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How can my father prevent a hepatitis relapse?

Dr Shirish Kumar
Haematologist,
WHO,
Geneva

Q: My father aged 65 suffered from acute hepatitis four months back. He took a tablet called silymarin and Liv.52 syrup for about two months under medical supervision. Since then he is feeling quite well and the LFT parameters are also under the normal range. We do not know the exact diagnosis as to whether this happened because of hepatitis virus or some other reason. Please suggest some precautionary tests or some other advice so that we can prevent another attack. Also suggest some follow up treatment.

A:Hepatitis is a general term that is used for any inflammation of the liver. This condition may be caused by different infections – a) viral [five viruses cause most of clinical disease and they are hepatitis A virus (HAV), HBV, HCV, hepatitis D virus (HDV), and hepatitis E virus (HEV)], b) bacteria, c) fungi or d)parasites. Hepatitis may also be due to non-infectious causes like medicines, toxins, or auto-immune diseases.Diagnosis of viral hepatitis is made by certain blood tests. Hepatitis A - Testing for hepatitis A antibody (IgM anti-HAV), Hepatitis B - hepatitis B core antibody (IgM anti-HBC), hepatitis B surface antigen and antibodies, Hepatitis C – detection of anti-HCV antibodies or by molecular tests for the presence of viral particles. There is no specific treatment indicated other than supportive care. Treatment is indicated for chronic HBV and chronic HCV infections to prevent progression to cirrhosis and the complications of cirrhosis.Liver function tests (LFT) are a group of blood tests done to assess liver injury and liver function. These include the measurements of serum proteins, different liver enzymes (ALT, AST, GGT and ALP), bilirubin, prothrombin time, cholesterol etc. Abnormal LFTs often suggest that something is wrong with the liver and provide clues to the nature of the underlying problem but they may also be abnormal in conditions that do not affect the liver (like bone disease or red cell breakdown) or sometimes be normal in liver disease.