Talk:Hepatitis

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Ariannacassidy, Bryantyangucsf, PerezMR, Danati265, Vnguyen220, CMedLib, Aliciadcadams. Peer reviewers: Ariannacassidy, Bryantyangucsf, PerezMR, Danati265, Vnguyen220, CMedLib, Aliciadcadams.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 23:21, 16 January 2022 (UTC)

Editing Prevention section

As part of the UCSF Wiki elective, I am working to improve this article with several of my classmates.

Briefly, I wanted to know thoughts on the best way to organize the article. Part of it depends on how my colleagues arrange theirs, but I was thinking:

 - Vaccination by type
 - Social/behavioral
 - Successes (with some epidemiology)

I would also like to include an image of the CDC vaccination schedule - but I'm not sure if I can do this under licensing restrictions.

I will be adding a Research Directions section that should tie in nicely with the above.

As a new member, I welcome any and all suggestions. Thank you! Aliciadcadams (talk) 19:36, 7 March 2016 (UTC)

I think I'm done with the Prevention Section - I could add more forever, but don't want to get carried away. If you can, please:

1) Suggest ways to polish Prevention Section 2) Suggest how to "beef up" Research Directions. I don't just want to provide a list of clinical trials (that's not what we're here to do), but I'm feeling kinda stuck. Thanks! Aliciadcadams (talk) 23:14, 9 March 2016 (UTC)

Editing Signs and Symptoms section and adding Society and culture

My plans for the signs and symptoms section are to add a brief introduction to the acute vs. chronic symptoms, in addition to providing a timeline for an acute infection as below:

1. Prodromal phase

2. Clinical jaundice

3. Recovery phase

For chronic hepatitis I plan on cleaning up the section in general, and lessening the focus on the chronic symptoms associated specifically with cirrhosis. I believe it would be better to link to the cirrhosis article itself for that discussion.

I also plan on adding a Society and culture section to the article. A majority of my focus will be the economic burden of the acute infectious hepatitides (HAV/HEV) in the developing world and chronic hepatitis in the developed world.

I would also like to have a notable cases sections, but I debate the usefulness of this information. Granted I have not dove as in-depth in my research for this. I'm curious what the community's opinion on this would be.

Thanks for any and all feedback. PerezMR (talk) 21:42, 7 March 2016 (UTC)

Hi and welcome. Please ensure that all added content is cited to reliable sources that comply with WP:MEDRS and does not constitute copyright violation. I would be very happy to guide you on this and you can contact me on my Talk Page. Best wishes. Graham Beards (talk) 23:11, 7 March 2016 (UTC)

Editing mechanism and adding an epidemiology and special populations section

As part of the UCSF WikiProject medicine I would like to add an epidemiology and special populations section to this article. My plan is a follows:

• Mechanism: I will work with another classmate to expand this section and give it a little more depth, focusing on viral hepatitis, alcoholic and non-alcoholic steatohepatitis.

tried to add an image here but looks funny. How do I fix? Danati265 (talk) 23:48, 17 March 2016 (UTC)

• Epidemiology: I will be giving an overview of global burden of disease focusing primarily on Viral hepatitis, alcoholic hepatitis and non-alcoholic steatohepatitis given these are the predominant causes.

1. Viral Hepatitis ( Hep A, B, C, D, E)

2. Alcoholic Hepatitis

3. Non-alcoholic steatohepatitis

I will do some linking to the viral hepatitis article, but from my reading, that article does not do an adequate job of discussing epidemiology for each of these entities.

• Special populations: I will be focusing HIV co-infection and effect of IVDU in this population. Another classmate will focus on pregnancy.

I appreciate any feedback you may have!Danati265 (talk) 00:03, 8 March 2016 (UTC)

I just realized that adding my section to the main article re-ordered my references such that some of them no longer correspond to original references. How do I fix this? Danati265 (talk) 21:46, 9 March 2016 (UTC) RESOLVED

Adding screening section

Hello! I am also a member of the UCSF team, and I will primarily be working on adding a screening section to this page.

I will mostly focus on screening for the viral hepatitides, mainly Hep B and Hep C, using guidelines from various governmental agencies and professional societies as my sources. Among other things, I will describe screening in specific patient populations, for example pregnant women, patients with HIV, etc. There will be a brief mention of the specifics of the lab tests used (though this will be covered in more detail in the diagnosis section).

I will briefly address screening for other kinds of hepatitis, though this will be very brief.

I am considering also addressing screening for hepatocellular carcinoma and other sequellae in patients who have a known diagnosis of chronic hepatitis.

It would be great to get other people's thoughts on the following questions:

1. Ideas for expansion of international screening guidelines? I have accessed WHO guidelines but am curious about others.
2. Expansion of screening to involve screening for hepatocellular carcinoma once a person has chronic hepatitis?Ariannacassidy (talk) 18:15, 9 March 2016 (UTC)

History / Outcomes & Prognosis

Hello all,

Yet another member of the UCSF Wikipedia elective, I'll be working on adding a section about History and improving the outcomes/prognosis area.

Pushing forward a big chunk of stuff about history that I have been working on, open to any suggestions. The next steps I will be taking over the next few days will focus around Blumberg and his Nobel Prize for his research surrounding the vaccine.

Have not yet took a big step into the Prognosis section due to my initial endeavors into the above but aiming to likely look at this early next week. Tentatively plan to perhaps discuss outcomes based on different serotypes of the virus, with a special section regarding fulminant hepatitis.

Please offer any suggestions you might have for information that should be included for this novice Wikipedia user! Bryantyangucsf (talk) 23:41, 9 March 2016 (UTC)

Finished material about Blumberg and vaccine. Unsure whether to include anythinga bout other hepatitis serotypes, the history stuff I found was far less interesting / significant as the hep B material. Will for now focus on updating the outcomes/prognosis section over next 2 days. Bryantyangucsf (talk) 19:23, 15 March 2016 (UTC)

Inserted some material about prognosis of acute hepatitis - I decided to break up the prognosis by acute vs chronic instead of doing line by line for every hepatitis, since I felt that it flowed better, but I'm open to feedback on this. Will work on chronic hepatitis prognosis tomorrow Bryantyangucsf (talk) 02:27, 17 March 2016 (UTC)

Editing Treatment and Management section

Greetings! Another member of the UCSF Wiki elective here, and a relative newbie. I have added a treatment section, which did not exist before, and am in the process of updating it. Any and all comments are welcome!

I noticed that another editor removed some of my brief plain language definitions for terms such as ascites and edema and replaced them with hyperlinks to those terms. Thank you for the links! I'm curious whether this was done to comply with Wiki protocol/MEDMOS, or because these terms were previously defined in the article, or for some other reason. I looked through the article history but was not able to locate when the revisions were made. If it is not inconsistent with MEDMOS, I would prefer to keep plain language definitions for readers who are skimming and are not familiar with these terms.

Also, just a note that we will be peer reviewing the article as a group next week and will attempt to clean up any inconsistencies and redundancies that still exist.

CMedLib (talk) 07:09, 17 March 2016 (UTC)

References

Hi, someone is persistently causing problems with the references (see the page History). They are using the same definition for different sources e.g <ref name=":18">. I don't understand why this is being done. The numbers in the ref tag are not related to the numbering of the reference list. I suggest that from now on that you define references using the first author as in <ref name = Yoon> or better still by using the PubMed ID number eg. <ref name = PMID1234>. It's taking me ages to fix these problems. Graham Beards (talk) 09:14, 18 March 2016 (UTC)

Thanks for your comment. We have noticed this issue. Not sure exactly how or why but seems to happen when a new section gets added with a new set of references. We will all go through our sections and make sure the ref tags appropriately correlate. Danati265 (talk) 14:25, 18 March 2016 (UTC)

Thanks, I have fixed the latest problems. Sorry, if I came across a little bullish earlier. Graham Beards (talk) 14:37, 18 March 2016 (UTC)

No worries, totally understand the frustration. Appreciate your helping us out with these fixes.Danati265 (talk) 02:06, 19 March 2016 (UTC)

I am not sure if I am inadvertently contributing to the reference problem but if so, could you please let me know? I have been editing the Treatment and Management section. When adding citations, I have used a PMID or DOI, or I have used the Wiki button for "Reuse source." Could that have caused an issue? Thank you for your hard work on this issue. CMedLib (talk) 20:24, 19 March 2016 (UTC)

Mains

I've added {{main|Hepatitis X}} to the article for A, B, C, D, and E. This may be against convention a bit. My reasoning is that visitors come to Hepatitis as a front door to the topic. They see in the TOC the kinds (ABCDE) then go to a section and, if a main were there, would be grateful and allow them to continue beyond the blurb.

Before there were no mains. Now there are mains. :) Anna Frodesiak (talk) 05:41, 9 September 2016 (UTC)

NASH

I would classify NASH as a cause of hepatitis. It; however, is a cause with an etiology that is only partly known. We should also list the most common type first. Doc James (talk · contribs · email) 06:11, 31 December 2016 (UTC)

As hepatitis is part of the descriptive name I cannot see NASH to be considered as a cause of hepatitis. The cause that imo needs to be listed is fatty liver or steatosis. Fatty liver results from steatosis in both alcohol-related and non alcohol-related types of liver disease; when severe, the steatosis can lead to (cause) hepatitis hence steatohepatitis. And I think it's so called to distinguish it from alcoholic hepatitis. ? --Iztwoz (talk) 08:39, 31 December 2016 (UTC)

Steatosis is simply Latin for fatty.

(It's Greek, from "stear" "στέαρ" meaning "tallow" not Latin) Graham Beards (talk) 13:23, 6 January 2017 (UTC)

Not all cases of fatty liver results in NASH.

NASH is not just the absence of alcoholic hepatitis. One can also get hepatitis from a bunch of other stuff.

Doc James (talk · contribs · email) 04:08, 1 January 2017 (UTC)

WHO says "Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis."[1]

NAIAID says "Viruses are the most common cause of hepatitis, but the condition can also be caused by other infections, heavy alcohol use, toxins, certain medications, and autoimmune disease."

NIDDK says "NASH is a form of NAFLD in which you have inflammation and liver cell damage, in addition to fat in your liver."[2] Doc James (talk · contribs · email) 04:12, 1 January 2017 (UTC)

This this source also lists NASH[3]. I would agree that NASH is a type of hepatitis but it is also a cause per [4] Doc James (talk · contribs · email) 04:18, 1 January 2017 (UTC)

The refs from WHO and NAIAD you gave do not include NASH as a cause of hepatitis. The ref from NIDDK defines NASH and does not list it as a cause of hepatitis. The somewhat obscure refs linked at 3 and 4 are misreadings - 3) states that the chapter describes acute and chronic hepatitis and their cause by viruses, and should read - and also describes autoimmune hepatitis and NASH - these are not listed as causes of hepatitis. 4) This ref just lists various causes of acute liver disease and chronic liver disease of which NASH is obviously included.

Copied from page (my highlights) Causes — Causes of hepatitis can be divided into the following major categories: infectious, metabolic, ischemic, autoimmune, genetic, and other. Infectious agents include viruses, bacteria, and parasites. Toxins, drugs, alcohol, and lipids are metabolic causes of liver injury and inflammation. Autoimmune and genetic causes of hepatitis involve genetic predispositions and tend to affect characteristic populations.

If the above is wrong the page needs changing. If the above is right the lead needs changing. --Iztwoz (talk) 11:39, 1 January 2017 (UTC)

Have adjusted the body of the text. I would not really describe NASH as "lipids" Doc James (talk · contribs · email) 11:14, 2 January 2017 (UTC)

The NIDDK ref given does not state or claim that NASH is a cause of hepatitis (neither do the other refs given) - what it does say is "If you have NASH, you have inflammation and liver cell damage, along with fat in your liver". So that if you have NASH you already have hepatitis which is just inflammation of the liver and therefore cannot be said to cause hepatitis. --Iztwoz (talk) 12:19, 2 January 2017 (UTC)

In table two "Various causes of acute and chronic liver diseases -> under Chronic is listed NASH"[5]

This ref says "The important non viral causes of chronic hepatitis are "Wilson's disease, AIH, NASH..."[6]

Doc James (talk · contribs · email) 13:23, 2 January 2017 (UTC)

The title of the page is Hepatitis not Chronic hepatitis. Thanks for the disease info.--Iztwoz (talk) 17:07, 2 January 2017 (UTC)

Also the inclusion of NASH is still not covered by any of the given refs. --Iztwoz (talk) 17:10, 2 January 2017 (UTC)

Hepatitis includes both acute and chronic disease. Not sure what you mean not covered in any of the refs? Mentioned here [7] Doc James (talk · contribs · email) 12:44, 3 January 2017 (UTC)

You keep referring to chronic hepatitis as though it were a separate condition from hepatitis. Chronic hepatitis can only occur as a continuation of hepatitis. The preceding paragraph on your page referenced says clearly - "When hepatitis inflammation when continued for more than six months duration the disease process is termed as chronic hepatitis. NASH can clearly become a chronic condition, as can the the other types listed Hepatitis B, C and D, and also Wilson's disease and others, (as per ref) and an uncommon type is autoimmune hepatitis. Are you of the opinion that the paragraph in the lead is just referring to chronic hepatitis? If so then it needs to be made clear and all the other types need to be included as well. By anybody's terms of reference -a chronic condition means long-term. --Iztwoz (talk) 08:12, 4 January 2017 (UTC)

No I am not just referring to chronic hepatitis? The lead applies to both acute and chronic hepatitis. Listing causes of chronic hepatitis as causes of hepatitis generally is simple logic. Doc James (talk · contribs · email) 10:57, 4 January 2017 (UTC)

Not to my logic - my logic (and ref books) says that hepatitis can become chronic so how can chronic hepatitis be a cause of hepatitis  ?--Iztwoz (talk) 11:39, 4 January 2017 (UTC)

The question is, is a cause of chronic hepatitis also a cause of hepatitis? And the answer is of course yes. Doc James (talk · contribs · email) 12:20, 4 January 2017 (UTC)

Would you then also say that chronic bronchitis is a cause of bronchitis? --Iztwoz (talk) 18:25, 4 January 2017 (UTC)

I would say the causes of chronic bronchitis are causes of bronchitis. They are not of course causes of acute bronchitis necessarily. Doc James (talk · contribs · email) 12:09, 6 January 2017 (UTC)

Vaccine for hepatitis

Per the source "Hepatitis B vaccines provide protection from HDV infection." Thus there is a vaccine indirectly. Doc James (talk · contribs · email) 13:40, 14 February 2017 (UTC)

Text

We do not need to list synonyms for "resolve on its own" in the lead. The term is clear.

This is a general overview of hepatitis. We can state antiviral medications are recommended for all people with chronic hep C. We do not need to list the specific meds in the lead. These 1) change 2) this level of details belongs in the body of the text. Doc James (talk · contribs · email) 13:49, 3 September 2019 (UTC)

Not sure what is unclear about "resolve on its own" Doc James (talk · contribs · email) 06:10, 4 September 2019 (UTC)

What is that ?

What does that mean? 188.27.177.241 (talk) 10:23, 29 August 2023 (UTC)

Hepatitis D risk groups?

The article currently says: "The CDC, WHO, USPSTF, AASLD, and ACOG recommend screening people at high risk for hepatitis D infection. These populations include people who are: Blood or organ donors.[10]..."

Reference #10 is an article about hepatitis C. I don't see any mention of hepatitis D, and it doesn't mention blood donors at all. In fact, the Hepatitis *D* section in this Wikipedia article lists 6 high risk groups, and 5 of the items cite this hepatitis *C* article.

I'm not a doctor so I can't say what the correct high-risk groups for hepatitis D are, but I don't think the sources here support the claims as written. (Since "Hepatitis D can only infect people already infected with hepatitis B", I would think the primary high risk group is people who have hepatitis B.) 2601:602:A080:1240:2656:D64A:1266:FF1D (talk) 21:15, 17 January 2024 (UTC)

High-risk population?

The article currently says: "The CDC, WHO, USPSTF, and ACOG recommend routine hepatitis B screening for certain high-risk populations. Specifically, these populations include people who are: [...] Blood, organ, or tissue donors".

The reference for this claim is a lengthy set of WHO guidelines, and the only mention of blood donation is the line "Blood and organ donors should also be screened". Unless I'm mistaken, I don't think they meant to imply that blood donors are a "high-risk population" for hepatitis B (or any other disease), but simply that hepatitis B should be one of the standard tests for the public blood supply.

I would say that blood donation from a person with hepatitis carries a high risk of transferring the disease, but I wouldn't say that this makes blood donors a "high-risk population". Similarly, I would agree that this calls for screening of donated blood/organ/tissues, but I would not say that it calls for screening blood/organ/tissue donors. But I'm not a doctor -- does the medical field use these terms differently? The way this article is written, it's maybe technically true if you squint just right, but I think it's going to be misinterpreted by most readers. 2601:602:A080:1240:2656:D64A:1266:FF1D (talk) 21:28, 17 January 2024 (UTC)