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What is Hepatitis? What are causes of Hepatitis?

Hepatitis is a medical condition in which the liver cells are inflamed.
– The word hepatitis comes from the Ancient Greek word hepar (root word hepat) which means ‘liver’, and the suffix Latin itis meaning inflammation.
– Its plural is hepatitides.
– This condition is recognized by the presence of inflammatory cells in the tissue of the organ.
– This condition can progress to cirrhosis and fibrosis.
– Hepatitis may occur with limited or no symptoms.
– It often leads to jaundice, anorexia (poor appetite) and malaise.
– Hepatitis is acute when it lasts less than six months.
– It is chronic when it persists longer.
– A group of viruses known as the hepatitis viruses cause most cases of hepatitis worldwide.
– It can also be due to toxins (notably alcohol, certain medications, some industrial organic solvents and plants).
– It can also be due to other infections and autoimmune diseases.

How many types of hepatitis are there?
There are five main types of hepatitis that are caused by a virus, A, B, C, D, and E – plus types X and G.
– Hepatitis A
This is caused by eating infected food or water.
– Hepatitis B
This is an STD (sexually transmitted disease).
– Hepatitis C
Hepatitis C is usually spread through direct contact with the blood of a person who has the disease.
– Hepatitis D
Only a person who is already infected with Hepatitis B can become infected with Hepatitis D.
– Hepatitis E
A person can become infected by drinking water that contains HEV (Hepatitis E Virus).
– Hepatitis X
If hepatitis cannot be attributed to the viruses of hepatitis A, B, C, D, or E, it is called Hepatitis X.
– Hepatitis G:
This is a type of hepatitis caused by the Hepatitis G virus (HGV).

Acute Causes

1. Viral hepatitis:
– Hepatitis A, B, C, D, and E.
– Yellow fever
– Adenoviruses
– Parvovirus B19

2. Non-viral infection
– Toxoplasma
– Leptospira
– Q fever
– Rocky mountain spotted fever
– Alcohol
– Toxins: Amanita toxin in mushrooms, carbon tetrachloride, asafetida
– Drugs: Paracetamol, amoxycillin, antituberculosis medicines, minocycline and many others (see longer list below).
– Ischemic hepatitis (circulatory insufficiency)
– Pregnancy
– Auto immune conditions, e.g., systemic lupus erythematosus (SLE)
– Metabolic diseases, e.g., Wilson’s disease

Chronic Causes
Viral hepatitis:
– Hepatitis B with or without hepatitis D.
– Hepatitis C (neither hepatitis A nor hepatitis E causes chronic hepatitis).

Autoimmune Causes
– Alcohol
– Drugs
– Methyldopa
– Nitrofurantoin
– Isoniazid
– Ketoconazole

Heredity Causes
– Wilson’s disease.
– Alpha 1-antitrypsin deficiency.
– Primary biliary cirrhosis and primary sclerosing cholangitis occasionally mimic chronic hepatitis.

Alcoholic Hepatitis Causes
– Long term alcohol consumption.
– Patients with chronic alcoholic liver disease.
– Alcoholic cirrhosis.

A large number of drugs can cause hepatitis:
– Agomelatine (antidepressant).
– Allopurinol.
– Amitriptyline (antidepressant).
– Amiodarone (antiarrhythmic).
– Atomoxetine.
– Azathioprine.
– Halothane (a specific type of anesthetic gas).
– Hormonal contraceptives.
– Ibuprofen and indomethacin (NSAIDs).
– Isoniazid (INH), rifampicin, and pyrazinamide (tuberculosis-specific antibiotics).
– Ketoconazole (antifungal).
– Loratadine (antihistamine).
– Methotrexate (immune suppressant).
– Methyldopa (antihypertensive).
– Minocycline (tetracycline antibiotic).
– Nifedipine (antihypertensive).
– Nitrofurantoin (antibiotic).
– Paracetamol (acetaminophen in the United States) can cause hepatitis when taken in an overdose. The severity of liver damage may be limited by prompt administration of acetylcysteine.
– Phenytoin and valproic acid (antiepileptics).
– Troglitazone (antidiabetic, withdrawn in 2000 for causing hepatitis).
– Zidovudine (antiretroviral i.e., against HIV).
– Some herbs and nutritional supplements.

Other Toxins that can cause hepatitis:
– Amatoxin-containing mushrooms.
– White phosphorus, an industrial toxin and war chemical.
– Carbon tetrachloride.
– Cylindrospermopsin, a toxin from the cyanobacterium Cylindrospermopsis raciborskii and other cyanobacteria.

Metabolic disorders can cause hepatitis:
– Hemochromatosis (due to iron accumulation).
– Wilson’s disease(copper accumulation) can cause liver inflammation.
– Necrosis.
– Non-alcoholic steatohepatitis (NASH) is effectively a consequence of metabolic syndrome.

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