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Chronic hepatitis is an inflammation of the liver that lasts for more than 6 months and is usually caused by the hepatitis B virus, a type of virus that can be transmitted by direct contact with blood or other secretions from an infected person. However, chronic hepatitis can also have other causes, such as hepatitis C or even excessive alcoholic beverages, for example.
Although in most cases, chronic hepatitis does not cause any obvious symptoms and is often identified during routine examinations, some people may show inaccurate signs, such as general malaise, decreased appetite or frequent tiredness for no apparent reason.
Still, even if it does not cause symptoms, hepatitis should always be treated, as if it continues to get worse, it can cause more serious complications, such as cirrhosis or liver failure. Thus, whenever a liver problem is suspected, it is advisable to consult a hepatologist to assess the presence of a problem and start the most appropriate treatment.
Main symptoms
In more than half of the cases, chronic hepatitis does not cause any obvious symptoms, developing gradually until cirrhosis appears, with symptoms such as nausea, vomiting, swollen belly, red hands and skin and yellow eyes.
However, when symptoms do exist, chronic hepatitis can cause:
- Constant general feeling of malaise;
- Decreased appetite;
- Frequent tiredness without reason;
- Constant low fever;
- Discomfort in the upper right side of the belly.
Since it is more common for chronic hepatitis to have no symptoms, many cases are identified only during routine blood tests. In these cases, the values of AST, ALT, Gamma-GT, alkaline phosphatase and bilirubin are generally increased.
How to confirm the diagnosis
If the doctor suspects a chronic hepatitis, in addition to new blood tests more specific for liver enzymes and antibodies, he can also ask for imaging tests, such as ultrasound or computed tomography.
There are also situations in which a biopsy may be requested, in which a small sample of liver tissue is sent to the laboratory to try to confirm the cause of the hepatitis or to try to understand the level of liver damage, helping to better adjust the treatment.
Possible causes of chronic hepatitis
In most cases, chronic hepatitis is caused by an infection with the Hepatitis B virus, however, other relatively common causes include:
- Hepatitis C virus;
- Hepatitis D virus;
- Excessive alcohol consumption;
- Autoimmune diseases.
Although it is more rare, chronic hepatitis can also be caused by the use of some types of medication, especially Isoniazid, Methyldopa or Phenytoin. When this happens, it is usually sufficient to change the medication for the liver inflammation to improve.
Check out some symptoms that may indicate hepatitis C or hepatitis B virus infection.
How the treatment is done
Treatment for chronic hepatitis depends on the severity of the damage to the liver and its causes. However, it is relatively common for treatment to start with the use of some type of corticosteroids to decrease inflammation and improve symptoms, until the specific cause is known.
Once the cause has been identified, treatment should be adequate to cure the disease whenever possible and to prevent complications from arising. Thus, in the case of hepatitis caused by the hepatitis B or C virus, the doctor may advise the use of some antiviral drugs, since if the hepatitis is caused by an autoimmune disease, it is important to start treatment for this disease, and if it is caused due to excessive alcohol or the use of medications, its use should be stopped.
At the same time, it may also be necessary to treat some complications that arise with increased inflammation, such as encephalopathy or the accumulation of fluids in the abdomen.
In the most severe cases, where the liver lesions are very advanced, it is usually necessary to have a liver transplant. Understand how the transplant is done and how and the recovery.
Created by: Tua Saúde Editorial Team
Bibliography>
- MSD MANUAL. Overview of Chronic Hepatitis. 2017. Available at:. Accessed on 25 Jul 2019
- HARVARD HEALTH PUBLISHING. Chronic Hepatitis. Available in: . Accessed on 25 Jul 2019
- European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection. Journal of Hepatology. Vol. 57. 167-168, 2012
- WORLD GASTROENTEROLOGY ORGANIZATION GLOBAL GUIDELINE. Hepatitis B. 2015. Available at:. Accessed on 25 Jul 2019