Other forms of hepatitis

The newly discovered hepatitis F and G viruses are believed to be transmitted via infected blood. Recent scientific studies indicate the existence of other, as yet unidentified, viral agents that cause hepatitis. There is accumulating evidence that there are other hepatitis viruses, based on the observation that known viruses do not account for all cases of hepatitis.

In addition to viral infection, alcohol, drugs, and autoimmunity can also cause hepatitis. There are a number of drugs that can produce hepatic injuries, including:

• Dose-related hepatotoxic reactions, such as may be caused by acetaminophen (Tylenol), carbon tetrachloride and methotrexate. Patients who ingest massive doses of acetaminophen are at risk for fulminant hepatic failure.
• Non dose-related hepatitis caused by drugs such as isoniazid, flurazepam, methyldopa, and intravenous tetracycline
• Cholestasis or blockage of bile flow due to the use of anabolic steroids, birth control pills, and haloperidol

Some patients may develop an autoimmune form of hepatitis. The immune system is designed to recognize foreign antigens. The antigens are recognized by antibodies that bind to the antigens and remove them from the body. In some cases, autoimmunity develops, and the immune system incorrectly reacts against one's own cells. In autoimmune hepatitis and primary biliary cirrhosis, the immune system attacks and destroys portions of the liver. If unchecked, persistent inflammation can eventually lead to cirrhosis. Patients with autoimmune hepatitis are treated with daily doses of prednisone or prednisolone, which are gradually reduced and withdrawn.

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Large doses of acetaminophen (Tylenol) can cause liver failure.

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