LIVER DISEASES

Viral hepatitis is a liver inflammation caused by some viruses that can mainly or only replicate within the liver (hepatitis A virus, HAV; hepatitis B virus, HBV; hepatitis E virus, HEV).  All these viruses can cause an acute infection which can be either silent or symptomatic, but only some of them (HBV, HCV, HDV) can establish themselves permanently in the organism, sometimes causing chronic liver damage (see specific paragraphs).

Acute infection:  In the majority of acute infection cases, the disease manifests with flu-like symptoms, malaise and tiredness, sometimes preceded by a change in the colour of urine (which becomes darker), faeces (which become lighter), the sclera and skin, that tend to assume a yellow hue (jaundice).  However, many patients do not feel these classic symptoms of acute hepatitis (asymptomatic hepatitis).  In rare cases, the infection is so severe that it causes and almost complete destruction of the liver, with a fast deterioration of the functions of other vital organs (fulminant hepatitis).

Chronic infection:  The persistence of the virus in the liver may cause a permanent inflammation of the liver tissue, that is to say, a chronic hepatitis.  In fact, chronic hepatitis is due to the immune system being incapable of eliminating the liver virus.  In about half of patients, chronic infection causes progressive liver lesions, and a part of these patients may develop cirrhosis (liver scarring).  Every year about 15,000 patients in Italy die of cirrhosis and about 6,000 of liver cancer, both diseases that are largely connected to chronic viral hepatitis.

Viral hepatitis is not the only disease that may affect the liver.  There are other pathologies that, alone or in conjunction with viral hepatitis, can cause various forms of chronic liver damage and cirrhosis.

They are: alcoholic liver disease, some forms of non-alcoholic liver steatosis, hereditary haemochromatosis and Wilson’s disease, autoimmune hepatitis.