Hepatitis is any disease that causes an inflammation/infection of the liver and it is mainly caused by hepatitis virus although some other viruses, parasites and bacteria could also cause inflammation of the liver. Hepatitis could also be caused by certain health conditions, consuming excessive alcohol over long periods of time, certain toxins or medications or autoimmune diseases.
Types of hepatitis
Hepatitis A is caused by Hepatitis A virus (HAV) and is spread through contaminated food and water. It is a short term or acute disease.
Hepatitis B is caused by Hepatitis B virus (HBV) through infected blood or sexual contact or passed from mother to baby during pregnancy. It could be an acute (short term) or chronic (long term disease) and more severe.
Hepatitis C is caused by Hepatitis C virus (HCV) through infected blood and some bodily fluids. It could be transmitted through sharing of contaminated needles. It is often a chronic infection and could lead to liver cirrhosis. Many do not have any symptoms at all.
Hepatitis D is caused by Hepatitis D virus (HDV) and it occurs only in people who are already infected with Hepatitis B. It can be acute or chronic (longer than 6 months). It could be contracted through bodily fluids or through birth from the mom to her baby.
Hepatitis E is caused by Hepatitis E virus (HEV) and like HAV, it is spread through contaminated food and water especially in areas with poor sanitation. It too is an acute disease although it could be more severe than Hepatitis A. It could be dangerous for pregnant women, the elderly or the immunocompromised people.
Alcoholic Hepatitis is caused due to long term consumption of excess alcohol. It could be reversed if caught early or if alcohol consumption is cut back. Due to this the liver cells could get injured and could lead to scarring and permanent damage (cirrhosis) to the liver eventually leading to liver failure.
Sometimes one’s own immune system can attack the liver thinking it is harmful. This is more common in women.
Symptoms
Symptoms of hepatitis could include fatigue, nausea, flu like symptoms, abdominal pain, joint pain, loss of appetite, jaundice (yellow skin and eyes), dark urine and pale stool and sometimes even liver failure although sometimes there are no symptoms at all.
Diagnosis
The doctor will first check your history to find out any reason for your illness and will do a physical exam to see if there is any tenderness or pain in the abdomen and liver and also check for any symptoms like yellowing of the eyes or skin. Results of the blood tests can provide information on the type of virus, the viral load (the amount of virus present), the antibody levels that are fighting the virus in your body, liver enzyme levels which show how well the liver is working amongst other things. A special liver ultrasound called transient elastography could be used to find out the amount of liver damage. They may also take a sample of your liver, also called liver biopsy, by poking a thin needle through your skin and into the liver to check for damage. An alternative to liver biopsy is magnetic resonance elastography (MRE) where the pattern of the sound waves can determine how much scarring is present in the liver.
Treatment
Treatment will depend on the type of hepatitis you have and its severity. Treatment for Hepatitis A and E is just bed rest, proper nutrition, avoiding alcohol and hydration and it usually resolves on its own. Pregnant women with Hepatitis E should be closely monitored. Treatment for chronic Hepatitis B, C and D might require antiviral medications along with regular check-ups with the doctor to see if the medications are indeed working. People infected with chronic Hepatitis B might need treatment for the rest of their lives. Acute Hepatitis B infection might not need any treatment. Corticosteroids could be used to treat autoimmune hepatitis and this suppresses the immune system. Vaccines for Hepatitis A, B and D are available but not for Hepatitis C and E. Also minimize the exposure to these viruses by staying away from alcohol and contaminated food and water, practice proper hygiene as well as contaminated needles and risky sexual contact. If the liver is severely damaged, you might need a liver transplant.
Some hepatitis infections can impair the quality of the sperm like its motility, its shape, its quantity and semen volume. (1) They also might have an increased risk of damage inside the sperm which can cause infertility and miscarriage. Hepatitis B and C affect fertility in males. There is some evidence that it can affect female fertility also. One study found that men with Hepatitis B are 1.59 times more likely to experience infertility than ones who haven’t been infected. (2) Hepatitis B virus has a specific protein which attacks the cell membrane of sperm and damages it decreasing its motility and fertilization rate. (3) A HBV infection in women could cause scarring or blockages in the fallopian tube or lead to infertility in the uterus. A HBV infection could lower the immunity in the women making them more vulnerable to sexually transmitted infections and pelvic infection. (4) So, it is important to see your doctor immediately if you feel you might have become infected with Hepatitis. Also, if you are having trouble conceiving and have hepatitis, it might be beneficial to see your fertility specialist about how to improve your odds of having a baby and also how the baby would not have hepatitis transmitted through the mother. Come feel free to talk to the experts at Xenith Advanced Fertility Centre if you have any questions about hepatitis and its effects on fertility.