Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.
The liver is located on the right upper quadrant of your abdomen. It performs many critical functions that affect metabolism throughout your body, including:
- bile production that’s essential to digestion
- filtering of toxins from the body
- excretion of bilirubin, cholesterol, hormones, and drugs
- metabolism of carbohydrates, fats, and proteins
- activation of enzymes, which are specialized proteins essential to metabolic functions
- storage of glycogen, minerals, and vitamins (A, D, E, and K)
- synthesis of plasma proteins, such as albumin
- synthesis of clotting factors
According to the Centers for Disease Control and Prevention (CDC), there are 4.4 million Americans currently living with chronic hepatitis. Many more people don’t even know that they have it.
Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. Hepatitis A is a milder version of the disease, and hepatitis C and D are more severe. Treatment options vary depending on what form of hepatitis you have and what caused the infection. You can prevent some forms of hepatitis through immunizations or lifestyle precautions.
This type derives from an infection with the hepatitis A virus (HAV). This type of hepatitis is most commonly transmitted by consuming food or water contaminated by feces from a person infected with hepatitis A.
This type derives from an infection with the hepatitis B virus (HBV). This type is transmitted through puncture wounds or contact with infectious body fluids, such as blood, saliva, or semen. Injection drug use, having sex with an infected partner, or sharing razors with an infected person increase your risk of getting hepatitis B. It’s estimated by the CDC that 1.25 million people in the United States have chronic hepatitis B and 350 million people worldwide live with this chronic disease.
This type comes from the hepatitis C virus (HCV). Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact. HCV is among the most common blood-borne viral infections in the United States. Approximately 2.7 million Americans are currently living with a chronic form of this infection.
This is also called delta hepatitis. Hepatitis D is a serious liver disease caused by the hepatitis D virus (HDV). HDV is contracted through puncture wounds or contact with infected blood. Hepatitis D is a rare form of hepatitis that occurs in conjunction with hepatitis B infection. It’s very uncommon in the United States.
Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor sanitation and is typically caused by ingesting fecal matter. This disease is uncommon in the United States. However, cases of hepatitis E have been reported in the Middle East, Asia, Central America, and Africa, reports the CDC.
Hepatitis A and E are normally contracted from eating contaminated food or drinking contaminated water. Hepatitis B, C, and D are contracted through contaminated blood. These forms of hepatitis can be either acute or chronic. Types B and C usually become chronic.
Hepatitis can be caused by liver damage from excessive alcohol consumption. This is sometimes referred to as alcoholic hepatitis. The alcohol causes the liver to swell and become inflamed. Other toxic causes include overuse of medication or exposure to poisons.
The immune system may mistake the liver as a harmful object and begin to attack it, hindering liver function.
If you have forms of hepatitis that are usually chronic (hepatitis B and C), you may not have symptoms in the beginning. Symptoms may not occur until liver damage occurs.
Signs and symptoms of acute hepatitis appear quickly. They include:
- flu-like symptoms
- dark urine
- pale stool
- abdominal pain
- loss of appetite
- unexplained weight loss
- yellow skin and eyes, which may be signs of jaundice
Since chronic hepatitis develops slowly, these signs and symptoms may be too subtle to notice.
During a physical examination, your doctor may press down gently on your abdomen to see if there’s pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam.
A liver biopsy is an invasive procedure that involves the doctor taking a sample of tissue from your liver. This is a closed procedure. In other words, it can be done through the skin with a needle and doesn’t require surgery. This test allows your doctor to determine if an infection or inflammation is present or if liver damage has occurred.
Liver Function Tests
Liver function tests use blood samples to determine how efficiently the liver works. These tests check how the liver clears blood waste, protein, and enzymes. High liver enzyme levels may indicate that the liver is stressed or damaged.
An abdominal ultrasound uses ultrasound waves to create an image of the organs within the abdomen. This test will reveal fluid in the abdomen, an enlarged liver, or liver damage.
Blood tests used to detect the presence of hepatitis virus antibodies and antigen in the blood will indicate or confirm which virus is the cause of the hepatitis.
Viral Antibody Testing
Further viral antibody testing may be needed to determine if a specific type of the hepatitis virus is present.
Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic.
Hepatitis A isn’t usually treated. Bed rest may be recommended if symptoms cause a great deal of discomfort. If you experience vomiting or diarrhea, you will be put on a special diet created by your doctor to prevent malnutrition or dehydration. Vaccination can also prevent hepatitis A infections by helping your body produce the antibodies that fight this type of infection. Most children receive the vaccination between ages 12 and 18 months. Vaccination is also available for adults.
Acute hepatitis B doesn’t require specific treatment. Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly because it must be followed for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is progressing. The CDC recommends hepatitis B vaccinations for all newborns. The vaccine is also recommended for all healthcare and medical personnel.
Antiviral medications are used to treat both acute and chronic forms of hepatitis C. People who develop chronic hepatitis C are typically treated with a combination of antiviral drug therapies. They may also need further testing to determine the best form of treatment. People who develop cirrhosis (scarring of the liver) or liver disease as a result of chronic hepatitis C may be candidates for a liver transplant.
Hepatitis D is treated with a medication called alpha interferon. According to the Public Health Agency of Canada, between 60 to 97 percent of people develop hepatitis D again even after treatment.
There are currently no specific medical therapies to treat hepatitis E. Because the infection is often acute, it typically resolves on its own. People with this type of infection are often advised to get adequate rest, drink plenty of fluids, get enough nutrients, and avoid alcohol.
Practicing good hygiene is one key way to avoid contracting hepatitis. If you’re traveling to a developing country, you should avoid:
- drinking local water
- raw fruit and vegetables
Hepatitis contracted through contaminated blood can be prevented by:
- not sharing drug needles
- not sharing razors
- not using someone else’s toothbrush
- not touching spilled blood
The utilization of vaccines is a second key to preventing hepatitis. Vaccinations are available to prevent the development of hepatitis A and B. Experts are currently developing vaccines against hepatitis C, D, and E.
Chronic hepatitis B or C can often lead to more serious health problems. Because the virus primarily affects the liver, people with chronic hepatitis B or C are at risk for:
- chronic liver disease
- cirrhosis (scarring of the liver)
- cancer of the liver (in rare cases)
When the liver stops functioning normally, liver failure can occur. Complications of liver failure include:
- bleeding disorders
- a buildup of fluid in the abdomen
- increased blood pressure in portal veins that enter the liver
- kidney failure
- hepatic encephalopathy, which can involve fatigue, memory loss, and diminished mental abilities due to the build up of toxins that affect the brain (especially ammonia)
- hepatocellular carcinoma, which is a form of liver cancer
People with chronic hepatitis C are encouraged to avoid alcohol because it can accelerate liver disease and failure. Certain supplements, prescription, and over-the-counter medications can also affect liver function. If you have chronic hepatitis C, check with your doctor before taking any new medications.