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Hepatitis

Liver disorder in which the liver is inflamed and swollen; cell death can also occur. There are numerous causes, which can be divided into two groups: infections caused by a virus or other micro-organism and inflammation caused by toxins. Both groups can be subdivided. The infective hepatitis group is divided into forms in which the liver is affected in the first place (hepatitis A and B), and forms in which the liver is affected as part of a more general disorder (as in glandular fever, German measles or cytomegalovirus infection). In the last case the inflammation is often slight. Viral hepatitis (A and B) gives the following clinical picture: poor appetite, nausea and vomiting, general malaise, fever, jaundice and an enlarged and painful liver. Hepatitis A (hepatitis infectiosa, often simply called ‘jaundice’ in children) is an infection transmitted by oral contact, with a short incubation period (2-6 weeks). It is relatively mild, and recovery is usually within 3 to 16 weeks. Hepatitis B (serum hepatitis) is transmitted by infected blood and blood products, but also by oral and anal sexual contact. This puts certain groups more at risk: transfusion patients, kidney dialysis patients, haemophiliacs, homosexuals, and drug addicts who use contaminated needles. The incubation period is longer (6 weeks to 6 months). This form can be more severe, is more likely to become chronic than hepatitis A, and is more often fatal. It has been established in recent years that other viruses can cause a comparable infection, with comparable symptoms and an incubation period of 7 to 8 weeks. During diagnosis laboratory tests should be made to establish which form of viral hepatitis is involved, and to exclude complications of other viral diseases (glandular fever, cytomegalia). The severity of the disease can be established by the level in the blood of certain liver enzymes derived from the dead cells and from bilirubin, the colouring agent in bile responsible for the characteristic yellow skin colouring in jaundice. Treatment is by rest, a low-calorie diet and avoidance of alcohol. Antibiotics are of no use in the treatment of viral infections.

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