In the cases the liver continues to suffer and sustain more inflammation and damage, some patients do not get recovered from the Acute Hepatitis completely. It may develop the Chronic Hepatitis. If the symptoms continue to persist for more than 6 months, this Hepatitis is considered to be Chronic Hepatitis. This may last for years.
- Alcohol-induced Chronic Hepatitis: The liver would be continuously damaged entirely, because of heavy alcohol consumption.
- Chronic Active Hepatitis: It causes an aggressive inflammation of the liver and the destroyer of the liver cells. It may lead to cirrhosis.
- Chronic Persistent Hepatitis: This is relatively milder chronic inflammation. This kind of Chronic Hepatitis generally does not lead to potential cirrhosis.
The common causes of Chronic Hepatitis are
- Viral Hepatitis
- Autoimmune Disorder (happens when the tissues are attacked by the body)
- Heavy and excessive alcohol consumption
- Metabolic Disorders (like Wilson’s Disease or Hemochromatosis)
- Reactions caused from certain medications, like medications given for TB etc.
In some people, it is caused by certain drugs and viruses.
The progression of the damage of the liver is slow when Chronic Hepatitis is attacked. So, the symptoms are generally found to be mild. It is also possible that some of the people do not experience any of the symptoms.
The general symptoms experienced by the people affected by it are,
- Poor Appetite
- Low Fever
- Feeling Ill
- Upper Abdomen Pain
- Symptoms similar to chronic liver diseases like spider-like blood vessels seen in skin, enlarged spleen and fluid retention.
Initially, the complete medical examination is done and complete medical history is checked. In addition to it, the diagnostic procedures required and done for the Chronic Hepatitis generally include
- Laboratory tests done for specific viruses
- Tests for liver function or Liver Biopsy
The second test is needed to determine scarring, underlying causes, cirrhosis and severity of inflammation.
The treatment is determined by the liver physician. The treatment is based and specific to the cause and severity of the liver condition. The underlying health and previous medical history of the diseases related to the liver of the patient is also considered. The treatment has the objective of alleviating the symptoms and stopping the damage to the liver.
The specific treatment recommended can be one of the following.
Antiviral Agents: In cases of the Chronic Hepatitis caused by Hepatitis B or Hepatitis C, infectable antiviral drug called interferon-alpha is given to stop the inflammation of the liver. For Hepatitis B, specific oral anti-viral agents like adefovir or lamivudine may be used in addition. For Hepatitis C, it is required to give ribavirin, in addition.
Corticosteroids: This treatment is needed for treating the chronic liver diseases that are caused by an autoimmune disorder. Scarring of the liver might be continued, though inflammation is reduced or suppressed.
Discontinuation of Certain Drugs: In case certain drugs cause the Chronic Hepatitis, those drugs are discontinued and it would clear up the relative symptoms.
Discontinuance of Alcohol: This treatment is needed to recover the Chronic liver diseases of alcohol induced liver. It is advised by the physicians for many chronic diseases and in Hepatitis C.
To prevent the spread of Viral Hepatitis Proper Hygiene: This is the key to prevent the spread of Hepatitis and many diseases.
The other preventive measures suggested are, Vaccination: Toddlers are given a routine Hepatitis B vaccine, according to the immunization schedule. People with risk of contracting diseases can take Hepatitis A vaccine while travelling (No vaccines for Hepatitis C,E and D)
Blood Transfusion: For Hepatitis B, C and HIV, the blood products are to be screened routinely for reducing the transfusion infection.
Antibody Preparation: An antibody preparation is helpful to administer and helpful in protecting from the contracting diseases in case the patient got exposed to Hepatitis B.
High risk situations and groups are aimed for Hepatitis B, C prevention are,
- Unsafe Blood Transfusion
- Unprotected Sexual Exposure
- Dental Manipulations or Surgical Procedures
- Hepatitis B or C in family
- Personnel of Medical or Paramedical
- Intravenous Drug Abuse
Dr Naimish Mehta has performed over 725 liver transplantation surgeries considered to be best liver transplant surgeon in India. Dr. Naimish Mehta is the Lead HPB and Liver Transplant Surgeon, in the Deptt of Surgical Gastroenterology & Liver Transplant Unit I, Sir Ganga Ram Hospital, New Delhi. He has 14 years of experience in the field of Hepato- Pancreatico-Biliary (HPB) Surgery performing complex operations on the Liver, Bile Ducts and Pancreas.