Talk:Hepatitis/Archive 1

Archive 1

Archive 2

This page is an Archive of the discussions from Hepatitis talk page (Discussion page). (November 2003 - December 2010) - Please Do not edit!

Death

Hepatitis B more often involves transmission by exposure to blood or other body fluids. About 1 million people die worldwide as a result of hepatitis B, often either of liver failure or liver cancer.

Hepatitus is not herpes. Some people think it is but it is no where near to the disease herpes.

Die in what period of time? A year? -- stewacide 22:42, 14 Nov 2003 (UTC)

"10 percent of hepatitis C diagnosed patients die." Well, I am sure it is more like 100%, right?

Cleanup

The article is very complete already, but could someone pl. add a reference to the phonemonon where standard liver function tests can show that a patient has 'hepatitis', even when no other symptoms, or possible causes, are present. Thanks. Holdspa 13:22, 8 September 2006 (UTC)

Well, I've rewritten almost everything, but I lack the time to research all the details. For now, I wonder if this is enough for a cleanup operation. JFW | T@lk 14:08, 19 Apr 2004 (UTC)

Its lovely. What are "IgG antibodies" introduced into the article without an introduction. :) --Tagishsimon

Uhh, this is a recurring problem on the medical side of WikiPedia. Articles are intended for layfolk as much as for people grounded in the medical sciences. I could have used "seropositivity" and risked misunderstandings about AIDS, and I could have rambled about immunological memory. It's hard to strike a balance (-: JFW | T@lk 02:20, 20 Apr 2004 (UTC)

And check the two "causes" in this sentence. Some mistake?:

In severe cases of alpha 1-antitrypsin deficiency (A1AD), the acculumated protein causes in the endoplasmic reticulum causes liver cell damage and inflammation. This is technically not an autoimmune disease.

I'll let you off on IgG since it's late :)

I deleted IgG antibody and changed it to Antibodies against hepatitis, leaving out discussion of the Ig class information and interpretation. Kd4ttc 23:16, 22 Apr 2004 (UTC)

Hepatitis A

I possibly had a case of Hepatitis A (the one that is caused by contaminated water and food) and it did not seem to be as bad as other cases I have heard of. The liver did not grow a lot. Doctor said it might be just a normal stomach virus depending on the inflamation of the liver. Just a small case possibly but painful nontheless. I'm glad it was not any bigger. Are death rates of non sexual Hepatitis very different than that of the sexual ones? Zulu, King Of The Dwarf People 00:07, 14 July 2005 (UTC) (edited, April 15 2006 -Zulu, King Of The Dwarf People)

I wouldn't mention this to the world. People may decline to use your toilets. Seriously, hepatitis A is self-limiting and has a good prognosis, while hepatitis B and C may become dormant and lead to cirrhosis. Hep A does not cause cirrhosis; very few cases go on to develop fulminant liver failure. JFW | T@lk

What sorts of symptoms did you have, Zulu? I really can't afford to see a doctor now and I'm experiencing some abdominal pain, occasionally dark (but not bloody) urine, decreased appetite, and some fatigue. Does this sound about right for Hep. A?

I had those symptoms also. I know that the deep colour of urine is caused by lack of water, which people get when they are sick with anything, so that can be just a symptom of a normal stomach virus, but I had that. The doctor did not say flat out that I had hepatitis but they told me that hepatitis was going around and that it is possible that I either had a minor case of it or a different stomach virus. Did you vomit a lot? If you did the trick is to lay down on your stomach. It sounds like the worse thing to do but it worked for me when I went to sleep... -Zulu, King Of The Dwarf People 14:12, April 15 2006 (UTC)

Dark urine is usually caused by dehydration. Hepatitis often leads to jaundice, and dark urine together with jaundice is not due to dehydration but due to increased removal of bilirubin by the kidneys from the bloodstream. JFW | T@lk 16:30, 10 October 2006 (UTC)

          Hi there... is there any possible cure for Hep A??? I might too young to encounter those symptoms... It is true that smoking can scar the liver.. but why among those who smoke, I am just the one who encountered such aching on my stomach and my eyes are like yellowish...  —Preceding unsigned comment added by 122.2.18.111 (talk) 15:41, 5 October 2007 (UTC) 

people from central city do not have any of these diseases —Preceding unsigned comment added by 69.92.96.102 (talk) 19:12, 20 May 2008 (UTC)

Phosphorus, metal or non-metal?

The article mentions phosphorus, the "metal". But the wikipedia article on phosphorus says it is a non-metal, which it actually is.

Definitely nonmetal.68.239.163.122 19:42, 10 January 2007 (UTC)

Re: Hepatitis Drug Induced

Two important classes of medications should be included in the list of potential toxins of the liver; and they are the sulfas, such as Bactrim, and narcotics, such as Vicodin, which can lead to fulminant necrosis. I had one patient have their liver enymes level become markedly elevated as a result of treament for a urinary tract infection (UTI) with the very commonly used sulfamethoxazole/trimethoprim combination and another have an elevation secondary to treament with the hydrocodone/acetaminophen combination prescribed for an arm fracture. Fortunately, the liver enzymes level returned to normal with cessation of the offending agent. Dalsan (talk · contribs)

Have any of these been reported in the literature? Otherwise this qualifies as original research, for which Wikipedia is not an outlet. JFW | T@lk 11:54, 7 April 2006 (UTC)

I'm adding azathioprine to the list. Its ability to cause drug-induced hepatitis is well-documented and I provide one journal and one textbook, although there are many more. BaseballBaby 02:36, 1 July 2006 (UTC)

acetominophen defintely causes a certain type of hepatitis. It is the number 1 cause of drug induced ____hepatitis. There is a prefix that I cannot remember. This is EXTREMELY important and should definitely be listed in this article. It is a double whammy when alcohol is involved. "oh, I'm going to take tylenol for my hang-over..."

Already mentioned as paracetamol in Other toxins that cause hepatitis. Also more in detail under Hepatotoxicity--Countincr ^{( T@lk )} 12:54, 8 July 2007 (UTC)

it implies that it only is a result of overdose. It can also be from accumulation over time. Free radical damage from Tylenol affects both the liver and kidney. What about Tylenol / Aspirin combination? What about the Tylenol / Alcohol combination? I don't think those combination toxin causes are stressed, are they?

Damage to the liver and Hepatitis are not the same. Latter is only when inflammatory cells are present in the parenchyma. It is very unusual for Paracetamol (Acetaminophen) to induce inflammatory response in normal dose. If you know the contrary provide source. Revising "Hepatotoxicity" is in my to do list and these issues should be addressed there.--Countincr ^{( T@lk )} 16:40, 8 July 2007 (UTC)

I don't think Tylenol should be "other toxins." It is, i think, the number one perscribed analgesic in the US, is it not? if Advil is listed as a drug, the Tylenol should be as well. Tylenol is the number one cause of Hepatitis presenting the ER per year. It also causes Fulminent Hepatitis. This is well proven. I know Dell and Microsoft and Apple PR people edit wikipedia, but is Tylenol PR people as well? Tkjazzer 07:10, 30 August 2007 (UTC)

"Hepatotoxic drugs: These agents are the second most common cause of FHF, responsible for approximately 25% of cases. Hepatotoxic drugs include acetaminophen (paracetamol), chlorinated hydrocarbons, salicylates, methanol, isoniazid, IV tetracycline, and sodium valproate. The most common drug involved is acetaminophen, and, in some locations, it is the most common cause of FHF. Overdose of acetaminophen causes direct hepatotoxicity and hepatocellular necrosis." http://www.emedicine.com/PED/topic808.htm

So it isn't PubMed, but emedicine is reliable. Tkjazzer 07:16, 30 August 2007 (UTC)

Notice, it says drug and not toxin. Tkjazzer 07:17, 30 August 2007 (UTC)

it may be a good idea(aerowolf9:user 25 october,2007)

Update, I heard a news report that that Tylenol reps monitor wikipedia, and this would be a heavily monitored page by them since it is the number 1 cause of drug induced fulminent hepatitis and has so many E.R. visits per year due to hepatitis from tylenol. Tkjazzer (talk) 03:38, 13 January 2008 (UTC)

I have moved paracetemol to the drug section as it makes little sense to have a drug section and toxin section and include a drug in the toxin section Nil Einne (talk) 11:40, 21 March 2009 (UTC)

Vandalism

I accidentally reverted 198.80.151.142 after he/she fixed some vandalism. Apologise. All fixed now. JFW | T@lk 16:26, 10 October 2006 (UTC)

Infectious mononucleosis causes of Hepatitis

Researching causes based on medical history for a friend, I went to the Infectious mononucleosis entry and found that Hepatitis is listed there as a severe effect; from that mononucleosis page: "Other complications include hepatitis (inflammation of the liver) causing jaundice, and anemia (a deficiency of red blood cells). In rare cases, death may result from severe hepatitis or splenic rupture." Yet here on Hepatitis there is no mention of mononucleosis at all. I would like to add it, but do not know under what heading it would be added, or to what part of the Hepatitis page it would go "under". I don't think an elaboration is needed just mention of it in the same way Hepatitis is mentioned there. Can someone help with this? B4Ctom1 19:23, 18 October 2006 (UTC)

Vandalism

There is a few incidences of vandalism within this article that need to be cleaned up

The word "bonjour" and the male pregnancy, nacho entries... —The preceding unsigned comment was added by Pitotshock (talk • contribs) 17:27, 1 February 2007 (UTC).

Which is it?

Hepatitis B is caused by a hepadnavirus, which can cause both acute and chronic hepatitis. Chronic hepatitis develops in the 15% of patients who are unable to eliminate the virus after an initial infection...95% of patients clear their infection and develop antibodies against hepatitis B virus. 5% of patients do not clear the infection and develop chronic infection; only these people are at risk of long term complications of hepatitis B.

So is it 5% or 15%? --71.229.77.97 15:53, 8 March 2007 (UTC)

5% Kd4ttc 21:57, 8 March 2007 (UTC)

Clean up

This article should be intended for general reader since more details are available elsewhere and requires extensive edit.--Countincr ^{( T@lk )} 11:52, 15 April 2007 (UTC)

The problem is that there are many forms of hepatitis with many different presentations. I don't think a "general list of symptoms" is useful. Rather, we should direct the reader to the appropriate articles. Your additions have some grammatical problems, and I'm not sure if the sources you have used are really suitable for this particular content. JFW | T@lk 05:21, 26 April 2007 (UTC)

• I do agree that presentation varies. However, general users may be interested to know common features and may be confused with too many links. There are indeed patterns that would point toward hepatic injury and shared between different "forms". References are given from sources which are rather easy to understand and have open access.--Countincr ^{( T@lk )} 21:05, 26 April 2007 (UTC)

Hepatitis B

I reworded the content in the Hepatitis B section. It was slightly opinionated. It still needs a citation for it's information and I'm also wondering if it should be moved to the tattoo page. Lenore Schwartz 18:59, 3 August 2007 (UTC)

The Hep B section contradicts itself. Firts it states tha 15% of petients are subject to chronic hep. Thenit says only 5% develop chronic Hep. Any doctors want to fix that? —Preceding unsigned comment added by 201.167.122.59 (talk) 03:36, 4 September 2007 (UTC)

Latter data was for US. In comparison to sub-Saharan Africa, most of Asia, and the Pacific where 8% to 10% of general population have chronic hepatits B incidence is much lower in US, as such it does not represent global prevelance. Also in US most patients contract Hep B in adulthood when chance of developing chronicity is low.--Countincr ^{( t@lk )} 18:46, 5 October 2007 (UTC)

See this section, which has good, consistent data: http://en.wikipedia.org/wiki/Hepatitis_B#Symptoms_and_complications Perhaps this section on the hepatitis page should be less detailed in deference to the specific hepatitis b article. Scray (talk) 06:16, 11 January 2008 (UTC)

I think that there should be a cross reference (indeed, some reference) to Baruch Samuel Blumberg who identified the virus and developed the first vaccine. He is already listed on Wikipedia under Nobel Laureats. --Purple Aubergine (talk) 23:31, 9 February 2008 (UTC)

Blumberg is already referenced on the Hepatitis B page, and I would agree that he deserves recognition. I don't think we need any more specific info on the general Hepatitis page, though. Scray (talk) 23:39, 10 February 2008 (UTC)

how many finger breadths below RCM

please add this information - physical exam stuff for diagnosising. I think it is usually 4-5 finger breadths below RCM for acute, but I do not know for others. —Preceding unsigned comment added by 75.47.188.212 (talk) 17:32, 11 December 2007 (UTC)

I think the presence or absence of hepatomegaly is not really a determinant in the diagnosis of hepatitis. If you can find a reliable source for the fact you quoted, please feel free to add it. JFW | T@lk 20:54, 12 January 2008 (UTC)

Hepatitis C

Corrected the statement that HCV is a flavivirus - it is not. The Flaviviridae family has three genera - flavivirus, pestivirus, and hepacivirus. HCV is the only member of the third of those. See the Flaviviridae page, and for an authoritative reference, the ICTV: http://www.ncbi.nlm.nih.gov/ICTVdb/Ictv/fs_flavi.htm Scray (talk) 05:24, 11 January 2008 (UTC)

But if it is a member of the flaviviridae, it would still be correct to call it a flavirus? JFW | T@lk 20:54, 12 January 2008 (UTC)

Not all members of Flaviviridae are flaviviruses - that's why I provided a listing of the genera of Flaviviridae in my comment. HCV is a hepacivirus, which is a genus separate from flavivirus. The genome organization is different, and phylogenetically they are quite distinct. Not an uncommon point of confusion, so worth getting right here. Scray (talk) 11:47, 14 January 2008 (UTC)

History

There seems to be no history here as per Wikipedia:Manual of Style (medicine-related articles). One would be useful. When were physicians able to diagnose hepatitis with some degree of accuracy? Was it always called "hepatitis" or was it confused with other symptoms. Thanks. Student7 (talk) 01:56, 17 January 2008 (UTC)

Not sure this is a good idea for this page. Hepatitis is a syndrome, rather than a disease. It is very heterogeneous. A history might be more relevant for each specific cause, and should probably be covered on each cause's separate page. Scray (talk) 03:13, 17 January 2008 (UTC)

The problem is that Wikipedia is the primary source of info online. People look here first. I have a bio from 1800 where the man died of "hepatitis." I think they knew what it was then, but obviously not the full array shown in the article. I know little about medicine or would attempt it myself. The problem for the amateur, lacking written references, is that google shows patient history and personal history and not the type I want.

How should the history be structured? I don't know. I would guess that the superficial history be developed here until physicians were able to distinguish between types/syndromes. Then the reader would be generically directed to the specific causes for further history. Does this make sense? Student7 (talk) 03:35, 17 January 2008 (UTC)

Hepatitis F and G

Updated to reflect that: (1) there is no Hepatitis F as a medical diagnosis (so the term "hepatitis F" is not valid), and the reports of hepatitis F virus discovery have been discredited, as discussed on the Hepatitis_F_virus page; and (2) there is no clinical diagnosis of hepatitis G, "hepatitis G virus" was a misnomer, and this virus is now classified as GB virus C - see discussion on that page. Scray (talk) 17:03, 21 January 2008 (UTC)

Length of vaccine effectivity

The article reports that vaccines for Hep A and B that last a lifetime is available. What are the vaccines' names? Twinrix (covers both) lasts 20 years for Hep A and 15 years for Hep B. —Preceding unsigned comment added by 146.232.75.208 (talk) 18:43, 12 March 2008 (UTC)

World Hepatitis Day

Hi all, I altered the info about World Hepatitis Awareness Day to reflect the change to the new World Hepatitis Day and a link. I can understand removing the link because of spamming concerns, but I think some basic info about World Hepatitis Day should be part of this article, given its a global non for profit campaign and picks up where the old World Hepatitis Awareness Day left off. Relative newbie to editing wiki articles, so I'm happy to hear others thoughts. Cheers, RDR17 (talk) 06:59, 24 April 2008 (UTC)

I'm a relatively new WP editor, too. I don't think this page needs whole sections devoted to events like WHD, but agree that a link to a WHD page is reasonable assuming that the WHD page can stand on its own.Scray (talk) 11:32, 24 April 2008 (UTC)

A few questions

In line with the new Am I Number 12 campaign, several issues have recently been raised, so could some clarification to the following questions be added to the article, please, as it is rather vague, as well as to the relevant strain's page:

• in the Hepatitis_B#transmission section, it says: "possibly by contact of nonintact skin or mucous membrane" - ie. does the mucuous membrane also have to be nonintact? and -
  • in a word - how easy is it to pass hepatitis-B on?

• once someone has been infected, can they be taken ill a second time in their life by either the same or different strain of the virus? and -
  • does immunity towards some types of hepatitis also mean immunity towards others?

i shall post other questions here if they come up.

Thank you in advance 62.176.111.68 (talk) 11:56, 21 May 2008 (UTC)

Good questions - but we should restrict discussion here to the content of the page. (1) HBV can be spread by exposure of intact mucous membrane (e.g. eye) to HBV-containing blood, which clearly can contain huge levels of infectious virus. The problem there is the inclusion of saliva in that section (even though it's right off the CDC site), because the CDC's "Hepatitis B: FAQ". {{cite web}}: Text "CDC Viral Hepatitis" ignored (help) also says, "HBV is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing." Seems inconsistent. (2) HBV is pretty "easy" to avoid if you don't use injected drugs, aren't born to an HBV-infected mother, and don't have unprotected sex (including oral sex) with someone who might have HBV. (3) chronic HBV infection can be associated with flares (worsening of clinical condition). (4) HAV, HBV, HCV, and HEV are unrelated viruses. Immunity to one provides no protection from the others. HDV is a special case - you cannot get it without HBV infection. Scray (talk) 00:59, 29 June 2008 (UTC)

Thanks for the replies - this info (and what follows) would be useful for the "Transmission" sections of the various strains. And you are right, the saliva bit does seem inconsistent, and now that you mention it, is probably the most relevant topic, due to the greater everyday likelihood of saliva exchange than of any other bodily fluid (not just through kissing but through sharing or failing to clean esting utensils). So it would be good if someone (preferably a doctor with wide experience of treating HBV who knows of published research material they can source) managed to clear it up - as i suspect, like many other things, it's not about a mathematical "hbv saliva => infection" scenario, but rather depends on other factors, such as general strength of immune system, age, or even the period elapsed since the carrier was him/herself was infected (eg. as with recent findings with aids, suggesting that perhaps the first few months after infection seem to be more likely for further infection of others, after which the infectability "dies down").

So, please - any doctors in the house? :-) —Preceding unsigned comment added by 62.176.111.68 (talk) 18:24, 1 July 2008 (UTC)

Deletion of File:Hepatitis.gif

This is a pretty table image, but I am preparing to delete it because it has numerous factual errors and cannot be edited directly. It should probably to replaced with a wiki-table to support collaborative editing. Here are a few of the problems:

Transmission:

"Parentral" should be "parenteral"

Maternal-fetal transmission should also be listed, particularly for HBV since that's the #1 mode worldwide

Classification:

HEV is not a calicivirus (also note spelling error "calcivirus"), it is a hepevirus

HCV is not a flavivirus, it is a member of the Flaviviridae

HDV is a "Deltavirus"

Viral antigens (presumably this is the ones for which tests exist):

HAV: does not have any antigen test licensed, does it?

HEV: does not either

HBV: HBcAg should be removed

HCV: Core antigen should be the only entry

Chronic hepatitis:

The cryptic abbreviation "a/c" should not be used here

That is why I'm deleting. Re-creating this as a table, for those who are proficient in such things, seems like a good idea. --Scray (talk) 12:16, 10 February 2009 (UTC)

Ok.Thank you for the details.HEV is calicivirus in the microbiology textbook we follow and its the same in most websites.But hepevirus seems to be the right version as per new sources on the web. Have uploaded new image with the changes as per your instruction.

Have simplified the antigens section. Will be adding the image back to hepatitis after the changes.Please do revert if needed.

-thank you Nishanthb (talk) 14:21, 10 February 2009 (UTC)

@ Scray Have replaced image with a wiki table.That is my first table by the way.Please edit the data if required.The image looked attractive than the present wiki table.But,it will be better once some color is thrown in to those columns.

Nishanthb (talk) 20:15, 10 February 2009 (UTC)

Nice work!! That is definitely an improvement - accuracy and collaborations are more important than aesthetics. I wonder whether this more properly belongs on the Viral hepatitis page, though? Let's see if anyone else comments and get a consensus. Also, I am not proficient with tables, but other editors are. --Scray (talk) 22:21, 10 February 2009 (UTC)

Can you give me the 'families' of Hepatitis viruses A to E please?Can add to the table. And should 'Classification' be changed to 'Type' ?

Nishanthb (talk) 03:01, 11 February 2009 (UTC)

You can find the families of the respected viruses in their own articles—look for the taxobox, although I would question the necessity. While comparing the images and the table, there are some missing points such as "Chronic Hepatitis" and "Symptoms"; although it may be reasonable to assume that some of them may be unnecessary, I can add them if you want (use the colspan attribute to get table cells to stretch across multiple columns).

A lot of the information in the table are provided in the linked articles, and reproducing (here at least) seems to be an overemphasis and a perhaps a waste. In my opinion I believe the best course of action would be to begin a section in Viral hepatitis discussing the multiple viruses holistically (in prose) with this table giving a quick and easy method of understanding the comparisons. I can begin if you guys want, however let's try for a consensus first so that we don't have to keep revising each other's edits. ChyranandChloe (talk) 04:02, 11 February 2009 (UTC)

The 'Chronic hepatitis' column can be added.The details can be limited to 'No' and 'Yes' if the % details make the table cluttered.

This table can be moved to Viral hepatitis too as it is. We can add more clinical features and treatment modalities of the different hepatitis which will probably make the table relevant in an article on hepatitis.I favor tables and believe its easier for new readers to understand the facts when they can be effortlessly compared.Also it may be alright to float the table to the right of the list of links in subsection 'Types' so that it doesnt expand the article vertically. Nishanthb (talk) 04:56, 11 February 2009 (UTC)

 Done See Talk:Viral hepatitis for the new discussion. ChyranandChloe (talk) 04:41, 12 February 2009 (UTC)

Fine.Thank you.Nishanthb (talk) 14:35, 12 February 2009 (UTC)

MEDMOS

I have had a quick stab at organising this in a WP:MEDMOS kind of fashion. The best source for this kind of content is probably the average medical textbook, because few high-quality WP:MEDRS will be devoted to undifferentiated hepatitis.

The section discussing all the subtypes could easily be shortened to the bare minimum, because there are subarticles for all of them.

I'm not sure how much content should be placed in a "diagnosis" or "treatment" section. I don't think there is a "generic" approach to the treatment of hepatitis. With regards to diagnosis it might be nice to make a reference to the "full liver screen" (UK terminology) or the "liver database" (USA terminology). JFW | T@lk 18:47, 10 March 2010 (UTC)