Liver Issues

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Fatty Liver

Fatty liver means the accumulation of fat in the liver cells. Fatty liver (steatosis) may be associated with or may lead to inflammation of the liver (steatohepatits, NASH). This can cause scarring and hardening of the liver. When scarring becomes severe, it is called cirrhosis, and this is a serious condition.

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HEPATITIS (General)

Hepatitis is a general term meaning inflammation of the liver. Hepatitis is a disease that can be caused by a variety of different causes such as viruses, alcohol, drugs, autoimmune.

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HEPATITIS A

Hepatitis A is a liver infection caused by the hepatitis A virus (HAV). The virus is spread when a non-immune person eats or drinks something contaminated by virus. Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease.

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HEPATITIS B

Hepatitis B virus can cause chronic liver disease which may progress to liver cirrhosis and liver cancer. A vaccine against hepatitis B has been available since 1982. Hepatitis B vaccine is 95% effective in preventing HBV infection.

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HEPATITIS C

Hepatitis C virus can cause chronic liver disease which may progress to liver cirrhosis and liver cancer.

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HEPATITIS E

Hepatitis E was not recognized as a distinct human disease until 1980. Hepatitis E is caused by infection with the hepatitis E virus.

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HEPATITIS B

Hepatitis B virus can cause chronic liver disease which may progress to liver cirrhosis and liver cancer. A vaccine against hepatitis B has been available since 1982. Hepatitis B vaccine is 95% effective in preventing HBV infection.

HEPATITIS (General)
HEPATITIS A
HEPATITIS B
HEPATITIS C
HEPATITIS D
HEPATITIS E

 

KEY FACTS

• Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
• The virus is transmitted through contact with the blood or other body fluids of an infected person - not through casual contact.
• Hepatitis B is preventable with a vaccine.

Symptoms

Hepatitis B virus can cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

Who is most at risk for chronic disease?

The likelihood that Hepatitis B infection will become chronic depends on the age at which a person becomes infected. Young children who become infected with Hepatitis B more likely develop chronic infections. About 90% of infants infected during the first year of life develop chronic infections. About 25% of adults who become chronically infected during childhood die from HBV-related liver cancer or cirrhosis.

About 90% of healthy adults who are infected with Hepatitis B will recover and get rid of the virus within six months.

How is Hepatitis B diagnosed?

Since many people with hepatitis B do not have symptoms, they do not know they have the disease. Hepatitis B is often discovered incidentally during the health screening.

Hepatitis B is diagnosed through blood tests. The blood test will detect certain Hepatitis B antigens and corresponding antibodies produced by the patient’s body. The viral DNA is also tested from the blood sample.

The scan, ultrasound, CT scan or MRI will look at the liver to detect any nodule within your liver. The stiffness of the liver (fibrosis or cirrhosis) is assessed by a special scan called fibroscan. Sometimes, liver biopsy is required to assess the degree of liver damage, in particular the inflammation and fibrosis.

Transmission

Hepatitis B virus is transmitted between people by contact with the blood or other body fluids (i.e. semen and vaginal fluid) of an infected person.

Common modes of transmission in developing countries are:

• vertical (from mother to baby at birth)
• early childhood infections (close interpersonal contact with infected household contacts)
• unsafe injections practices
• blood transfusions
• sexual contact

In many developed countries, patterns of transmission are different. The majority of infections in these countries are transmitted during young adulthood by sexual activity and injecting drug use. Hepatitis B is a major infectious occupational hazard of health workers. Hepatitis B is not spread by contaminated food or water, and cannot be spread casually in the workplace.

The virus incubation period is 90 days on average, but can vary from about 30 to 180 days. Hepatitis B may be detected 30 to 60 days after infection and persist for widely variable periods of time.

Treatment

There is no specific treatment for acute hepatitis B. Only selected group of patients with chronic hepatitis B can be treated with drugs, including interferon and anti-viral agents, which can help some patients. The aim of the treatment is to lower the viral load and defer the complications of the disease.

What shall I do if I am Hepatitis B carrier?

All persons with Hepatitis B should undergo regular medical follow-up. The purpose of regular medical check-up is to screen for liver cancer and liver inflammation.

If the patient does not have liver cirrhosis, the regular medical visits are scheduled at 6 monthly intervals during which blood tests, such as liver function test and liver cancer marker alphafetoprotein are checked. Ultrasound scan of the liver is done once a year to look for any suspicious lesion in the liver. Early detection of liver cancer plays a vital role in effective treatment.

If the patient has liver cirrhosis, the regular medical visits including blood tests and scans are scheduled more frequently.

We advice patients to avoid alcohol, traditional medicines, slimming pills as these substances may cause additional liver damage.

Prevention

Hepatitis B vaccine is the mainstay of hepatitis B prevention.

The complete vaccine series induces protective antibody levels in more than 95% of infants, children and young adults.

People in high risk groups should also be vaccinated, including:

• persons with high-risk sexual behaviour;
• partners and household contacts of Hepatitis B infected persons;
• injecting drug users;
• persons who frequently require blood or blood products;
• recipients of solid organ transplantation;
• those at occupational risk of HBV infection, including health care workers;
• international travellers to countries with high rates of HBV.