Viral Hepatitis

Pathophysiology: Hepatitis refers to an inflammatory disease which is mainly affects liver. Viral hepatitis is classified as A, B, C, D, E and G. Hepatitis viruses cause liver damage. Inflammation happens throughout liver and hepatocytes are destroyed by cytotoxic cytokines and natural killer cells. Cellular necrosis occur but liver usually able to repair itself and regain complete function if no other complications occur. There are three phases: Prodromal phase, Icteric phase and Recovery phase.

Disease Statistics: Prevalence in the general population varies from 0.4% to 5.2% for anti-HCV and from 0.1% to 5.6% for HBsAg. Estimates for liver cancer attributable to chronic hepatitis B/C in the Netherland also suggest regional variation.

Treatment: Intravenous rehydration is given as supportive care but no specific emergency treatment is recommended as such. Patients are admitted in conditions of severe complications. Evaluation for hepatic encephalopathy is done. Certain patients may benefit from pharmacologic therapy. Patients are advised to avoid prolonged or vigorous physical exertion until their symptoms improve and maintain adequate hydration.

Research: The National Hepatitis Center (NHC) is an independent foundation working in cooperation with the government, patient associations, academic hospitals, public health organizations (GGD’s) and the RIVM.