Definition
The inflammation of the liver (hepatitis) is a reaction of the immune system and vascular connective tissue to internal and external damage in the liver. There are several causes of inflammation of the liver: Viruses Bacteria Autoimmune reaction: by the body’s own defense system (immune system) Drugs or toxins A distinction is also made between acute inflammation of the liver that lasts less than two months and has a rapid course. If the acute inflammation does not heal, it can develop into chronic liver inflammation if the inflammation lasts longer than 6 months.
The chronic inflammation has a slow progression and uncharacteristic symptoms, which can lead to late complications and death. The symptoms of liver inflammation differ in particular from the type and cause of the inflammation. In general, symptoms such as malaise, fatigue, loss of appetite, nausea, tiredness and fever occur.
In some cases, jaundice (icterus) occurs, in which the skin and eyes turn yellow and the urine turns dark.
- Viruses
- Bacteria
- Autoimmune reaction: By the own defense system (immune system)
- Medicines or toxins
The pathogens of viral liver inflammation are called hepatitides. All of them trigger liver inflammation, but do not belong to the same virus family.
Acute hepatitis The pathogens of hepatitis A and E trigger acute inflammation and are excreted with the stool (faecal) and absorbed through the mouth (oral). This transmission route is therefore called fecal-oral. Hepatitis A (inflammation of the liver A) is transmitted by the hepatitis A virus and is known as travel hepatitis because it is transmitted through contaminated water or raw foods such as oysters or salad (low standard of hygiene).
First symptoms of acute hepatitis appear after 3-5 weeks and mild jaundice may occur. The course of hepatitis A depends on age and usually lasts for about 5 weeks. When travelling to areas where hepatitis A (tropics and subtropics) is common, you should be vaccinated.
Hepatitis E (hepatitis E virus) is also a travel hepatitis (consumption of risk products such as salad, ice cubes, tap water), but can also be transmitted in Germany by the consumption of uncooked meat (wild boar, offal). Risk areas are the Indian subcontinent, Africa, Southeast Asia and the Caribbean, if overnight stays are made in rather modest accommodations during the journey. First symptoms appear after 2-8 weeks, which disappear on their own.
The infection can become severe with age and has a mortality rate of 1-4%. Hepatitis E infection can have a particularly severe course, especially in pregnant women. Currently, no vaccine against hepatitis E is approved in Germany.
Chronic hepatitis pathogens Hepatitis B, C and D viruses, which usually enter the body via the bloodstream (parenterally), are among the pathogens causing chronic liver inflammation. The following symptoms occur in chronic liver inflammation: Water accumulation in the abdomen (ascites), jaundice (icterus), rash on the palm of the hand (palmarerythema) and there is restructuring of the liver tissue. In Germany there are 400,000 people who carry the hepatitis B virus.
The viral disease is still widespread worldwide and occurs particularly frequently in Africa, South East Asia and South America. Hepatitis B is mainly transmitted through sexual contact, but can also be transmitted from mother to child through saliva or breastfeeding. Another route of transmission is via the blood – for example, needle sharing in the case of heroin abuse.
The incubation period of the disease is between 45 and 180 days and, if chronic, is fatal in 30-90% of cases 5 years after infection. However, this disease can be treated by interferon therapy or the use of nucleoside analogues. Prophylactic vaccinations should be taken to prevent infection.
Vaccination against hepatitis B indirectly protects against the hepatitis D virus, which is usually transmitted via needle sharing. Hepatitis C is also very widespread worldwide and is also mainly transmitted via intravenous drug use. Sexual transmission plays a rather subordinate role. In addition, there are some viruses that cause generalized infections, but can also affect the liver. These include the HI virus (HIV), the Epstein-Barr virus (Pfeiffer’s glandular fever), the varicella zoster virus (chickenpox, shingles) and the cytomegalovirus (strongly influenza-like symptoms).In addition, viruses can also cause hepatitis, which are otherwise responsible for mumps, rubella or various febrile diseases.
