Chronic Active Hepatitis

Chronic Active Hepatitis – General Information

Chronic Active Hepatitis – Symptoms

There are not yet established particular and exact problems and situations which can lead to the appearance of the Chronic Active Hepatitis; this is the reason why this disease is hard and difficult to diagnose. However, the most possible circumstances are the presence of a viral agent and the genetic abnormalities. These can consolidate the basis for further development. In what concerns the most common symptoms, these include anorexia, fatigue, fever or malaise. If we also consider that more then half of the patients are young girls (aged between 11 and 15 years old), these symptoms can influence a lot their general health condition. 

In most of the cases, the sufferers present a normal evolution of the symptoms, from mild to moderate and then more complicated ones. On the other hand, there are some cases when the patients develop advance symptoms from the beginning. These may include: ascites, hepatic encephalopathy, bacterial peritonitis, bleeding or varices. Because the disease can evolve in such a different way from a sufferer to another, it is hard for the doctors to find a general way to diagnose it. That is why the doctor must observe the patient carefully for a certain period of time (about 3-5 months) before he establishes a correct diagnosis. During this period, he must measure the levels of auto-antibodies in the body and the serum gamma globulin in the blood.  In addition, the person suspected of suffering from Chronic Active Hepatitis can present the following signs: diabetes, ulcerative colitis, thyroiditis, and vasculitis.

Chronic Active Hepatitis – Treatment

Chronic Active Hepatitis presents three different forms: type one is the most common one and it affects more than 40% of those who suffer form this disease; type two is not that frequent but it affects especially young people and it can lead to other complications, such as diabetes or cirrhosis; the third type consists of the presence of antigen antibodies in the liver. The purposes of therapy in the case of Chronic Active Hepatitis are to diminish the inflammation which can appear, to decrease morbidity and to prevent further development which could finally result in cirrhosis. If not diagnosed in due time, this disorder can even lead to death; as studies show, more than half of the sufferers who do not benefit of any kind of therapy die in about 4 years. In such conditions, it is vital for the patients to diagnose the disease and to treat it. The most common procedures for treating Chronic Active Hepatitis are immunosuppressive therapy and the administration of corticosteroids; these solutions decrease the risk of death but they do not necessarily stop the progression of the disease.   

In what concerns the corticosteroids, they seem to be the most efficient method for treating the disorder; they do prolong life and, in addition, they proved to diminish or even eliminate signs and symptoms such as loss of appetite, fatigue or fever. Furthermore, they establish they levels of bilirubin, albumin and aminotransferase and they reduce the inflammatory substances located in the liver. In what concerns the other way of treating Chronic Active Hepatitis, neither the LE cells nor the antibodies are not expected to interfere with the therapy. But, as in the case of this particular disease, doctors choose immunosuppressive therapy, the treatment does not present an urgent response and, in most of the cases, the patient needs to continue the treatment for an indefinite period of time. Apart from these methods, doctors can also use adjunctive therapies, such as the azathioprine or the administration of alpha interfreon or cyclosporine. In what concerns the most severe cases of Chronic Active Hepatitis, the only solution is liver transplantation. If your doctor chose this way of treatment, you must be aware of the further care you should receive. This includes:

• Tests related to the progress of the liver functions; these kinds of testes should be performed weekly in the first 3 months after the surgery and then at every 3 months, for a couple of years.
• Regular visits in order to diagnose any problems which may appear any symptoms or signs of liver disease.

Although this procedure is not that complicated and it should not present any problems, there are, however, some complications which can develop:

• Cirrhosis or some disorders associated to it: hepatic coma, coagulopathy, ascites
• Esophageal varices
• Portal hypertension
• Malnutrition
• Poor growth

The most important factors which can determine the appearance of such complications are: the young age of the patient, coagulopathy or intense histologic activity. However, doctors nowadays try to find out in which circumstances the disorder is likely to reappear.