The most common cause of jaundice is viral hepatitis.
Viral hepatitis may be due to-
Hepatitis
Hepatitis B
Hepatitis C
Hepatitis E
Viral hepatitis may also be due to the virus like Epstein-Bar virus, herpes simplex virus or due to yellow fever.
Clinical features.
Very vague signs and symptoms are there in hepatitis.
Headache, nausea, vomiting, myalgia, joint pain precedes the development of jaundice.
This is followed by diarrhoea and abdominal discomfort.
Urine becomes dark and stool is pale, there is pain on palpation over the site of liver, but liver is minimally enlarged.
Investigations.
Liver function tests
Serum transaminases rises between 200 to 2000U/L.
Alkaline phosphatase rarely exceeds twice the upper limit of normal.
White cell count is normal.
But lymphocytes are increased.
HEPATITIS A
Hepatitis A (HAV) –it is highly infectious and spread is through oro-faecal route. Infected individual shreds the virus through the faeces about 2-3 weeks before the onset of symptoms and 2 weeks after the onset of symptoms. Poor sanitation and overcrowding are the main source of infection. Sometime water and shellfish may act as a vehicle of transmission. But chronic carrier state is not there. Diagnosis is the evidence an anti HAV in the blood.
Improving the social situations like overcrowding, poor sanitation will prevent the outbreak.
Prognosis is usually good. But patients in chronic liver disease cause serious problems to health.
HEPATITIS B
In Hepatitis B -Humans are only the source of infection. It is one of the most common causes of chronic liver failure and hepatocellular carcinoma in the world. The peculiarity of acute infection of Hepatitis B is that, acute infection is asymptomatic, especially when acquired by birth. And majority among the people with chronic hepatitis is also asymptomatic. When it is associated with serum transaminases in blood, there is a chance of cirrhosis of liver after a period of years.
The source of infection determines the progression of the chronic liver disease.
The transmission from mother for the child in the perinatal period is the most common cause of infection and carries the highest risk.
Route of transmission of hepatitis B -
Injection ,drug use.
Infected blood products.
Acupuncture needles, tattoos.
Homosexual and heterosexual activities.
90% of transmission is from HbsAg positive mother.
HEPATITIS D
Hepatitis D - (HDV) virus has no independent existence. The source and mode of spread are same as Hepatitis B VIRUS. An individual can get hepatitis D virus infection simultaneously with HBV or as an added infection in a carrier of HBV.
The blood finding of anti-HDV is the evidence of HDV infection.
Prevention of hepatitis B effectively prevents hepatitis DD.
HEPATITIS C
Acute symptomatic infection with hepatitis C is rare. So the infection is identified only after development of chronic liver disease. But it is not necessary that everyone who got infected with hepatitis C should develop cirrhosis. 20% of the persons infected with hepatitis may get cirrhosis within 20 years.
Risk factors for hepatitis C infection-
Intravenous drug misuse
Needles stick injury, unclean vaccination needles.
Sharing tooth brushes, razors, and brushes.
Liver biopsy is needed to stage the degree of liver damage.
HEPATITIS E
The spread of hepatitis E is through oro-faecal route like hepatitis A. In the majority f the cases it is self-limiting, and does not cause cirrhosis.
However, if a pregnant lady gets an infection with hepatitis E, the chance of acute liver failure is very high and also the mortality.
Treatment.
The treatment of hepatitis A and E is comparatively safe with homeopathy.
As a primary measure, keeping good hygiene and drinking boiled and cooled water will prevent the spread.
Homeopathic medicine is highly recommended for the above type of hepatitis.
Medicines like chelidonium, Merc sol, Nux vom etc.are usually very effective and the symptoms as well as the blood reports become normal within a week's time.
Hepatitis B and C-since the outcome of Hepatitis B and C is very serious and fatal, deep acting medicines are necessary. And the patient can continue homeopathic medicines along with the present medication or can take homeopathic medicine only.
There are many remedies that are effective for Hepatitis B and E. The duration of treatment depends on the chronicity of the disease, age of the patient.
