Hepatitis | The disease

Hepatitis frequently leads to non-specific symptoms. Most cases do not present with jaundice. If symptoms occur, they often are misinterpreted as flu. If you belong to one of the groups at high risk for viral hepatitis, you should seek medical advice to assess if you are infected. The earlier the disease is detected the better the treatment options are.

In this chapter you will find answers to the following questions:

  • What are the symptoms of hepatitis?
  • What is the natural course of the disease?
  • What treatment options are available and what are the response rates to the different treatments?
  • Which factors influence the course of the disease?
  • Which subsequent damages due to viral hepatitis can occur to the body?

Symptoms

  • no/mild symptoms

or

  • unspecific intestinal symptoms, loss of appetite
  • abdominal tension and bloating
  • flu-like symptoms
  • nausea
  • vomiting
  • stomach ache
  • fever
  • diarrhea
  • fatigue
  • loss of energy
  • muscle wasting
  • vascular changes in the skin
  • reddened palms and soles of the feet
  • itching/ pruritus
  • jaundice
  • dark-coloured urine
  • light-coloured stool
  • mental alterations
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Course of disease

HAV HBV HCV HDV HEV
course acute acute/chronic acute/chronic acute/chronic acute
incubation period [ days] 15-50 40 – 160 20 – 60 30-40
without symptoms/mild symptoms - frequent frequent
transition to chronic infection no 5-15 % 60-80 % 100 % no
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Potential complications

Liver fibrosis

  • Vermehrung des Bindegewebes
  • replacement of hepatocytes by connective tissue cells

Liver cirrhosis

  • shrinking of the liver
  • induration of the liver as a result of increasing fibrosis
  • impaired function of the liver due to replacement of liver cells by scar tissue

Reasons for liver cirrhosis

  • excessive alcohol consumption 40-60 %
  • virus-related hepatitis B or C 25-30 %
  • hemochromatosis
  • non-alcoholic fatty liver diseases
  • primary biliary cirrhosis
  • primary sclerosing cholangitis
  • autoimmune hepatitis

Functional disorders

  • reduced hormone production
  • reduced enzyme production
  • impaired production of blood clotting factor (increased risk of bleeding)
  • impaired water and saline secretion
  • increased risk of bleeding
  • decreased detoxification

Hormonal disturbances

in women

  • menstrual irregularity

in men

  • loss of body hair
  • impotence
  • involution of the testicles
  • enlargement of one or both mammary gland/s

disorders of circulation

  • blocked blood flow from the gastrointestinal tract via the portal vein into the liver, leading to portal hypertension
  • esophageal varices and hemorrhoids as bypasses around the cirrhotic liver
  • splenomegaly

disturbance of water and saline secretion

  • ascites
  • water retention, predominantly in the legs (edema)

disturbances of detoxification

  • lack of elimination of the intestinal production of ammonia
  • reduced cognitive performance (hepatic encephalopathia)
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