Hepatitis, especially Hepatitis B, C and D, can all have serious consequences. Many people wonder whether there are dietary treatments for these conditions.

But what are these different types , and what sort of long-term consequences can they have for those that are infected?

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Different types of hepatitis

Different types of hepatitis caused by different viruses can occur, namely:

• Hepatitis A, which is caused by the hepatitis A virus, is transmitted by the faecal-oral route and recovery is usually complete with few long-term consequences.
• Hepatitis B, caused by the hepatitis B-virus, is transmitted by contact with blood and body fluids and can lead to chronic hepatitis and cirrhosis of the liver.
• Hepatitis C, which is caused by the hepatitis-C virus, is transmitted into the blood from contaminated needles (drug users) and blood products (e.g. blood transfusions or inadvertent contact with infected blood), sexual contact and saliva, and can often develop into chronic hepatis and cirrhosis of the liver.
• Hepatitis D, which is caused by the hepatitis D virus, is transmitted from intravenous or sexual sources and usually becomes chronic.
• Hepatitis E, which is caused by the hepatitis E virus, is transmitted by the faecal-oral route and is usually acute with less risk of permanent damage.

Consequently the dietary treatment of the acute forms of hepatitis, which do not have long-term consequences such as liver damage and cirrhosis, will differ from dietary measures that are used for chronic forms of hepatitis which do cause permanent damage. Hepatitis A and E are usually acute, short-term illnesses with less risk of permanent liver damage, while hepatitis B, C and D can result in serious liver damage in the long-term.

However, all forms of hepatitis start out with an acute viral infection of the liver. Some other infective organisms such as Epstein-Barr virus, cytomegalovirus, herpes simplex, yellow fever and rubella (German measles) can also cause acute hepatitis.

Hepatitis A
Hepatitis A is contracted by contact with contaminated drinking water, food and sewage. The safest way to prevent contamination is to apply scrupulous hygiene at all times - wash hands after going to the toilet and make quite sure that the water you drink is safe and clean.

The prime symptom of acute hepatitis A infection is severe anorexia or loss of appetite. Patients refuse to eat and may consequently lose a great deal of weight. Other symptoms, which exacerbate anorexia, include vomiting and nausea, abdominal pain and jaundice. The urine may also have a dark colour. Jaundice is a condition where the skin develops a yellow colour and even the whites of the eyes can become yellow. The yellow colour of the skin and sclera of the eyes is due deposits of bilirubin, a breakdown product of bile, which is no longer efficiently removed by the infected liver.

The good news is that most patients with hepatitis A recover fully and usually don't develop liver damage. High-risk patients, such as individuals who are very young, very old or immune-compromised (HIV-AIDS or organ transplant patients) may develop long-term complications.

Hepatitis B and Hepatitis C
These types of hepatitis can develop into chronic conditions and cause long-term live damage. The initial symptoms are similar to those of hepatitis A with anorexia, nausea and vomiting, which all have a negative effect on food intake.

Hepatitis D and E
These forms of hepatitis occur more frequently in people living in crowed and unhygienic conditions. Contaminated water is usually the main source of infection, but can be controlled by applying simple rules of hygiene such as boiling all drinking and cooking water and washing hands after going to the toilet and before preparing food. Children should also not swim in contaminated water sources.

Stages of acute Viral Hepatitis
Acute viral infection of the liver which characterises all types of hepatitis has four stages, namely:

• Early phase - occurs in about 25% of patients and is characterised by a raised temperature, pains in the joints, arthritis, skin rash and swelling of the face, lips, eyelids, etc (angio-oedema).
• Pre-jaundice phase - patients feel ill and tired, have muscle pains, lose their appetite, vomit, develop nausea and experience taste changes
• Jaundice phase - full-blown jaundice develops
• Convalescent phase - most of the symptoms start to improve and the patient usually recovers if he/she is suffering from acute hepatitis A

Keep in mind that the other types of hepatitis can develop into chronic hepatitis with long-term liver damage.

(Dr I.V van Heerden)

(Reference: Krause's Food, Nutrition & Diet Therapy (2000). Edited by Mahan & Escott-Stump, Chapter 32, pp 695-717. WB Saunders Co, Philadelphia, USA)
 

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