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Complications of Mononucleosis: Hepatitis

One of the complications of infectious mononucleosis is hepatitis. However, this mono complication does not always result from mononucleosis. While hepatitis linked to mono is generally mild, it can pose health risks and in some cases can be quite serious. But what exactly is hepatitis and how is this disease related to mononucleosis?

What is Hepatitis?

Hepatitis is a condition involving inflammation of the liver. There are three main types of hepatitis, each of which are caused by viral infection:

  • hepatitis A: this infection is spread through contaminated food and water. In rare occasions, it is mistaken for mono.
  • hepatitis B: this form of hepatitis is spread through sexual intercourse and blood exposure i.e. through blood transfusions or contaminated needles used to administer IV drugs.
  • hepatitis C: can be spread through sexual intercourse or blood exposure. Hepatitis C can be chronic and can be spread to an individual's spouse or offspring.

Hepatitis Symptoms

Like mononucleosis symptoms, there are certain symptoms associated with hepatitis. In addition to liver inflammation, hepatitis symptoms include:

  • decreased appetite
  • gastrointestinal irritation, including diarrhea nausea or vomiting
  • jaundice of the skin and whites of the eyes
  • right-sided abdominal pain
  • pale stool or dark-colored urine

Mono and Hepatitis

Hepatitis occurs in up to 90% of patients with infectious mononucleosis. Mono causes inflammation of the liver in approximately 1 out of every 10 people. Mono-related hepatitis is caused by the Epstein-Barr Virus which also causes mono. However, mono-related hepatitis is generally mild and only in rare cases does serious liver damage occur. When hepatitis is severe in individuals with mono, diagnosis should investigate a cause beyond mononucleosis. In rare instances where chronic hepatitis occurs because of infectious mononucleosis, it cannot be spread to an individual's spouse or offspring.

Diagnosis of Hepatitis

The diagnosis of hepatitis can be performed through a physical exam, which can check for such hepatitis symptoms as jaundice, an enlarged or tender liver or fluid in the abdomen (ascites).

In addition, laboratory tests may also be performed, including liver function tests. These tests include a variety of blood and urine tests, which evaluate damage incurred to the liver, as well as a liver biopsy, which also evaluates the severity of damage to the liver caused by hepatitis.

Treatment

There is currently no cure for hepatitis.

As with mononucleosis treatment, there are a variety of treatment options available for hepatitis:

  • hepatitis A: does not require special treatment as this condition usually resolves on its own. Within the first two weeks of infection, an injection of immune globulin (IG) may be administered to prevent the exacerbation of symptoms.
  • hepatitis B: usually resolves within a period of a few months.. Drug therapy may be administered, which may include Lamivudine or Interferon Alfa.
  • hepatitis C: a combination drug therapy of pegylated interferion and ribavirin is the most effective drug therapy for the treatment of hepatitis C.

    Prevention

    Vaccines are currently available for the prevention of hepatitis A and B. There is currently no vaccine for hepatitis C; however, individuals with hepatitis C are more vulnerable to acquiring hepatitis A and B, meaning that a physician will likely recommend vaccination for these two forms of hepatitis.



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