Hepatitis

Description

Hepatitis is an inflammation of the liver. Hepatitis is now a major health concern, causing an estimated 10,000 deaths annually in the United States alone.

Causes

Hepatitis can be caused by viruses, or by excessive and chronic consumption of alcohol, ingestion of environmental toxins, or prolonged use of prescription medications or certain over-the counter medications.
Viral transmission may be accomplished by the fecal-oral route, which includes ingestion of contaminated food and water. It may also be transmitted by body secretions, sexual contact, blood transfusions, contaminated needles or other sharp objects, and during childbirth.¹

Types

Hepatitis A virus is primarily transmitted by person-to-person contact and by exposure to contaminated food and water sources. It is rarely transmitted by bloodborne means. It is estimated that there are 125,000 to 200,000 new cases of hepatitis A per year in the USA. According to the FDA, many infections with hepatitis A virus do not result in clinical disease, especially in children. When the disease does occur, it is usually mild and recovery is complete in 1-2 weeks. Occasionally, the symptoms are severe and convalescence can take several months. Patients suffer from feeling chronically tired during convalescence, and their inability to work can cause financial loss. Less than 0.4% of the reported cases in the U.S. are fatal. These rare deaths usually occur in the elderly.
Hepatitis B is transmitted by bloodborne means, by sexual contact, through body secretions, and at childbirth from infected mothers to their infants. There are 140,000-320,000 new cases of hepatitis B infection in the United States each year. This type can cause chronic active hepatitis which can lead to liver cancer.
Hepatitis C (HCV) is transmitted by bloodborne means, through body secretions, and at childbirth from infected mothers to their infants. Currently there is no vaccine to prevent hepatitis C. While the number of new infections per year has continually declined (from an average of 240,000 in the 1980s to roughly 25,000 in 2001 in the US), an estimated 3.9 million (1.8%) Americans have been infected.
The other viral forms of hepatitis are hepatitis D, E and G. These forms are rare, but type D has an extremely high mortality rate.¹

At Risk

Persons who have household or sexual contact with people infected with hepatitis A, or are exposed to contaminated food or water, are at risk. During outbreaks, day-care center employees or attendees may also be at risk.
At highest risk for hepatitis B are homosexual men, injecting drug abusers, or others who have sexual contact with infected persons.
Most hepatitis C infections are generally due to illegal injection drug use.

Prevention and Management

Good sanitation, personal hygiene, proper food preparation and avoidance of tainted water supplies are the best preventive measures.
Most infants are now vaccinated against hepatitis B. All healthcare workers and others at high risk should be vaccinated against hepatitis B.
Hepatitis can result from excessive intakes of vitamin A.²
Vitamin C may be beneficial. In one study, patients who received 10 grams of vitamin C per day recovered in half the time expected.³

Additional Information

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References

¹ Diseases. Springhouse (PA):Springhouse Corporation; 1993 p 50.
² Geubel AP et al. Liver damage caused by therapeutic vitamin A administration: estimate of dose-related toxicity in 41 cases. Gastroenterology 1991;100(6):1701-9
³ Baur H, Staub H. Treatment of hepatitis with infusions of ascorbic acid: Comparison with other therapies. JAMA 1954;156(5):565.