Hepatitis A

Hepatitis A has only got acute forms of the disease and is caused by the hepatitis A virus (HAV). The fact that the HAV can only cause an acute form of the disease is an advantage for the patient, because an acute form of the disease causes symtoms not longer to last for about 2 to 6 months and the body can treat the virus on its own well.

The experience of symptoms are divided in the stages of age in this variant of the disease. Symptoms are often not noticed by older children (10-16), because they might think that the symptoms are not corresponding to the hepatitis. This may sometimes also be the case in adults. Some of the symptoms of hepatitis A include: headaches, and nausea. Adults often experience other types of symptoms like icterus: turning yellow of the skin and eye. The cause of this yellow skin is due to the fact that hepatitis causes conjugated hyperbilirubinemia. This means that the patient is having too much bilirubin in the bloodstream. Bilirubin is a yellow breakdown product, in the blood, caused by the body which clears (old) red blood cells. Another symptom of hepatitis A among adults is the decolourization of excrement.

Fatigue is also one of the major symptoms of hepatitis A. Hyperbilirubinemia also causes this. Due to the fact that too much bilirubin is produced in the bloodstream, the body has cleared many red blood cells, containing hemoglobin. Hemoglobin is a protein which carries oxygen. The lack of oxygen, and therefore also aerobic respiration, limits the energy production of the patient, causing the patient to be tired (fatigue). In severe cases, this can lead to confusion and even coma.

 

Hepatitis B/C

These forms of the disease can be in both acute and chronic forms, caused by the hepatitis B virus (HBV) and hepatitis C virus (HCV). A chronic form of hepatitis means that the signs and symptoms of the disease will last for at least more than 6 months to the patient. The chronic form also can cause more serious symptoms to the patient compared to the acute form.

This state/condition of this chronic phase may be mild and harmless at some points, causing little damage. However, at some point, the liver can become seriously damaged. This causes significant damage to tissues of the organ. This is a very important symptom of this type of hepatitis, namely: cirrhosis. In this condition, parts of the liver tissue has become fibrotic which means that connective tissue of the liver have become damaged and thicker by proteins that have connected closely to the cells, making the liver surface rough and stiff as well. This will eventually also cause scarring of parts of the liver surface. These scars and thick liver tissue can be used to identify the cirrhosis. This can eventually also lead to other major effects. The disease can progress into the following issues and can cause the following for each infection of the two viruses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

As seen as above, the fibrotic and damaged liver tissue can cause liver canver and liver failure over time. Before cirrhosis can appear, the liver must have constantly performed many processes involving repairing that liver tissue. This also counts during the cirrhosis. The fact that the body constantly has to repair the liver tissue cells (=hepatocytes), can cause a chance in genetic replication of DNA which leads to a mutation of the hepatocytes. This is called a mutation. This mutation will eventually cause an unregulated cell growth. It will also cause the DNA replication of the cells to be affected greatly. These two factors will eventually cause cancerous cells and over time a tumor in the liver. This whole process of the cancer which has been formed by an affected genetic process is called carcinogenesis. This process is also caused by the HBV and HCV itself. The viruses namely are DNA viruses. DNA viruses have the ability to integrate and fully enter DNA of cell. In this case, the HBV enters the hepatocytes. Here, a mutation is caused by affecting the DNA replication. This will eventually cause an unregulated cell growth as well causing, again, carcinogenesis.

 

Another major effect of what cirrhosis can cause besides liver cancer of liver failure, as as seen above, is ascites. Ascites is the presence of extravagance fluid, which should have actually gone to the liver, between two areas in the abdomen: the outside peritoneum (epithelium tissure on the inside of the abdominal cavity) and the inside peritoneum. When the hepatocytes become damaged or even die off by the cirrhosis, the pressure on underlying cells, stellate cells, will increase. This pressure will to more pressure. However, this new pressure is underneath the stellate cells, namely, across the upper surface of the central vein of the liver. This pressure is called portal hypertension. This portal hypertension will cause fluid from the blood vessels, underneath the surface of the central vein of the liver, to enter tissues and even large open spaces, instead of it entering the liver. The excess fluid often goes to the large open space between the outside peritoneum and the inside peritoneum. This is when ascites can be characterized.

 

The excess fluid can also cause difficulties regarding other organs, like the spleen

It can namely cause congestive splenomegaly. This is the enlargement of the

spleen, caused by factors around its area. In this case, the factor is the extravagant

fluid. Because the excess fluid can't get back into the liver by the portal hypertension,

it has to find another way out of the compressed area. Besides of this being the

space of the two areas of the outside peritoneum and the inside peritoneum, the

excess fluid will go to the area where it came from, namely, the spleen. The fluid

which backs up in the spleen will cause the enlargement.

 

 

                                                                

 

 

 

 

 

 

 

 

 

 

 

 

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As the liver becomes more and more damaged by the cirrhosis, the brain can also be affected. Due to the cirrhosis, the liver's ability of detoxification of the blood decreases. Toxins in the blood, like ammonia, continue to move to the brain. These toxins can then cause damage to the brain causing mental deficits such as hepatic encephalopathy. This affection is characterized by especially confusion and in some cases coma.

 

 

Hepatitis D

Symtoms of hepatitis are similar to the symptoms of hepatitis B and C, but can be experienced at a worse level. This is because a person with hepatitis D had also experienced symptoms and developments of symptoms of hepatitis B. This is because a person can only get hepatitis D from hepatitis B. A hepatitis B virus namely develops into a HDB (hepatitis D virus). About 5% of all the people who have hapatitis B, also have hepatitis D. It can't be cured and there are currently no vaccinations against the virus.

 

Hepatitis E

Most of the patients with this type of hepatitis are kids below the age of 16. Symptoms among the children are comparable like the symptoms of hepatitis A. However, an important and characterized symptom of this type of the disease is liver growth. Liver growth can cause symptoms like diarrhea and pressure on the abdomen.