms do not improve after stopping taking them
  • New symptoms appear

So that acute hepatitis in children can be detected and treated immediately, take your child to the doctor immediately if you experience initial symptoms in the form of nausea, vomiting, stomach pain, diarrhea, tea-colored urine, and low-grade fever.

It's important to remember, don't wait for further symptoms to appear in the form of yellow, pale stools, until you lose consciousness.

Diagnosis of Hepatitis

To diagnose hepatitis, the doctor will conduct a question and answer about the patient's symptoms and medical history, followed by a physical examination. On physical examination, the doctor will check for discoloration in the whites of the eyes (sclera) and press on the right upper abdomen.

Next, the doctor will carry out further examinations to confirm the diagnosis, including:

  • Liver function tests , to check the levels of proteins or enzymes in the bloodstream, which can indicate damage to the liver
  • Hepatitis virus antibody test, to find out the type of hepatitis virus antibodies in the blood and determine whether hepatitis is acute or chronic
  • Abdominal ultrasound, to determine the type of abnormalities in the liver, such as liver damage, liver enlargement, or liver tumors
  • Liver biopsy , to determine the cause of damage to the liver tissue

Hepatitis Treatment

Hepatitis treatment is adjusted to the type of hepatitis and its severity. Treatment methods for hepatitis that can be done include administering drugs and liver transplants. Here is the explanation:

Interferon drugs

Some types of hepatitis due to viral infections can heal by themselves. However, administration of drugs is necessary to stop the spread of the virus and prevent further liver damage.

The type of drug prescribed by the doctor is interferon , which is usually given by injection every week for 6 months.

Immunosuppressant drugs

To treat hepatitis caused by autoimmune diseases, doctors can give immunosuppressant drugs , especially corticosteroids, such as prednisone and budesonide. Apart from that, patients can also be given the drugs azathioprine, mycophenolate, tacrolimus, and cyclosporin.

Antiviral drug

In some conditions, for example in chronic hepatitis B or hepatitis C, doctors can also give antiviral drugs , such as entecavir , ribavirin , or tenofovir. These drugs can inhibit the growth and development of viruses with different mechanisms.

Heartworm medication

In patients with hepatitis caused by liver worms, the administration of drugs is adjusted to the type of worm that infects the liver. These drugs include:

  • Praziquantel or albendazole, for clonorchiasis
  • Triclablendazole and possibly nitazoxanide , for fascioliasis

Liver transplant

If hepatitis has caused severe liver damage, the doctor will recommend a liver transplant . Through this procedure, the patient's damaged liver is replaced with a healthy liver from a donor.

In addition to the above treatments, people with hepatitis due to the use of certain drugs need to stop taking these drugs.

Hepatitis complications

If not handled properly, hepatitis can cause various complications, such as:

  • Cirrhosis
  • Liver failure
  • Heart cancer

Prevention of Hepatitis

The risk of hepatitis can be reduced by taking the following steps:

  • Wash your hands regularly with running water and soap, especially after outdoor activities and before touching food
  • Having safe sex, such as with one partner or using a condom
  • Do not share use of personal items, such as razors or toothbrushes
  • Eat a balanced nutritious diet, exercise, and get enough rest
  • Do not consume alcoholic beverages and do not use drugs
  • Do not consume raw food and drinking water that is not guaranteed to be clean
  • Vaccinating hepatitis according to the schedule given by the doctor

To prevent mysterious acute hepatitis , make sure your child regularly washes their hands with soap and running water, eats food that is cooked thoroughly, does not share cutlery with other people, and avoids contact with sick people.

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