pathology

To begin we will explore liver diseases that derive from viral infections. The term hepatitis refers to the inflammation of the liver and can range from acute to chronic. The types of hepatitis differ in terms of the mode of transmission, severity and pathogen.

Hepatitis A

- Mode of Transmission: through the fecal-oral route from contaminated water/food, person-to-person contact etc.
- Severity: acute (mild or asymptomatic hepatitis)
- Symptoms: include fever, fatigue and jaundice.
- Diagnosis: made through blood tests.
- Treatment: a vaccine is available to decrease propagation but affected individuals usually recover on their own.

Hepatitis B

- Mode of Transmission: through blood and body fluids usually from needles/syringes.
- Severity: can either be acute or chronic and is based on how long the individual has been affected.
  - Acute hepatitis: when the virus is initially contracted
  - Chronic hepatitis: when the virus remains for more than 4-6 months
  - Symptoms: fatigue, dark urine, jaundice etc
  - Diagnosis is mostly through blood tests and sometimes liver biopsy.
  - Treatment: a vaccine is available to prevent infection but other treatments include antiviral medications.

Hepatitis C

- Mode of Transmission: similar to Hepatitis B but mainly through blood. So IV drug abusers and patients who have a history of blood transfusion are more at risk.
- Severity: is mostly chronic which increases their risk of hepatocellular carcinoma and cirrhosis.
- Symptoms: fatigue, joint pain, fever etc.
- Diagnosis: made through blood tests and liver biopsy.
- Treatment: no vaccine is available but antiviral medication can help reduce damage to the liver

Hepatitis D

Hepatitis D: is a defective virus that can only be acquired if the patient has a pre-existing or current infection of Hepatitis B.
Mode of Transmission: parenterally
Severity: depends on whether the individual acquires Hepatitis D while having Hepatitis B (co-infection) or after a Hepatitis B infection (superinfection).
Treatment: Hepatitis B vaccine is used to prevent infection

Next, we will dive into the most common cause of liver disease in Western countries, Non-Alcoholic Fatty Liver Disease (NAFLD). It is a condition where there is a build-up of fat in the liver cells and can be divided into 2 types that differ based on the presence of inflammation and hepatocellular injury.

Non-alcoholic fatty liver (NAFL)

A build of fat (steatosis) without any inflammation or hepatocellular injury.

Non-alcoholic steatohepatitis (NASH)

Steatosis, alongside inflammation and hepatocellular injury.

- The cause of fatty liver disease is not well known however experts believe obesity is the most common cause.
- NAFLD usually arises without any noticeable symptoms and the development of liver damage. Patients with NASH won’t see any symptoms until the disease has progressed significantly.
- Diagnosis is made from blood tests and treatments are based on lifestyle changes such as losing weight, lowering alcohol consumption etc.

Subsequently, we will examine a similar disease that is extremely preventable known as Alcoholic Liver Disease caused by excessive alcohol consumption. There are 3 types that differ based on severity.

Steatosis

Characterized by the presence of fat in the liver. This is the least severe of the 3 and is caused by short-term ingestion (around 80g of alcohol). It can disappear after 2 to 4 weeks by abstaining from alcohol and presents with very few symptoms.

Alcoholic Hepatitis

Also known as Steatophepatitis, is alcohol consumption that results in inflammation of the liver on top of steatosis. This is caused by chronic ingestion (around 80-160g a day). Damage to the liver at this stage is no longer reversible and symptoms include jaundice, abdominal pain, nausea/vomiting etc

Cirrhosis

Damage to the liver that is so severe it causes fibrosis in the liver tissue which leads to liver failure. This is caused by chronic ingestion over 10 to 20 years. Symptoms include confusion, increased infections, ascites etc.

Finally, we will explore cirrhosis which is an end-stage condition where liver tissue is permanently damaged and scarred from fibrosis. As this condition progresses the liver will begin to fail.

Cirrhosis

Cirrhosis has many causes including most of the diseases we’ve discussed previously as well as autoimmune diseases, metabolic diseases, drugs etc.
There’s an array of symptoms which include fatigue, itchy skin, confusion, internal bleeding, jaundice etc.
Diagnosis is made based on the patient’s history, blood test and liver biopsy.
There is no cure for the disease, so treatment includes treating the underlying causes of cirrhosis and managing the symptoms.

AI Section

Prompt: Can you create a short and concise summary of Non-Alcoholic Liver disease

Answer: Non-Alcoholic Fatty Liver Disease (NAFLD):

Types: NAFL (fat build-up without inflammation) and NASH (fat build-up with inflammation).
Cause: Linked to obesity, often asymptomatic until advanced stages.
Diagnosis: Blood tests, managed through lifestyle changes

Prompt: Can you compare and contrast the different types of viral hepatitis mentioned

Answer:

Comparison:

All types of hepatitis involve liver inflammation but differ in transmission, severity, and treatment.
Hepatitis A and B have vaccines; C and D do not.
B and C can become chronic, leading to long-term liver issues.

Contrast:

Hepatitis A spreads via the fecal-oral route, while B, C, and D spread through blood or fluids.
A is usually acute; B has acute and chronic forms.
D requires B infection; others can occur independently.
Treatment options vary, with A often self-recovering and B, C, and D may need antivirals.

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