Hepatitis (liver inflammation)

Overview

Hepatitis is inflammation of the liver. In addition to an infection (mainly hepatitis A - E), poisoning (primarily alcohol), overnutrition and various diseases can also cause liver inflammation. Typical symptoms include pressure pain and pressure in the upper abdomen, pale stools and yellowish discolouration of the skin and eyes. Such symptoms should be discussed with a doctor.

Symptoms

Depending on the cause, the disease can be asymptomatic

• Fatigue, reduction in performance
• Fever, headaches
• Pressure pain and pressure in the upper abdomen
• Yellowish discolouration (eyes first, then the skin)
• Nausea, vomiting
• Loss of appetite
• Diarrhoea, pale stools
• Beer-coloured urine
• Itching

Complications

• Chronification (sick > 6 months)
• Co-infections (infection by other pathogens)
• Fatty liver
• Liver cirrhosis
• Liver cancer

Causes and treatment

Causes

• Infections
  • Hepatitis viruses A - E
  • Herpes viruses, e.g. herpes simplex, virus causing glandular fever
  • Yellow fever, dengue fever, HIV
  • Bacteria: typhoid, tuberculosis, syphilis
  • Parasites: e.g. malaria, worms
• Poisons and medication
  • Overdose or misuse of medication
  • Alcohol
  • Mycotoxins
• General diseases
  • Metabolic disorders, e.g. metabolic syndrome, extreme obesity
  • Bile duct diseases, e.g. gallstones
  • Tumours
• Autoimmune disorders
  • Autoimmune hepatitis
• Rare hereditary diseases

Risk factors

• Unvaccinated persons (vaccination against hepatitis A, B is recommended)
• Insufficient standards of hygiene (developing countries)
• Healthcare or security-sector workers
  • e.g. stab and bite injuries
  • Contact with bodily fluids
• Unprotected sexual intercourse
• Contaminated needles
  • Medical personnel
  • Piercings, tattoos
  • Drug addicts (“needle sharing”)
• Trips to developing countries
• Immune deficiency

Further treatment by your doctor / in hospital

Possible tests

• Blood test
• Search for pathogen (virus, antibodies)
• Ultrasound
• Liver biopsy (tissue sample), if necessary

Possible therapies

Depending on the cause of the hepatitis

• Watchful waiting
• Bed rest
• Alcohol withdrawal and weaning
• Antiviral medication
• Suppression of immune system
• Last resort: liver transplant

What can I do myself?

• Vaccination against hepatitis A, B
• Before leaving on a trip: contact travel doctor or institute of tropical medicine
  • Vaccinations
  • Travel recommendations
• Follow general hygiene standards
  • Hand hygiene
  • Drinking water, food hygiene
• Healthy diet, normal weight
• Avoid alcohol
• Follow the safer sex rules
  • Always use a condom or femidom during sexual intercourse
  • Don't get sperm or blood (including menstrual blood) in your mouth, and don’t swallow
• Don’t share drug paraphernalia (no “needle sharing”)

When to see a doctor?

• Yellowish discolouration of eyes and skin
• Pressure pain and pressure in the upper abdomen
• Pale stools, dark urine
• Persistent itching
• Symptoms during or after a trip
• Suspicion following contact with infected persons, materials

Further information

Federal Office of Public Health, FOPH (Bundesamt für Gesundheit, BAG)
www.bag.admin.ch/bag/en

Swiss Hepatitis (Hepatitis Schweiz)
www.hepatitis-schweiz.ch/en/

Synonyms

liver inflammation, hepatitis, inflammation of the liver, autoimmune hepatitis