Model Answer
0 min readIntroduction
Acute hepatitis refers to the inflammation of the liver, typically developing over weeks or months. It is characterized by a rapid onset of symptoms like jaundice, fatigue, abdominal pain, nausea, and vomiting. While many cases are self-limiting, acute hepatitis can progress to acute liver failure, necessitating urgent medical intervention. The causes of acute hepatitis are diverse, ranging from viral infections to drug-induced liver injury and autoimmune disorders. Understanding these causes is crucial for accurate diagnosis and appropriate management.
Viral Hepatitis
Viral hepatitis is the most common cause of acute hepatitis globally. Several viruses can infect the liver, leading to inflammation.
- Hepatitis A Virus (HAV): Transmitted via the fecal-oral route, often associated with contaminated food and water. Typically causes a mild, self-limiting illness.
- Hepatitis B Virus (HBV): Transmitted through blood, semen, or other body fluids. Can cause acute or chronic infection. Vaccination is available.
- Hepatitis C Virus (HCV): Primarily transmitted through blood contact, often associated with intravenous drug use. Frequently leads to chronic infection.
- Hepatitis D Virus (HDV): Requires co-infection with HBV for replication. Can cause more severe liver disease.
- Hepatitis E Virus (HEV): Transmitted via the fecal-oral route, similar to HAV. Often causes a self-limiting illness, but can be severe in pregnant women.
Drug-Induced Liver Injury (DILI)
DILI is a significant cause of acute hepatitis, accounting for a substantial proportion of cases. It occurs when the liver is damaged by medications, herbal remedies, or dietary supplements.
- Paracetamol (Acetaminophen): Overdose is a common cause of acute liver failure.
- Antibiotics: Amoxicillin-clavulanate, erythromycin, and isoniazid are frequently implicated.
- Statins: Used to lower cholesterol, can cause liver enzyme elevations and, rarely, acute hepatitis.
- Herbal Remedies & Dietary Supplements: Many contain hepatotoxic compounds.
Alcoholic Hepatitis
Excessive alcohol consumption can lead to alcoholic hepatitis, characterized by inflammation and damage to the liver. The severity can range from mild to life-threatening.
- Chronic alcohol abuse is a prerequisite.
- Severity is graded based on the Maddrey discriminant function.
Autoimmune Hepatitis
Autoimmune hepatitis occurs when the body's immune system attacks the liver cells. It is more common in women and is often associated with other autoimmune disorders.
- Type 1 Autoimmune Hepatitis: Most common type, associated with other autoimmune diseases.
- Type 2 Autoimmune Hepatitis: Less common, often associated with autoimmune thyroiditis.
Other Causes
Less common causes of acute hepatitis include:
- Ischemic Hepatitis: Reduced blood flow to the liver, often due to heart failure or shock.
- Budd-Chiari Syndrome: Blockage of the hepatic veins.
- Wilson's Disease: Genetic disorder causing copper accumulation in the liver.
- Alpha-1 Antitrypsin Deficiency: Genetic disorder leading to liver and lung disease.
- Infections: Epstein-Barr virus (EBV), Cytomegalovirus (CMV), Leptospirosis.
| Cause | Transmission/Mechanism | Typical Presentation |
|---|---|---|
| HAV | Fecal-oral | Mild jaundice, fatigue |
| HBV | Blood, body fluids | Variable, can be asymptomatic or severe |
| DILI (Paracetamol) | Overdose | Acute liver failure, jaundice |
| Alcoholic Hepatitis | Chronic alcohol abuse | Jaundice, abdominal pain, fever |
Conclusion
Acute hepatitis is a multifaceted condition with a wide range of etiological factors. Viral infections remain the most prevalent cause, but drug-induced liver injury and autoimmune disorders are increasingly recognized as significant contributors. Accurate diagnosis, based on clinical presentation, serological testing, and exclusion of other causes, is essential for appropriate management and prevention of complications. Public health initiatives focusing on vaccination, safe medication practices, and responsible alcohol consumption are crucial in reducing the burden of acute hepatitis.
Answer Length
This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.