Dr. M.J. Bazos, MD
Patient Handout
HEPATITIS,
CHRONIC
About Your
Diagnosis
Chronic hepatitis occurs when there is
persistent injury and inflammation to the liver cells that lasts for longer than
6 months. This condition can be divided into two classifications: chronic
persistent and chronic active hepatitis. There are several causes: viruses,
metabolic conditions, immunologic abnormalities, and medications. The most
common causes are hepatitis B and C. Jointly these two viruses are the cause of
more than 75% of the cases of chronic hepatitis. If you have chronic hepatitis B
or C, you can be infectious to others. About 20% of the time autoimmune chronic
hepatitis is the cause. In this condition, the body’s immune system reacts
to itself, causing damage to the liver. There are also some inherited disorders
that can cause chronic hepatitis. These include Wilson’s disease and
alpha- 1-antitrypsin deficiency. Long-term use of some medications can also
cause a small number of cases of chronic hepatitis. These drugs include
phenytoin, nitrofurantoin, and isoniazid. Chronic hepatitis occurs in about 2 in
1,000 individuals. The condition is detected by a liver biopsy. Evaluation of
infectious hepatitis blood markers are of use if the cause is infectious. The
prognosis is generally good with chronic persistent hepatitis. About 40% to 50%
of patients with chronic active hepatitis die within 5 years of the onset of
symptoms. The cause of death is usually from liver failure and complications of
portal hypertension (increased pressure in the liver
veins).
Living With Your
Diagnosis
The most common symptom of
chronic hepatitis is fatigue. Other symptoms include mild upper abdominal
discomfort, decreased appetite, and achy joints. Some patients may have signs of
liver failure and cirrhosis. Signs of liver failure are jaundice (a yellow color
to the skin or whites of the eyes), ascites (abdominal swelling caused by
fluid), and coma. Depending on the cause, other organ systems can be affected.
Those organs include the thyroid, intestines, eyes, joints, spleen, kidneys, and
skin. Because of the chronic scarring of the liver, hepatocellular cancer can
develop in some patients with chronic
hepatitis.
Treatment
The
treatment of chronic hepatitis depends on the cause. Prednisone or other
corticosteroids help to reduce the inflammation. Azathioprine or mercaptopurine
are drugs used to treat chronic hepatitis caused by immune disorders. Interferon
is a drug used to treat chronic hepatitis caused by hepatitis B and C. However
interferon is not effective in all cases. Relapses can occur in about half of
those treated. In severe cases of liver failure, a liver transplantation is an
option.
The
DOs
• Modify physical activity
according to the symptoms. A good fitness program may help with the
fatigue.
• A well-balanced diet is
necessary.
• Make sure you properly
wash your hands if you have chronic hepatitis or are caring for someone with the
disease. This is particularly important after contact with blood or other body
fluid. It will help with prevention and transmission of the
disease.
• An individual with chronic
hepatitis B or C should use separate or disposable eating and drinking
utensils.
• Use latex condoms. It may
prevent transmission of the hepatitis B and
C.
• If exposed to blood and body
fluids on the job, use proper protective equipment such as gloves and eye
protection to lessen the chance of accidental
exposure.
• If you are in a high-risk
group, you should receive hepatitis B vaccine. High-risk groups are health
workers, homosexual men, and household contacts of
carriers.
• All newborns and children
should be immunized with Hepatitis B
vaccine.
The
DON’Ts
• Avoid
alcohol
• Avoid medications that can
be harmful to the liver such as acetaminophen, sedatives, and
tranquilizers.
• Avoid salt in the
diet.
• Avoid sexual contact with an
individual infected with hepatitis
B.
• Avoid contact with blood or
blood products.
• If you have had
chronic hepatitis B or C, you should not donate
blood.
• Women who have chronic
hepatitis B or C should not breast-feed their babies.
• If you are an intravenous drug
addict, do not share needles and other equipment because of possible
contamination.
When to Call Your
Doctor
• If symptoms of chronic
active hepatitis develop.
• If
symptoms worsen or do not improve with
treatment.
• If new symptoms develop,
particularly worsening jaundice or abdominal pain.