Hepatitis is an inflammatory disease that affects liver function, with diverse causes and complex clinical manifestations. This disease can be categorized into various types such as viral, alcoholic, drug-induced, and autoimmune hepatitis. Among these, viral hepatitis is a major focus of global public health due to its high transmissibility. According to statistics from the World Health Organization, approximately 325 million people worldwide suffer from chronic hepatitis, with severe cases potentially leading to cirrhosis or liver cancer.
The diagnosis and treatment of hepatitis depend on the specific cause. For example, viral hepatitis requires a targeted approach based on the type of virus, while non-viral hepatitis may necessitate lifestyle adjustments or changes in medication use. Understanding the causes, symptoms, and preventive measures of hepatitis is key to reducing the risk of disease transmission and improving prognosis.
The causes of hepatitis can be divided into two main categories: infectious and non-infectious. Viral hepatitis is primarily caused by hepatitis viruses A, B, C, D, and E, with hepatitis B and C being the most likely to lead to chronic infections. Non-viral causes include long-term alcohol abuse, drug toxicity (such as certain pain relievers or chemotherapy drugs), and autoimmune disorders that cause the immune system to attack liver cells.
Non-infectious risk factors include obesity, diabetes, and excessive use of non-steroidal anti-inflammatory drugs (NSAIDs). Individuals with long-term exposure to industrial chemicals or those undergoing prolonged radiation therapy may also develop hepatitis due to liver cell damage.
Patients with acute hepatitis may exhibit noticeable symptoms within weeks of infection, while those with chronic hepatitis may remain asymptomatic for years until severe liver damage occurs. Typical symptoms include:
Symptoms can vary depending on the type of virus: hepatitis A is often accompanied by fever and diarrhea, while hepatitis C may present with joint pain and rashes as initial symptoms. Chronic hepatitis patients may only show severe symptoms such as ascites and esophageal varices when the disease progresses to cirrhosis.
Diagnosing hepatitis requires a combination of clinical symptoms, laboratory tests, and imaging studies. Blood tests are the core diagnostic tool, measuring liver enzymes (such as AST and ALT), viral antibodies, and viral nucleic acids (such as HBV DNA).
Ultrasound or computed tomography can assess structural changes in the liver, such as nodular liver surfaces caused by cirrhosis. When autoimmune hepatitis is suspected, testing for antinuclear antibodies (ANA) and smooth muscle antibodies (SMA) is crucial. Although liver biopsy is more invasive, it can accurately assess the degree of tissue damage and the stage of fibrosis.
Treatment strategies depend on the underlying cause: viral hepatitis may require antiviral medications, while alcoholic hepatitis necessitates complete abstinence from alcohol and vitamin supplementation. Patients with chronic hepatitis B can use entecavir or tenofovir to suppress viral replication, while hepatitis C has seen the development of direct-acting antiviral agents (DAAs) that offer high cure rates.
Patients with severe liver failure may require an artificial liver support system or assessment for liver transplantation. Autoimmune hepatitis requires the use of steroids or immunosuppressants, with close monitoring for drug side effects such as osteoporosis or increased infection risk during treatment. The primary treatment for drug-induced liver injury is to discontinue the offending medication and use antidotes such as N-acetylcysteine for acetaminophen overdose.
Vaccination is the most effective way to prevent viral hepatitis: vaccines for hepatitis A and B are included in public vaccination programs in many countries. The vaccination schedule typically requires completing a primary series and booster doses to achieve sufficient immunity. It is recommended to complete vaccinations 6 to 12 months prior to traveling to areas where hepatitis is endemic.
In terms of public health policy, some countries effectively prevent vertical transmission from mother to child through screening pregnant women and administering hepatitis B immunoglobulin to newborns.
If you experience unexplained persistent fatigue, tea-colored urine, or yellowing of the eyes, you should seek medical attention for liver function screening. Those with the following experiences should actively follow up:
Even asymptomatic chronic hepatitis patients are advised to undergo ultrasound and alpha-fetoprotein tests every 6 to 12 months to detect early liver cell carcinogenesis. Suspected acute liver failure (such as confusion and coagulation abnormalities) is a medical emergency and requires immediate medical attention.
Chronic hepatitis patients should avoid excessive intake of high-salt, high-fat, and processed foods to reduce the metabolic burden on the liver. It is recommended to increase high-quality protein sources (such as fish and soy products) and fresh fruits and vegetables rich in antioxidants, while strictly limiting alcohol. Dietary adjustments should align with the individual’s disease stage and treatment plan, which should be discussed with a physician or nutritionist.
Can everyday items (such as utensils or towels) used by hepatitis patients transmit the infection?Viral hepatitis (such as hepatitis B and C) primarily spreads through blood or bodily fluids, so sharing utensils or touching clothing usually does not result in infection. However, if items are contaminated with blood or come into contact with open wounds, there is still a risk. The hepatitis B virus is particularly resilient in the external environment, so it is advisable to thoroughly wash hands with soap after contact with another person's blood.
Do patients undergoing antiviral treatment for hepatitis C need regular follow-up checks after treatment?Even if the hepatitis C virus has been cleared, patients still need to monitor liver function and fibrosis levels every 6 to 12 months. There may be residual risks of cirrhosis or other complications after treatment, and ongoing monitoring can help detect abnormalities early. Physicians may recommend more frequent imaging or blood tests based on the extent of liver damage.
Can hepatitis patients engage in vigorous exercise, or will it worsen their condition?Moderate exercise can improve liver health, but vigorous exercise may lead to exhaustion or metabolic abnormalities, which could hinder recovery. Patients should choose moderate-intensity activities (such as brisk walking or swimming) and adjust the intensity based on their physician's assessment. If symptoms such as fatigue or worsening jaundice occur, exercise should be stopped immediately, and medical attention should be sought.
Do individuals who have received the hepatitis B vaccine need to have their antibody levels checked regularly?After receiving the hepatitis B vaccine, some individuals may experience a decline in antibody levels over time. It is recommended that high-risk groups (such as healthcare workers and household contacts) have their antibody titre checked every 5 years; if the antibody concentration is insufficient (<10 mIU/mL), a booster shot is required. Generally, if adults show sufficient antibody levels after completing the vaccination series, they can maintain long-term protection.
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