Hepatitis is an inflammation of the liver which can be caused by a virus (A, B, C, D, E) or by the consumption of toxic substances (alcohol, drugs, etc.). What are the symptoms of hepatitis? Can it be cured and with what treatments?
[Mise à jour le 19 avril 2022 à 18h34] Hepatitis is a liver disease that can be caused by viruses. We thus speak ofhepatitis AofHepatitis B, hepatitis C, hepatitis D and hepatitis E. But also linked to non-viral causes such as excessive alcohol consumption… cases of acute hepatitis, of unknown causes for the moment, are listed in children in Europe and particularly in France, in April 2022. What is hepatitis? Can it be cured? How ?
A viral hepatitis means a virus infection of liver tissue. There are five main hepatitis viruses: A, B, C, D and E. The severity of the disease and the treatment to be followed depend on the type of hepatitis and the individual, it sometimes leads to cirrhosis or cancer. Hepatitis is manifested by yellow skin (jaundice or jaundice)dark urine, nausea, vomiting and abdominal pain.
- Hepatitis A : acute viral hepatitis caused by the hepatitis A virus. It is often caused by contaminated food or water.
- Hepatitis B : acute viral hepatitis caused by the HBV virus. It is transmitted from human to human during sexual intercourse, contact with blood or through contaminated objects.
- Hepatitis C : acute or chronic hepatitis caused by the HCV virus or by the consumption of toxic substances (alcohol, drugs, etc.)
- Hepatitis D: acute or chronic hepatitis caused by the HDV virus which needs the hepatitis B virus to replicate. There cannot be hepatitis D if there has been no contamination with hepatitis B before.
- Hepatitis E: viral hepatitis transmitted from animals to humans. It is transmitted mainly through the consumption of raw or undercooked pork.
They can be acute, that is to say occurring at a given moment and disappearing spontaneously as for hepatitis A, or become chronic after infection, like hepatitis C or more rarely hepatitis B. “Acute viral hepatitis usually manifests as a flu-like syndrome with fever, fatigue, joint aches and pains, headaches and sometimes digestive signs, followed by a yellow discoloration of the skin and mucous membranes called jaundice.“, explains Dr. Jean-Luc Leymarie, general practitioner.
It is a chronic inflammation of the liver which most often follows acute hepatitis. Chronic hepatitis is more serious, with possible progression to cirrhosis or liver cancer. Note that other viruses such as cytomegalovirus (CMV) or the herpes virus can cause hepatitis.
“Fulminant hepatitis is a rare syndrome associating massive necrosis of the hepatic parenchyma and a reduction in the size of the liver (acute atrophy) which occurs during infection by certain hepatitis viruses or in the event of toxic or drug damage.“, continues the doctor. The hepatitis B virus is sometimes responsible for fulminant hepatitis and up to 50% of fulminant hepatitis B involves co-infection with the hepatitis D virus.
► Hepatitis viral are caused by virus infection. In developed countries, Hepatitis A, B and C viruses cause approximately 90% of acute hepatitis cases. Hepatitis D and E viruses are also responsible for hepatitis.
► Non-viral hepatitis is mainly caused by ingestion of products toxic to the liver (alcohol, drugs, toxic chemicals…). They can also be the result of diseases affecting the liver, such as fatty liver disease (NASH or “fatty liver”).
The most visible symptoms often appear late:
- severe fatigue which resembles that of an influenza-like illness,
- jaundice skin and eyes,
- urine staining (dark urine),
- nausea and vomiting.
Diagnosis is based on blood serology. A liver biopsy may be requested in addition.
Hepatitis is transmitted differently depending on the virus in question, by the accidental ingestion of faeces for hepatitis A, bodily secretions such as saliva, sexual secretions or by blood contamination for other hepatitis.
Treatments vary depending on the type of hepatitis:
- Hepatitis A : “Normally, the body manages to fight the hepatitis A virus. This disease therefore does not require no treatments specific medical procedures, but rest and good nutrition are indicated. Symptoms disappear after 4 to 6 weeks“recalls our interlocutor.
- Hepatitis B : In the vast majority of cases (90%), hepatitis B virus infection resolves spontaneously and no pharmacological treatment is necessary. The recommendations are then the same as for hepatitis A : rest and healthy eating.
When the infection persists for more than 6 months, this means that the body cannot eliminate the virus. So he needs help. In this case, several drugs can be used.
L’hepatitis A heals in a few weeks without treatment. We observe prolonged forms over several weeks which heal. Hepatitis A never progresses to a chronic infection (unlike hepatitis B or hepatitis C). Hepatitis A is cured and induces lifelong immunity (a second infection with the HAV virus is impossible).
L’acute hepatitis B progresses towards recovery in the majority of cases (more than 90%). “When the acute infection does not heal, the evolution is towards chronic hepatitis B, defined by the persistence of the virus in the body for more than six months., says the doctor. Chronic hepatitis B occurs in 2 to 10% of cases and requires long-term follow-up and sometimes treatment.
In 90% of cases, hepatitis C goes unnoticedits diagnosis can then be made during screening for hepatitis C. Acute hepatitis C can evolve in two different ways:
- towards healing in 15 to 30% of cases;
- towards the transition to chronicity (chronic hepatitis C) in 70 to 85% of cases. Chronic hepatitis C is defined by the persistence of the virus in the body for more than six months.
There are vaccines for hepatitis A and B. Vaccination against hepatitis A only concerns people exposed to this virus. It has the effect of greatly reducing the risk of contracting this infection. “The Hepatitis B vaccination is mandatory for all infants since January 1, 2018 from the age of 2 months. It is included in hexavalent vaccines. It is also recommended for all children or adolescents up to the age of 15 who have not been vaccinated.concludes Dr. Leymarie.
There is no no vaccine against the hepatitis C virus yet.
Thanks to Dr Jean-Luc Leymarie, general practitioner in Rueil Malmaison (92)