Hepatitis is a liver disease which results from repetitive inflammations & destructions in the liver. The symptoms of hepatitis are varying from no signs to acute that can lead to death.

Although some patients with hepatitis may recover in a few months without any complications, others may develop chronic hepatitis. Chronic hepatitis is when patients have had the disease over six months. As the hepatitis may develop into liver cirrhosis or liver cancer, patients with hepatitis need to see doctors & have a proper treatment.

Hepatitis is mostly viral, due to infection of hepatitis viruses. The main non-viral causes of hepatitis are alcohol and drugs.

Viral hepatitis is classified into A, B, C, D and E type. Hepatitis A is found to rarely progress to chronic disease. And hepatitis D and E don't make serious diseases. However hepatitis B and C are likely to lead to chronic hepatitis, which then can progress to liver cirrhosis or cancer.

About 7% of the population are infected with the hepatitis B virus in Korea; 0.4~2.1% of the population are infected with the hepatitis C virus.

Therefore, the prevention and treatment of the B and C hepatitis is an urgent task in many countries.

Hepatitis B
The hepatitis B virus is mainly passed through blood or serum from persons with acute or chronic hepatitis. It can be transmitted through the body fluids such as saliva, urine, semen, faeces, gastric juice and serous fluid. It can also be transmitted through food, but a large amount at a time should be taken to become infected. Therefore the chance of infection through oral uptake is very little.

But hepatitis B virus is never transmitted through the air, because hepatitis B infection needs to have direct contacts with infection sources.

Many infection cases have been reported in blood transfusions from an infected person; using needles contaminated with patients… blood; sharing razors, toothbrushes or other personal items that may come in contact with blood of patients; having sex with an infected partner; poor sanitation. It is particularly easy to be spread through open wounds in the skin and mouth.

A baby from an infected mother should get proper medication at birth. Without such treatment, the baby is in danger of becoming a carrier and developing chronic hepatitis, liver cirrhosis, or liver cancer.

Hepatitis C Virus
The hepatitis C virus is usually spread by blood transfusions or by sharing needles. Infection through sexual contacts or vertical infection is rarely found in the hepatitis C.

Hepatitis B has less than 5% chance of becoming chronic hepatitis, but half of hepatitis C patients become chronic. 20% of chronic hepatitis C patients will develop liver cirrhosis or liver cancer, which is often fatal. Once hepatitis C infection occurs, it is easy to miss the chance for treatment because there are no symptoms.

According to an 8-year follow-up study on chronic hepatitis, about 38% of the hepatitis B cases and 2% of hepatitis C cases were cured by the immune system. Fifteen percent of the patients with hepatitis C developed liver cancer, which was 3 times more than that for hepatitis B patients.

The causes of hepatitis vary, but the symptoms are similar regardless of type. Hepatitis is divided into acute or chronic hepatitis depending on how long the infection persists. The symptoms of acute hepatitis are classified as below.

- Prodromal or Pre-jaundice stage
- Icteric or Jaundice stage
- Convalescence or post-jaundice stage

Typical symptoms during the pre-jaundice period include general fatigue, anorexia, nausea, vomiting and at times pain in the right upper stomach, low fever and rarely aching joints and skin rashes. Patients often lose their taste for favorite items such as coffee or cigarettes.

The pre-jaundice symptoms usually abate during the jaundice period, when skin and whites of the eyes turn yellow, and the whole body itches. Sometimes jaundice does not appear.

In the post-jaundice phase, most symptoms disappear. 90 % of hepatitis B patients will fully recover within four months. Half of the remaining 10% will develop chronic hepatitis.

Prevention of Hepatitis

Prevention is the most effective treatment for hepatitis.
Hepatitis B & C are caused by blood transfusions, unsterilized needles, saliva, shared items (toothbrushes, razors and nail clippers) and close contacts with patients. Thus, personal and public hygiene are the most important for prevention. However, no matter how hard one tries to avoid infection, the possibility of transmission remains.

1. Hepatitis B Prevention: Vaccination
A hepatitis B vaccine, which provides active immunity, is the best way to avoid infection of hepatitis B. Patients who do not have hepatitis B antibodies should be vaccinated.

2. Hepatitis C Prevention: Regular Checkups
There is no vaccine developed for hepatitis C; the only way to prevent hepatitis C infection is careful public hygiene. Patients with hepatitis C need to take regular blood tests and proper treatments to avoid development into chronic hepatitis.

Treatment of Hepatitis
There are no specific treatments for patients with acute hepatitis. They can only get symptomatic therapy and need to follow on physicians… advice. Usually they don…t require hospital treatment, but those with severe liver exacerbation will need to stay in the hospital.

Most important treatment is plenty of rest and a balanced diet which is high in carbohydrates and protein, but in case of patients with serious jaundice, with low in fat. Unless they have a vitamin deficiency, they don't need vitamin supplements.

Drugs for the liver may be helpful, but caution is needed in taking drugs that metabolized in the liver because they can put a heavy load on the liver. Patients must take care to carefully use pain killers, antifebrins, sedatives, hypnotics and morphine-based medications and should avoid alcohol.

Treatment of chronic hepatitis is similar to that of acute hepatitis. However, chronic hepatitis poses a greater risk of advancing to liver cirrhosis or liver cancer, so aggressive treatment is needed. If the patient can eradicate the virus from the body and acquire antibodies for hepatitis virus, they can avoid liver cirrhosis or cancer.

Interferon alpha is widely known for good and reliable efficacies for the treatment of hepatitis B & C. It is found more effective in women, patients with light symptoms, those who suffer from chronic hepatitis only for a short time and those who have high levels of liver enzymes. The combination treatment of interferon alpha & ribavirin has been regarded as a gold standard against chronic hepatitis C.