Viral Hepatitis

Viral hepatitis is an infection that causes liver swelling and damage. There are several different viruses that can produce hepatitis. Each are transmitted differently and have their own unique characteristics.

Key Facts

  • Hepatitis can be caused by several viruses. The most common are named hepatitis A, B, C, D, and E. When hepatitis is caused by an unknown virus, it is called hepatitis X.
  • Viral hepatitis can cause both acute infections, which means the body can fight them off on its own, and chronic infections, which require medical treatment to remove.
  • Symptoms of viral hepatitis can be mild (such as fatigue) to severe (such as cirrhosis and liver failure).

Causes

In all cases, viral hepatitis is caused by the transmission of a virus. However, different hepatitis viruses are likely to be transmitted in different ways:

  • Hepatitis A: Coming into contact with food or water that has been contaminated with an infected person’s stool. In rare cases, it can also be spread through blood.
  • Hepatitis B: Spread through contact with an infected person’s blood or bodily fluids, such as semen, vaginal secretions, or saliva. Having sex and sharing needles are both common ways to contract this disease.
  • Hepatitis C: Spread through contact with an infected person’s blood. Mother-to-child infections make up about 10 percent of transmissions.
  • Hepatitis D: Can only be contracted when hepatitis B is already present. Like that virus, it is also spread through contact with an infected person’s blood or bodily fluids.
  • Hepatitis E: Coming into contact with food or water that has been contaminated with an infected person’s stool. It can also be spread by eating undercooked meat. This virus is most common in developing countries.

Symptoms

Although each type of hepatitis virus affects the liver, they can present different symptoms and persist for different lengths of time. In general, however, their characteristics are determined by whether the hepatitis infection is acute (short-term) or chronic (long-term).

Acute Hepatitis

Acute hepatitis typically lasts between six weeks and six months. Hepatitis A and B are the most common causes of acute hepatitis, but it can be caused by each type of hepatitis virus.

The following are some of the most common symptoms of acute hepatitis:

  • Fatigue
  • Fever
  • Jaundice (yellowing of eyes and skin)
  • Light-colored stools
  • Loss of appetite
  • Nausea and vomiting
  • Pain in the upper-right abdomen

It’s important to note that while some people may develop many of these symptoms, others may develop little to no symptoms.

Chronic Hepatitis

Chronic hepatitis lasts longer than six months. In some cases, it can persist for many years. It is most frequently caused by hepatitis C, followed by hepatitis B.

The majority of people with chronic hepatitis experience only mild symptoms, such as fatigue or nausea. These can come on very slowly and gradually. However, chronic hepatitis can become more serious, resulting in cirrhosis and/or liver failure.

The following are some of the most common symptoms of chronic liver failure:

  • Absent periods (women)
  • Bleeding or bruising easily
  • Enlarged breasts (men)
  • Fatigue
  • Fluid in the abdomen (ascites)
  • Forgetfulness or mental confusion
  • Itchiness
  • Jaundice (yellowing of skin and eyes)
  • Lack of appetite
  • Nausea and vomiting
  • Swollen legs
  • Vomiting blood
  • Weight loss

Diagnosis

The following are some of the most common ways to diagnose acute viral hepatitis:

Physical Exam: A doctor or medical professional will check for symptoms of acute viral hepatitis, such as yellowing skin, fever, or swelling.
Family and Medical History: Factors that may make someone more likely to have viral hepatitis include a family history of the disease, sexual activity, and liver cancer. Specific factors will vary depending on the type of hepatitis.
Blood Tests: A sample of blood will be tested for hepatitis antibodies. If present, more tests can determine whether the infection is acute or chronic.

Hepatitis B and C are the most common causes of chronic hepatitis. Hepatitis A cannot become chronic. The following are some of the most common ways to diagnose chronic viral hepatitis:

  • Imaging Tests: These form an image of the liver so that doctors can better detect signs of liver damage, such as cirrhosis. These tests may include a computerized tomography (CT) scan, an ultrasound, and magnetic resonance imaging (MRI).
  • Liver Biopsy: This is a surgical procedure that removes a tiny portion of liver tissue so that doctors can examine it under a microscope to determine what is wrong.

Treatment

Treatment for viral hepatitis depends on the specific virus type and the severity of the infection. The following are the most common treatments for each type:

Hepatitis A

Once infected, there is no immediate treatment for hepatitis A. Instead, patients should rest, drink plenty of liquids, and eat healthy foods. The virus will usually disappear after six months.

Hepatitis B

In general, hepatitis B is not usually treated until it becomes chronic. However, if treatment begins shortly after infection, doctors may administer a hepatitis B vaccine and immune globulin protein shot to boost the immune system.

If the infection lasts longer than six months or begins to harm the liver, doctors may prescribe a course of medications. These include the following:

  • Entecavir (Baraclude)
  • Telbivudine (Tyzeka)
  • Tenofovir Alafenamide (Vemlidy)
  • Tenofovir Disoproxil Fumarate (Viread)
  • Interferon Alfa-2b (Intron A)
  • Peginterferon Alfa-2a (Pegasys)

In severe cases, when hepatitis B leads to liver failure or liver cancer, a liver transplantation may be needed.

Hepatitis C

The most common way to treat hepatitis C is by using antiviral medications. A typical course of treatment will last between 8 and 24 weeks. Which medications are prescribed will depend on the specific type of hepatitis C virus.

Hepatitis C medications include the following:

  • Daclatasvir (Daklinza)
  • Elbasvir/Grazoprevir (Zepatier)
  • Glecaprevir and Pibrentasvir (Mavyret)
  • Ledipasvir/Sofosbuvir (Harvoni)
  • Ombitasvir/Paritaprevir/Ritonavir/Dasabuvir (Viekira Pak, Viekira XR)
  • Simeprevir (Olysio)
  • Sofosbuvir (Sovaldi)
  • Sofosbuvir/Velpatasvir (Epclusa)
  • Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi)

In severe cases, when hepatitis C leads to liver failure or liver cancer, a liver transplantation may be needed.

Hepatitis D

There is no vaccine or specific treatment for hepatitis D. However, doctors may prescribe a type of medication called an interferon, which boosts the immune system.

Hepatitis E

Because hepatitis E usually goes away on its own after 4 to 6 weeks, treatment is usually limited to getting rest, drinking plenty of liquids, and eating healthy foods.

If the infection becomes chronic, doctors may prescribe medications like interferons or ribavirin to boost the immune system.

Outlook

Depending on the virus type and when treatment begins, hepatitis may go away within several weeks or become a lifelong condition. For example, hepatitis A and E usually disappear within 6 months. Former carriers of hepatitis A will be immune to the virus.

Hepatitis B may go away on its own or turn into a long-term condition. Some people with chronic hepatitis B infections develop more serious conditions, such as cirrhosis or liver cancer. Others may become “carriers,” which means they test positive for hepatitis B and can pass it on despite not having any symptoms. For this reason, it’s important for people who have had hepatitis B to get tested regularly.

Hepatitis C can be cured with proper treatment. However, because it often does not present any symptoms, it’s common for hepatitis C to develop into a more serious chronic condition that may cause long-term damage, such as cirrhosis or liver cancer. This makes it important to get tested as soon as any signs are detected so that treatment can begin immediately.

Hepatitis D can sometimes go away with interferon treatment. However, it will often develop into a chronic condition, which means those carrying the virus will have to manage the symptoms of both hepatitis B and D.

Next Steps

Our center has long been on the leading edge of hepatitis care and research. For many years, we have helped study new drug regimens and bring promising new drug developments into the clinical arena. Our patients continue to have the opportunity to participate in clinical trials for the newest and most promising medicine.

Call us at (877) LIVER MD/ (877) 548-3763 or use our online form to schedule an appointment.

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