Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.
Types of viral hepatitis and their causes
Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally transmitted hepatitis.
Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.
Hepatitis A: Hepatitis A is caused by 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.
Hepatitis B: Hepatitis B is transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, containing the hepatitis B virus (HBV). 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 1.2 million people in the United States and 350 million people worldwide live with this chronic disease.
Hepatitis C: Hepatitis C 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 bloodborne viral infections in the United States. Approximately 2.7 to 3.9 million Americans are currently living with a chronic form of this infection.
Hepatitis D: Also called delta hepatitis, hepatitis D is a serious liver disease caused by the hepatitis D virus (HDV). HDV is contracted through direct contact with infected blood. Hepatitis D is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B. It’s very uncommon in the United States.
Hepatitis E: Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply. 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, according to the CDC.
Causes of noninfectious hepatitis
Alcohol and other toxins: Excessive alcohol consumption can cause liver damage and inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol directly injures the cells of your liver. Over time, it can cause permanent damage and lead to liver failure and cirrhosis, thickening and scarring of the liver.
Other toxic causes of hepatitis include overuse or overdose of medications and exposure to poisons.
Autoimmune system response: In some cases, the immune system mistakes the liver as a harmful object and begins to attack it. It causes ongoing inflammation that can range from mild to severe, often hindering liver function. It’s three times more common in women than in men.
Symptoms
If you have infectious forms of hepatitis that are chronic, like hepatitis B and C, you may not have symptoms in the beginning. Symptoms may not occur until the damage affects liver function.
Signs and symptoms of acute hepatitis appear quickly. They include:
- fatigue
- 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
Chronic hepatitis develops slowly, so these signs and symptoms may be too subtle to notice.
Prevention
- local water
- ice
- raw or undercooked shellfish and oysters
- raw fruit and vegetables
Hepatitis B, C, and D 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
Hepatitis B and C can also be contracted through sexual intercourse and intimate sexual contact. Practicing safe sex by using condoms can help decrease the risk of infection.
Vaccines: The use of vaccines is an important key to preventing hepatitis. Vaccinations are available to prevent the development of hepatitis A and B. Experts are currently developing vaccines against hepatitis C. A vaccination for hepatitis E exists in China, but it isn’t available in the United States.
Treatment
Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic.
Hepatitis A: Hepatitis A usually doesn’t require treatment because it’s a short-term illness. Bed rest may be recommended if symptoms cause a great deal of discomfort. If you experience vomiting or diarrhea, follow your doctor’s orders for hydration and nutrition.
The hepatitis A vaccine is available to prevent this infection. Most children begin vaccination between ages 12 and 18 months. It’s a series of two vaccines. Vaccination for hepatitis A is also available for adults and can be combined with the hepatitis B vaccine.
Hepatitis B: 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 continued for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment.
Hepatitis B can be prevented with vaccination. The CDC recommends hepatitis B vaccinations for all newborns. The series of three vaccines are typically completed over the first six months of childhood. The vaccine is also recommended for all healthcare and medical personnel.
Hepatitis C: 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. Currently, there is no vaccination for hepatitis C.
Hepatitis D: No antiviral medications exist for the treatment of hepatitis D at this time. According to a 2013 study, a drug called alpha interferon can be used to treat hepatitis D, but it only shows improvement in about 25 to 30 percent of people (pubmed.ncbi.nlm.nih.gov).
Hepatitis D can be prevented by getting the vaccination for hepatitis B, as infection with hepatitis B is necessary for hepatitis D to develop.
Hepatitis E: Currently, no specific medical therapies are available 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. However, pregnant women who develop this infection require close monitoring and care.
Autoimmune hepatitis: Corticosteroids, like prednisone or budesonide, are extremely important in the early treatment of autoimmune hepatitis. They’re effective in about 80 percent of people with this condition.
Azothioprine (Imuran), a drug that suppresses the immune system, is often included in treatment. It can be used with or without steroids. Other immune-suppressing drugs like mycophenolate (CellCept), tacrolimus (Prograf), and cyclosporine (Neoral) can also be used as alternatives to azathioprine for treatment.
Natural ways to help manage syptoms
Zinc: Hepatitis C lowers your levels of this mineral, which you need to keep your liver and immune system healthy. Some research suggests zinc may ease your symptoms and make treatments work better. It may be safe to try but talk to your doctor first. Limit your daily dose to no more than 40 milligrams from either food or supplements.
Supportive Links:
“EASL recommendations on treatment of hepatitis C 2018.” Journal of hepatology 69.2 (2018): 461-511.
https://www.journal-of-hepatology.eu/article/S0168-8278(18)31968-8/abstract
“Alcoholic liver disease and hepatitis C: a frequently underestimated combination.” World journal of gastroenterology: WJG 15.28 (2009): 3462.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715970/
“Systematic review: patient‐reported outcomes in chronic hepatitis C‐the impact of liver disease and new treatment regimens.” Alimentary pharmacology & therapeutics 41.6 (2015): 497-520.
Note: “Western Pharmaceutical” is defined as a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Quote from National Cancer Institute: http://www.cancer.gov
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