Viral Hepatitis

"Viral hepatitis can be prevented by taking care of the means by which it is transmitted".

DR. JOSÉ IGNACIO HERRERO SANTOS
SPECIALIST. HEPATOLOGY UNIT

Hepatitis is a group of diseases characterized by inflammation of the liver.

When this inflammation has appeared recently we speak of acute hepatitis and the processes that last more than six months we call them chronic hepatitis.

Viral hepatitis is a communicable disease, and therefore potentially preventable.

The transmission of viruses A and E occurs through contaminated food and water, so good food hygiene and proper treatment of food and water can help prevent infection. In addition, there is a very effective vaccine for the hepatitis A virus that is already beginning to be included in vaccination schedules.

The B, C and delta viruses are transmitted by blood and by sexual relations, although the C virus is not very effective in its transmission by sexual routes. Blood banks test all samples to rule out infection by these viruses, so the spread has been greatly reduced in recent years.

There is a very effective and safe vaccine that prevents infection by the B virus and, consequently, the superinfection by delta virus that only occurs in carriers of the B virus. This vaccine is already included in the vaccination calendar. Unfortunately, there is not yet a vaccine that prevents the infection by the C virus.

Autoimmune hepatitis, of unknown cause, cannot be prevented.

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What are the symptoms of viral hepatitis?

Acute hepatitis may not produce any symptoms and may go unnoticed by the patient. At other times there may be non-specific symptoms such as general malaise, tiredness, nausea. In addition, in some cases jaundice develops, ie, yellow pigmentation of the skin and mucous membranes, which is accompanied by dark urine (coluria) and white or yellowish stools (acolia).

Chronic hepatitis is also characterized by very few symptoms and is often diagnosed by chance when tested for other reasons.

When there are symptoms, the most frequent are fatigue, mild and unspecific discomfort in the right side of the abdomen or mild digestive disorders.

What are the most common symptoms?

  • General discomfort.
  • Fatigue.
  • Nausea.
  • Yellow pigmentation of skin and mucous membranes (jaundice).

Do you have any of these symptoms?

You may have hepatitis

What are the causes of viral hepatitis?

Numerous causes are capable of producing hepatitis, either as the only manifestation or in the whole of a disease that can affect other organs and systems.

For practical purposes, we can divide the possible causes of hepatitis into three major groups: living agents, drugs or toxins, and a last group of diseases of unknown cause, which would still have to include the still numerous group of patients in which medicine is unable to identify a cause for their hepatitis.

In the first group of living agents we find the hepatitis viruses, which are by far the most frequent cause of hepatitis in our environment.

Although the "alphabet" of hepatitis has been increasing in recent years, the most common viruses are A and E -causing acute epidemic hepatitis, transmitted by contaminated food or water- and B, C and delta viruses, -causing both acute and chronic hepatitis-, which are transmitted primarily by parenteral means, that is, through transfusions, contaminated needles or sexual relations.

The second group, drugs and toxins, is headed by alcohol. The intake of alcoholic beverages constitutes one of the main causes of hepatitis in the Western world. Some drugs are also capable of producing hepatitis, especially acute ones, but they are a rare cause of chronic hepatitis.

Finally, there is the chapter on diseases of unknown cause, which includes autoimmune hepatitis, in which the patient's own immune system damages his or her liver, and cryptogenetic hepatitis (with no known cause) itself.

What is the prognosis of viral hepatitis?

Acute epidemic hepatitis, produced by viruses A and E, never becomes chronic, and is cured spontaneously in most cases, even though less than 1 percent may have a fulminant course requiring urgent treatment and even liver transplantation.

Acute hepatitis B is cured in 90 percent of cases, but the remaining 10 percent progress to chronic hepatitis.

Acute hepatitis C becomes chronic in up to 80-90 percent of cases.

Autoimmune hepatitis is always chronic. All chronic hepatitis can progress to liver cirrhosis, with the complications that can result.

How are viral hepatitis diagnosed?

The data that initially leads to the diagnosis is the increase in the blood levels of transaminases, enzymes that are released into the blood by cell death produced by the inflammation of the liver.

This elevation can be very important in acute hepatitis, and is mild or moderate in chronic hepatitis.

From there, the diagnosis is completed with other analytical determinations that will also help find the cause of the hepatitis and determine its severity and prognosis.

For a definitive diagnosis, in many cases it is necessary to perform a liver biopsy.

How are viral hepatitis treated?

Treatment of acute hepatitis:

  • Acute hepatitis B virus is not treated either, following its evolution to avoid complications and assess its possible chronification.
  • Acute hepatitis C, given its high rate of chronification, is treated with medication to prevent chronification.

Chronic hepatitis, due to the potential development of cirrhosis, is usually always treated under the supervision of a specialist.

Finally, autoimmune hepatitis is treated with corticoids, and on many occasions with other associated immunosuppressive drugs such as azathioprine, cyclosporine, tacrolimus or mycophenolate.

Where do we treat it?

IN NAVARRA AND MADRID

The Hepatology Unit
of the Clínica Universidad de Navarra

We are pioneers in the application of gene therapy in the treatment of liver tumors and hereditary metabolic diseases, and we have extensive experience in the diagnosis and treatment of viral hepatitis and in the treatment of liver cancer using radioembolization systems with Ytrium-90 microspheres. 

The Clinic is at the forefront in Spain in performing liver transplantation between living people.

Treatments we perform

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Why at the Clinica?

  • Highly specialized team of professionals with more than 25 years of experience.
  • Nursing team specialized in hepatic patients.
  • Important research activity on the molecular mechanisms that cause some of these diseases.

Safer than ever to continue taking care of you

We update safety protocols weekly with the latest scientific evidence and the knowledge of the best international centers with which we collaborate.