Hepatitis, inflammation of your liver, is typically caused by five specific viruses. But the Epstein-Barr virus (EBV) that causes mononucleosis infection has also been linked to hepatitis.
Hepatitis is inflammation of your liver. Viruses are the
- heavy alcohol use
- exposure to toxic chemicals
|Hepatitis A and E||contaminated food or water|
|Hepatitis B, C, and D||contact with a the blood or other bodily fluids of someone who has it|
In addition to these viruses, EBV, which causes mononucleosis infection, has also been linked to hepatitis. This virus is extremely common. It’s estimated that more than
Severe infection is uncommon in people with immunosuppression and extremely rare in people whose immune system is not suppressed.
Read on to learn about the connection between mononucleosis and hepatitis.
EBV is a type of herpes virus most commonly passed through
Many people become infected in childhood and don’t develop symptoms.
EBV lies dormant in your body after the initial infection and can (rarely) reactivate.
Hepatitis is classified as “acute” if it onsets suddenly or “chronic” if it lasts at least 6 months.
EBV is a non-hepatotropic virus, meaning that, unlike hepatitis viruses, it doesn’t primarily target your liver. While EBV can still cause acute hepatitis in some cases, it doesn’t typically cause chronic damage to your liver like hepatitis B or C.
Symptomatic EBV hepatitis is rare, and it’s extremely rare to develop symptoms of hepatitis without symptoms of mononucleosis.
EBV hepatitis is usually mild and resolves itself. Severe and fatal EBV hepatitis has been reported in immunocompromised people. It’s extremely rare in people whose immune systems are not immunocompromised.
EBV hepatitis can have similar symptoms to classic viral hepatitis. Symptoms may include:
- nausea and vomiting
- abdominal pain
- dark urine
- light-colored stools
- joint pain
- loss of appetite
EBV hepatitis usually also presents with symptoms of mononucleosis. They can include:
- night sweats
- muscle weakness
- rash with flat pink or purple spots
- swollen lymph nodes in neck and armpits
- swollen tonsils
- sore throat
- loss of appetite
- abdominal pain
- nasal inflammation
- general feeling of being well
Upon examination in the hospital, doctors discovered she had an elevated heart rate and mild tenderness in her abdomen. She fully recovered, and all her liver function tests were normal at a 6-month follow-up.
She was released from the hospital 4 days later, and a month later, her liver tests had typical results.
Doctors can usually diagnose EBV hepatitis clinically by considering your symptoms and the results of a blood test.
A liver biopsy may be needed if your symptoms are atypical or if laboratory findings are unusual. A liver biopsy is when a doctor takes a sample of liver tissue to be examined under a microscope for signs of the virus.
Doctors use a blood test to see if you’re positive for EBV. They also use a blood test to look at levels of your liver enzymes and other markers of infections, like your blood cell counts.
A high white blood cell count with numerous atypical white blood cells and elevated liver enzymes are the most common findings of a blood test in people with EBV hepatitis.
Most cases of mononucleosis are mild and resolve themselves with minimal treatment. But you may want to contact a doctor for an evaluation if you’ve ever been diagnosed with mono and then develop signs of hepatitis.
It’s important to seek immediate medical attention if you develop:
- breathing difficulties
- trouble swallowing fluids
- intense abdominal pain
According to the National Health Service, these symptoms can be signs of complications that need treatment at a hospital.
Hepatitis A, B, and C are each caused by a different type of virus. Mononucleosis can’t directly lead to these conditions, but it’s plausible that it could suppress your immune system and make you more prone to infection or reactivate the hepatitis virus if you’ve previously contracted hepatitis B or C.
For example, in a 2021 case study, researchers saw a 47-year-old man who developed a reactivation of hepatitis B after he contracted EBV.
Mononucleosis is usually caused by EBV. It’s not uncommon for this infection to raise levels of your liver enzymes. It can also lead to acute hepatitis.
Hepatitis is usually mild and self-resolving. People with immunosuppression are at the highest risk of developing hepatitis from EBV infection.
It’s possible for EBV hepatitis to occur with or without the symptoms of mononucleosis.
Most cases of mononucleosis don’t require any particular treatment, but it’s important to seek medical attention if you develop concerning symptoms like trouble breathing or intense pain.