Hepatitis

Hepatitis

This literally means “inflammation of the liver” and when hepatitis is present the liver enzymes ALT and AST are typically elevated.  Alkaline phosphatase, bilirubin, and INR may also be abnormal but not necessarily.  Hepatitis has many etiologies, but the most common are viral, alcoholic and drug-induced hepatitis.  Hepatitis A, B and C are well-known viruses that attack the liver but Epstein-Barr, CMV and others can as well. Hepatitis A is a foodborne illness and never becomes chronic whereas Hepatitis B and C are typically acquired via contact with blood or body fluids and often become chronic.  Alcohol is toxic to the liver when consumed regularly and in large amounts and can lead to life-threatening hepatitis and ultimately cirrhosis.  Many medications both prescription and non-prescription, can cause hepatitis even when administered correctly. Thus it is imperative to obtain a detailed drug history. Acetaminophen (Tylenol) excess is a well-known cause of fulminant hepatitis. Less common causes of hepatitis include autoimmune hepatitis in which the patient’s own immune system thinks their liver cells are foreign and “attacks” the hepatocytes  thereby causing inflammation.  Ischemia, or low blood flow to the liver, which deprives the liver of oxygen can also cause a severe hepatitis and even liver failure.  Severe hepatitis, regardless of etiology, will require hospitalization for close monitoring and may require liver transplantation.