Viral hepatitis

For a lay person:

Viral hepatitis is inflammation of the liver caused by one of several viruses, named hepatitis A, B, C, D and E. Hepatitis A and E usually spread through contaminated food or water and get better on their own, while hepatitis B and C spread through blood and sex and can become long-term infections that damage the liver.

For a trained medical person:

Hepatitis A and E are faecally-orally transmitted and usually self-limiting, though E can be severe in pregnancy; hepatitis B, C and D are blood-borne and can cause chronic infection, cirrhosis and hepatocellular carcinoma. Diagnosis is by liver function tests and virus-specific serology and nucleic acid testing, with assessment of fibrosis in chronic disease. Management is supportive for acute infection, antivirals for chronic hepatitis B, curative direct-acting antivirals for hepatitis C, and vaccination for A and B.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Heat Worse than Dampness Type: Clear Heat and Drain Damp; Yin Jaundice; Acute Hepatitis Cwith Jaundice; Acute Hepatitis without Jaundice Liver Qi Stagnation with Spleen Damp Syndrome (Often Seen in He patitis A & B); Liver Qi Stagnation with Phlegm and Toxin Stasis Syndrome (Ofte n Seen in Hepatitis C); Chronic Hepatitis Damp-Heat Obstructing Middle Jiao; Liver Qi Stagnation and Spleen Deficiency; Liver and Kidney Yin Deficiency; Spleen and Kidney Yang Deficiency; Blood Stasis and Obstruction of the Channels and Collaterals Sy ndrome. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Get urgent care for jaundice with confusion, drowsiness, bleeding or bruising, or vomiting, which can signal liver failure; hepatitis needs medical diagnosis and treatment, is notifiable in many countries, and Chinese medicine is adjunctive at most. Some herbs can injure the liver, so check every herb with your doctor if you have hepatitis.