Hepatitis is an inflammatory disease affecting liver function, with diverse causes and complex clinical manifestations. It can be classified into various types, including viral, alcoholic, drug-induced, and autoimmune hepatitis. Among these, viral hepatitis is highly contagious and has been a major focus of global public health efforts. According to the World Health Organization, approximately 325 million people worldwide suffer from chronic hepatitis, with severe cases potentially leading to cirrhosis or liver cancer.
Diagnosis and treatment of hepatitis depend on the specific etiology. For example, viral hepatitis requires tailored antiviral therapy based on the virus type, while non-viral hepatitis may involve lifestyle modifications or changes in medication use. Understanding the causes, symptoms, and preventive measures of hepatitis is key to reducing disease transmission and improving prognosis.
The causes of hepatitis can be divided into infectious and non-infectious categories. Viral hepatitis is mainly caused by hepatitis A, B, C, D, and E viruses, with hepatitis B and C being the most likely to cause chronic infection. Non-viral causes include long-term alcohol abuse, drug toxicity (such as certain painkillers or chemotherapy drugs), and autoimmune attacks on liver cells.
Non-infectious risk factors include obesity, diabetes, and excessive use of non-steroidal anti-inflammatory drugs (NSAIDs). Long-term exposure to industrial chemicals or radiation therapy can also cause liver cell damage leading to hepatitis.
Patients with acute hepatitis may develop noticeable symptoms weeks after infection, while chronic hepatitis patients may remain asymptomatic for years until significant liver damage occurs. Typical symptoms include:
Symptoms vary depending on the virus type: hepatitis A often presents with fever and diarrhea, while hepatitis C may initially manifest as joint pain and itchy rash. Chronic hepatitis may only show severe symptoms such as ascites and esophageal varices when progressing to cirrhosis.
Diagnosing hepatitis involves clinical assessment, laboratory tests, and imaging studies. Blood tests are central, measuring liver enzymes (such as AST and ALT), viral antibodies, and viral nucleic acids (e.g., HBV DNA).
Ultrasound or CT scans can evaluate structural changes in the liver, such as nodular surface changes caused by cirrhosis. Testing for antinuclear antibodies (ANA) and smooth muscle antibodies (SMA) is crucial when suspecting autoimmune hepatitis. Liver biopsy, though invasive, provides precise assessment of tissue damage and fibrosis stage.
Treatment strategies depend on the etiology: antiviral medications for viral hepatitis, complete abstinence from alcohol and vitamin supplementation for alcoholic hepatitis. Chronic hepatitis B patients may use entecavir or tenofovir to suppress viral replication, while hepatitis C now has high cure rates with direct-acting antiviral agents (DAAs).
Severe liver failure may require artificial liver support systems or evaluation for liver transplantation. Autoimmune hepatitis is treated with corticosteroids or immunosuppressants, with close monitoring for side effects like osteoporosis or increased infection risk. Drug-induced liver injury primarily involves discontinuing the offending medication and using antidotes such as N-acetylcysteine for acetaminophen poisoning.
Vaccination is the most effective way to prevent viral hepatitis: hepatitis A and B vaccines are included in many national immunization programs. The vaccination schedule typically involves initial doses and booster shots to establish sufficient immunity. It is recommended to complete vaccination 6 to 12 months before traveling to hepatitis-endemic areas.
Public health policies, such as screening pregnant women and administering hepatitis B immunoglobulin to newborns, effectively prevent mother-to-child transmission.
If you experience unexplained persistent fatigue, tea-colored urine, or yellowing of the eyes and skin, seek medical attention promptly for liver function screening. Those with the following history should actively follow up:
Chronic hepatitis patients, even if asymptomatic, are advised to undergo ultrasound and alpha-fetoprotein tests every 6 to 12 months for early detection of hepatocellular carcinoma. Suspected acute liver failure (e.g., altered consciousness and coagulation abnormalities) is a medical emergency requiring immediate hospitalization.
Chronic hepatitis patients should avoid excessive intake of salty, fatty, and processed foods to reduce liver metabolic burden. It is recommended to increase high-quality proteins (such as fish and soy products) and fresh vegetables and fruits rich in antioxidants, while strictly limiting alcohol. Dietary plans should be tailored according to the disease stage in consultation with a doctor or nutritionist.
Can sharing daily items (such as utensils or towels) with hepatitis patients lead to infection?Viral hepatitis (such as hepatitis B and C) mainly spreads through blood and bodily fluids. Sharing utensils or contact with contaminated clothing usually does not cause infection. However, if items are contaminated with blood or open wounds come into contact with infected objects, there is a risk. Hepatitis B virus survives longer outside the body, so thorough cleaning with soap after contact with others' blood is recommended.
Do hepatitis C patients who receive antiviral treatment need regular check-ups even after the virus is cleared?Yes, patients should follow up every 6 to 12 months with liver function tests and fibrosis assessments. Residual cirrhosis or other complications may still pose risks, and ongoing monitoring allows early detection of abnormalities. The doctor may recommend more frequent imaging or blood tests based on the extent of liver damage.
Can vigorous exercise worsen hepatitis?Moderate exercise can improve liver health, but intense activity may cause fatigue or metabolic disturbances, which are detrimental to recovery. Patients should choose moderate activities (such as brisk walking or swimming) and adjust intensity based on medical advice. If symptoms like fatigue or worsening jaundice occur, exercise should be stopped immediately and medical attention sought.
After receiving the hepatitis B vaccine, is regular antibody testing necessary?After hepatitis B vaccination, antibody levels may decline over time. High-risk groups (such as healthcare workers and close contacts) are recommended to test antibody titers every 5 years, and if levels are below 10 mIU/mL, a booster dose is advised. For most adults, if sufficient antibodies are confirmed post-vaccination, long-term protection is generally maintained.
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