Hepatology

Liver is responsible for many critical functions within the body. It helps your body digest food, store energy, and remove poisons. If it becomes diseased or injured, the loss of those functions can cause significant damage to the body. There are over 100 different forms of liver disease that affect men, women and children. These diseases include cirrhosis, alcohol abuse, hepatitis A, B, C, D, and E, Epstein Barr virus (infectious mononucleosis), non-alcoholic fatty liver disease and iron overload (hemochromatosis). The main symptoms of liver imbalance include weakness and fatigue, weight loss, nausea, vomiting, and yellow discoloration of the skin (jaundice).

Screening for Liver diseases has been advocated with the intention of intervening to halt its progression. Abnormal liver tests are those that measure synthesis of proteins made by the liver (albumin, clotting factors) or the liver's capacity to metabolize drugs. The impact of diagnosis of hepatitis C virus on quality of life is worse in patients aware of their viral status compared with individuals unaware of their viral status.

The use of herbal products as medications has its origin thousands of years ago. In Western countries, herbal medicine products are gaining increasing popularity. Some herbal products may potentially benefit people with liver disease.

Several disorders contribute to liver disease in pregnancy such as acute fatty liver of pregnancy (AFLP) and intrahepatic cholestasis of pregnancy (IHCP), hyperemesis gravidarum and hemolysis and elevated liver enzymes and low platelets (HELLP) syndrome. Liver disease such as acute viral hepatitis can occur in pregnancy and pregnancy may occur in a patient with underlying chronic liver disease including patients with cirrhosis and portal hypertension, and patients who have undergone liver transplantation.

Hepatitis C is a devastating liver disease caused by Hepatitis C virus (HCV) which causes acute and chronic infection. In some cases, chronic hepatitis often leads to liver cancer or cirrhosis. Chronic Hepatitis causes liver damage and fibrosis, hepatomegaly, hepatocellular carcinoma.

HCV is a bloodborne virus transmitted due intravenous drug use, unsterilized medical equipment, from mother to baby during birth, sexual contact with infected person. HCV virus has no vaccine, therefore prevention of virus prevalence is recommended.

 

Hepatitis B is a liver infection caused by the Hepatitis B virus (HBV). HBV is transmitted through activities that involve percutaneous or mucosal contact with infectious blood or body fluids. HBV can survive outside the body at least 7 days and still be capable of causing infection. The best way to prevent hepatitis B is by getting the hepatitis B vaccine. The pathogenesis and clinical manifestations of hepatitis B are due to the interaction of the virus and the host immune system, which lead to liver injury and potentially cirrhosis and hepatocellular carcinoma. Patients can have either an acute symptomatic disease or an asymptomatic disease.

Non-viral hepatitis is an inflammation of the liver caused by toxins, drugs, or other harmful chemicals that destroy cells in the liver (Hepatocytes).  Acute hepatitis damages hepatocytes, make up 70-85% of the total mass of the liver. The disease is a growing problem due to the increasing number of dietary supplements with liver side effects. If hepatitis leads to liver failure, a liver transplant is the only treatment option that can improve survival.

Overall, about one-third of people with HIV also have hepatitis C. Hepatitis C virus (HCV) can be transmitted in some of the same ways as HIV and hepatitis B. HIV can worsen hepatitis C. HIV not only increase the risk of liver damage, but it can also speed up the onset of liver damage following infection. People who are coinfected with HIV and HCV should work closely with health care providers in order to monitor and treat both conditions.

Liver transplantation surgery technique to replace a diseased or injured liver with a healthy liver delivered from a healthy person. The liver is involved in various metabolic functioning including metabolism of drugs and toxins, removing degradation products of normal body metabolism (for example clearance of ammonia and bilirubin from the blood), and synthesis of many important proteins and enzymes (such as factors necessary for blood to clot). Doctors or surgeons suggest liver transplant surgery to the patients who suffer from severe Drug-induced liver injury (DILI) or Chronic liver failure. This surgery carries a risk of other complications including infection, liver inflammation, blood clots, liver rejection, and memory thinking problems.

The best way to prevent hepatitis is by getting the hepatitis vaccines. Vaccination is safe and effective and it is recommended for all. Efforts to develop a hepatitis C vaccine started more than 20 years ago, when the hepatitis C virus was identified. The hepatitis C virus is more variable than are the viruses that cause hepatitis A and hepatitis B. Hepatitis C virus occurs in at least six genetically distinct forms with 50 subtypes. A global vaccine would have to protect against all these variants of the virus.