Hepatitis?

Sitting at clinic and I figured I'd answer a question that I have gotten quite a bit lately. "How did he get hepatitis?" It's a potentially taboo question so I imagine many people have wanted to ask but didn't. Most people think of hepatitis as a virus cased by drug use or sexual contact (hep b/c) or poor sanitation (hep a). However hepatitis is actually a condition of the liver literally translated from Greek to mean "liver inflammation". Hepatitis is most commonly caused by a virus (aka hepatitis a/b/c/d/e) but it can also be caused by exposure to certain toxins or an autoimmune reaction. In Nathan's case, his hepatitis was caused by an autoimmune attack on his liver, specifically CD-8 T cells (a type of lymphocyte which is a type of white blood cell) went out of control and infiltrated and damaged his liver then subsequently attacked his bone marrow causing his marrow to fail even after his immune system calmed down. This is why I've referred to his liver condition as "autoimmune hepatitis" although I'm sure not everyone truly knows what that means. So there's your fun fact for the day... Hepatitis is not a virus, it is simply inflammation of the liver which could have many potential causes. And I'm very thankful that his particular case of hepatitis was acute and has fully resolved. 

The other question I've been asked is whether this form of hepatitis is vaccine preventable and the answer is no. There are vaccines which cover certain types of viruses that can cause hepatitis (hep A/B) but no vaccine can protect your liver from becoming inflamed or irritated by any number of potential triggers... and I think that is why the word "hepatitis" causes such confusion. Vaccines are meant to protect against specific viruses and that's it. There is no vaccine that could possibly protect against an overgrowth of a specific type of lymphocytes which then decide to attack the liver and bone marrow. Just like there is no vaccine that can protect against environmental exposure to a toxin which also can attack the liver. That simply isn't the purpose of vaccines.