How The Liver Works
The liver is found tucked up under the ribcage on the right-hand side of the abdomen, and you should not normally be able to feel it. It is a large organ, typically weighing between 1200 and 1500 grams, usually being slightly heavier in men.
The liver is vital to good health, being responsible for:
Processing protein and fat
Making bile, which breaks down fats in food so it can be absorbed from the gut.
Storing body fuel which is made from sugar, and broken down into readily available glucose to be released into the bloodstream when needed.
Helping make clotting factors that help the blood to clot.
Removing toxic substances from the body such as alcohol and poisons.
Processing medication.
Prevention Of Hepatitis B
Immunizations for Hepatitis B are also available in a three shot series given as an initial dose followed by doses at one and six months. For those not engaging in high-risk behavior, the risk of acquiring the disease is not significant. Those who may be exposed to blood or body fluids of infected persons, usually through sexual contact, should receive the immunization series. Chronically infected individuals may benefit from treatment with interferon. The treatment requires frequent injections and is often accompanied by a flu-like syndrome. This treatment must be reported to and generally is not cleared by the FAA for safety sensitive duty until such treatments are completed.
Anatomy And Physiology Of The Liver
The liver is a large organ located in the upper right quadrant of the abdomen. Tremendous amounts of blood pass through the liver to be filtered and detoxified. In broad terms, the liver is similar to a recycling center for the body. The liver and kidney process most of the blood-borne toxins in the body and either eliminate the hazards or convert them into a less hazardous form. The liver eliminates hazards and passes them into the stool, while the kidney eliminates hazards into the urine. Most medications are metabolized or changed to a different form in the liver. These different forms may be either more active or less active than the original form.
The liver also processes nutrients and assists in the conversion of food to nutrients. In this role, the liver may convert sugars into more complex substances to be used slowly by the body using insulin. It also converts dietary cholesterol and fats into the healthy and unhealthy forms of cholesterol. The liver aids in fat digestion by producing bile which is stored in the adjacent gall bladder. The liver is an essential organ for daily functioning of the body.
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Portal And Periportal Inflammation
Portal inflammation may involve all or some portal fields. In acute viral hepatitis most portal fieds are infiltrated with inflammatory cells, mostly lymphocytes with some plasma cells containing IgG and iron laden macrophages. Lymphocytic infiltration is sometimes present in the form of lymphoid follicles even with germinal centers and when it is associated with portal bile duct damage consisting in stratification, vacuolization and lymphocytic infiltration as in chronic active hepatitis C we call it hepatitic bile duct lesion Poulsen-Cristoffersen lesion) .
Portal inflammation may also be accompanied with bile extravasates, granulomas, purulent exudate, destruction of bile ducts, ductular reaction, fibrosis and may extravasate into the periportal liver parenchyma thus disrupting the periportal limiting plate of hepatocytes. And from there, it may spread to the central acinar area and even reach an adjacent portal field to form a porto-portal septum.
In this sequence a peculiar relationsh between inflammatory cells and hepatocytes develops at the parenchymal/mesenchymal interface such as periphery of portal fields and periphery of newly formed inflammatory septa. There is destruction of single or small groups of hepatocytes which are surrounded by and in close membrane contact with lymphocytes and macrophages. The phenomenon has been called:
Is Hepatitis B Contagious
Hepatitis B is highly contagious. It spreads through contact with infected blood and certain other bodily fluids. Although the virus can be found in saliva, its not spread through sharing utensils or kissing. It also doesnt spread through sneezing, coughing, or breastfeeding. Symptoms of hepatitis B may not appear for 3 months after exposure and can last for 212 weeks. However, you are still contagious, even
To screen for hepatitis B, your doctor will perform a series of blood tests.
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What Is The Function Of The Liver
The liver is your body’s largest organ, a dark-red gland that is located in the upper right area of your abdomen, just beneath your diaphragm. The bile produced by your liver collects into the gallbladder, located on the liver’s underside, which is itself attached to the small intestine via a bile duct. The manifold functions of the liver also include:
- Blood filtration and the detoxification of alcohol, drugs, and environmental poisons
- Converting sugars to glycogen
- Breaking down and storing fatty acids
- Synthesizing proteins like albumin and fibrinogen and prothrombin
- Disposing of depleted blood cells by breaking them down to their basic components
- Destroying bacteria filtered from the blood
- Maintaining the balance of sex hormones
- Policing the proteins that pass through the digestive system
How Can I Prevent Spreading Hepatitis B To Others
If you have hepatitis B, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they arent infected, get the hepatitis B vaccine. You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis B. Dont donate blood or blood products, semen, organs, or tissue.
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What Is Viral Hepatitis
Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.
How Is It Tested For And Diagnosed
After you discuss your symptoms with your doctor, they may order a blood test to check for the presence of a viral or bacterial infection. A blood test will reveal the presence of the hepatitis A virus.
Some people have only a few symptoms and no signs of jaundice. Without visible signs of jaundice, its hard to diagnose any form of hepatitis through a physical examination. When symptoms are minimal, hepatitis A can remain undiagnosed. Complications due to a lack of diagnosis are rare.
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What Is Liver Inflammation
Liver inflammation is a reaction that occurs when liver cells are attacked by a disease-causing microbe or substance. The liver is an organ in the digestive system that assists the digestive process and carries out many other essential functions. These functions include producing bile to help break down food into energy creating essential substances, such as hormones cleaning toxins from the blood, including those from medication, alcohol and drugs and controlling fat storage and cholesterol production and release.
The word hepatitis refers to liver inflammation. Most forms of hepatitis result from , although in some cases it is caused by an autoimmune disorder, in which the bodys immune system attacks liver cells because it cannot tell the difference between harmful invaders and healthy liver tissue. Damage to the liver from alcohol, toxins, and certain drugs can also result in inflammation. Some inherited diseases can cause inflammation and hepatitis, along with prolonged obstruction of bile flow. Some forms of liver inflammation produce mild symptoms, while others can be serious or life threatening.
Seek immediate medical care for serious symptoms associated with complications of liver inflammation, such as , hallucinations, extreme fatigue, , fever , vomiting blood, or severe mood changes .
What Are The Symptoms Of The Hepatitis A Virus
Low energy is the most common symptom of HAV. Other symptoms include fever, tiredness, loss of appetite, nausea, headache, itchy skin, muscle soreness, pain near the liver, and jaundice .
Symptoms of HAV can occur two to seven weeks after infection and are often mild. Children may not have any symptoms. Symptoms usually go away within two months. If you think you have HAV, it is important to see a doctor symptoms of HAV are similar to other more serious liver diseases.
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Prevent Hepatitis B Infections In Newborns
If you are pregnant and have hepatitis B, talk with your doctor about lowering the risk that the infection will spread to your baby. Your doctor will check your virus levels during pregnancy. If virus levels are high, your doctor may recommend treatment during pregnancy to lower virus levels and reduce the chance that hepatitis B will spread to your baby. Your doctor may refer you to a liver specialist to find out if you need hepatitis B treatment and to check for liver damage.
When it is time to give birth, tell the doctor and staff who deliver your baby that you have hepatitis B. A health care professional should give your baby the hepatitis B vaccine and HBIG right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.
What Is The Prognosis
Most people will recover on their own with no lasting liver damage. Sometimes, depending on the type of hepatitis, the disease may come chronic . In rare cases, hepatitis may be fulminant with sudden death as a consequence of hepatic failure.
In some cases, hepatitis may progress to cirrhosis or liver cancer.
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Who Should Be Vaccinated
Children
- All children aged 1223 months
- All children and adolescents 218 years of age who have not previously received hepatitis A vaccine
People at increased risk for hepatitis A
- International travelers
- Men who have sex with men
- People who use or inject drugs
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
Any person who requests vaccination
There is no vaccine available for hepatitis C.
Vaccines And Immune Globulin
Vaccines to prevent hepatitis A and hepatitis B are available in the United States. A vaccine for hepatitis E is currently available only in China. No vaccines against hepatitis C or D virus are available. However, vaccination against hepatitis B virus also reduces the risk of infection with hepatitis D virus. Hepatitis vaccines are given by injection into muscle.
Routine vaccination with the hepatitis A vaccine Hepatitis A Vaccine The hepatitis A vaccine helps protect against hepatitis A. Typically, hepatitis A is less serious than hepatitis B. Hepatitis A often causes no symptoms, although it can cause fever, nausea… read more and hepatitis B vaccine Hepatitis B Vaccine The hepatitis B vaccine helps protect against hepatitis B and its complications . Generally, hepatitis B is more serious than hepatitis A and… read more is recommended in the United States for all children and for adults at high risk of getting hepatitis Hepatitis is common throughout the world. Hepatitis can be Acute read more ).
As with most vaccines, protection requires allowing a number of weeks for the vaccine to reach its full effect as the immune system gradually creates antibodies against the particular virus.
Babies born to mothers with hepatitis B are given hepatitis B immune globulin and hepatitis B vaccine.
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Prevention Of Hepatitis A
Fortunately, prevention of these diseases is usually easy to accomplish. Exceptions can occur when Hepatitis A contaminated food is unsuspectingly consumed in an area where transmission risk is usually very low . When traveling to areas with poor hygiene, using the same steps one would use to avoid travelers diarrhea are fairly effective in preventing Hepatitis A.
You should avoid uncooked foods and only eat fruits and vegetables that you personally peel. Avoid water or ice. Even bottled water may be contaminated if not obtained from a reliable clean source. In the past, people traveling to high risk areas were given gamma Globulin or immune serum globulin which gave a partial temporary immunity. These painful shots conveyed passive immunity, a transient protection gained from other infected persons? serum.
Vaccines for Hepatitis A have been developed. They are much more effective in conveying a lifelong active immunity. The vaccine series is given as a two shot series with the second shot given 6 months after the first for adults. Significant immunity occurs within several weeks of the first immunization. These shots are usually very well tolerated and relieve the need for repeated painful gamma globulin injections.
For those individuals traveling to high risk areas, the vaccine is highly recommended. Information concerning high risk areas of the world may be obtained from the Centers for Disease Control and Prevention.
Faa Policies Regarding Hepatitis
The acute forms of hepatitis are disqualifying for aviation duties. If the condition resolves spontaneously, an individual may return to flying after clearance from the treating physician and when the pilot feels confident they can perform all of their required duties. This condition may be reported to the FAA at the time of the pilots next FAA physical examination. Controllers must clear through the Regional Flight Surgeon before returning to safety sensitive duties.
Chronic hepatitis conditions requiring the use of medication must be cleared by the FAA prior to exercising the privileges of the aeromedical certificate. As of April 2013 stable Hepatitis C not requiring medication can be cleared by the Aviation Medical Examiner with current clinical reports and laboratory studies. Certification is dependent upon minimal symptoms from the disease and tolerance of the medications. Periodic reports from the treating physician are required for continued certification.
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Chronic Hepatitis B Complications
Chronic hepatitis B can lead to
- cirrhosis, a condition in which scar tissue replaces healthy liver tissue and prevents your liver from working normally. Scar tissue also partly blocks the flow of blood through the liver. As cirrhosis gets worse, the liver begins to fail.
- liver failure, in which your liver is badly damaged and stops working. Liver failure is also called end-stage liver disease. People with liver failure may require a liver transplant.
- liver cancer. Your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.
Cirrhosis Of The Liver
Several conditions may damage the liver, including Hepatitis A, B and C infections, non-alcoholic fatty liver disease, and excessive alcohol consumption, all of which may lead to cirrhosis of the liver. Cirrhosis of the liver is a condition where the inflammation from these conditions has reached a level of severity where scarring and lesions in the liver tissue develop. Cirrhosis is a serious condition, as it significantly interferes with liver function until the liver eventually fails completely.
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Acute Vs Chronic Infection
Doctors distinguish between chronic and acute infection with hepatitis viruses. Acute infection is a short-term condition, lasting under six months. Chronic infection is a long-term condition, lasting more than six months.
Hepatitis B infection can be either acute or chronic. Most people who get acute hepatitis B dont end up progressing to chronic hepatitis B. By contrast, acute hepatitis C tends to develop into chronic hepatitis C. Approximately 7585 percent of adults newly infected with hepatitis C develop a chronic infection, according to the CDC . Others clear the infection.
When you get acute hepatitis C you may or may not have symptoms. Most cases of acute hepatitis C are asymptomatic, meaning people dont notice the symptoms. Symptoms are only noticeable in 15 percent of cases of acute hepatitis C.
So You Think You Know Hepatitis
Many people assume hepatitis is a disease that only affects alcoholics, drug users, and those who are unvaccinated. Actually, the word hepatitis is broken down this way: hepat originates from the Greek word for liver and the suffix -itis is Greek for inflammation. Therefore, hepatitis refers to any process causing inflammation of liver cells. Hepatitis can be short-lived in which there is total recovery within six months or can last longer than six months . Although viruses most frequently cause acute hepatitis, there are several other causes, which include side-effects from medications and herbs, autoimmune and/or cholestatic diseases, genetic disorders, excessive fat intake, and alcohol abuse.
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Hepatitis C: How Does It Spread
It spreads through infected blood. In the U.S., sharing needles or other items used to inject drugs is the most common cause of infection. Getting a tattoo or body piercing with an infected needle is another means of exposure. A mother may pass the virus to their child at birth. In rare cases, unprotected sex spreads hepatitis C, but the risk appears small. Having multiple sex partners, HIV, or rough sex seems to raise risk for spreading hepatitis C.
Inflammation Of The Liver
In the liver, as in every vascularized tissue, cell death evokes an inflammatory reaction which is morphologically manifested by the appearance of inflammatory cells together with edema and congestion around parenchymal cells which, in the case of the liver, are damaged hepatocytes or damaged bile ducts or damaged blood vessels. Therefore we talk of HEPATITIS, CHOLANGITIS, VASCULITIS.
Inflammation of the liver lacks the gross classical signs of swelling , reddening , pain , but microscopically it classically shows presence of inflammatory exudate with morphologically documentable cytological and tissue changes.
The type and distribution of the inflammatory exudate and the type of changes will vary sometimes according to the etiological agent. We say sometimes because, in the liver, the inflammatory reaction may not help to clearly distinguish between an hepatitis due to a chemical agent or to an infectious agent such as a virus, e.g. it may not distinguish between a viral and a toxic hepatitis.
Obviously we encounter in the live acute and chronic inflammation.
Lobular changes
Diffuse lobular inflammation
DIFFUSE LOBULAR INFLAMMATION: Diffusely scattered mononuclear cell infiltration of the lobule especially in the perivvenular area. Lymphocytes and monocytes predominate but neutrophils, eosinophils and plasma cells may be present.
Kupffer cell hyperplasia
Liver cell regeneration
Central vein endophlebitis
> De-glycogenation
Intracellular and canalicular cholestasis
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