Hepatitis is an inflammation of the liver. It’s considered acute until it lasts six months, at which point it’s considered chronic. Complications that can develop from chronic hepatitis include a scarring of the liver called cirrhosis, liver failure, and liver cancer.
Here’s what you need to know about hepatitis, its causes and symptoms, and how it can be prevented, diagnosed, and treated.
Viral Hepatitis
The five different types of hepatitis that can be caused by viruses are hepatitis A, B, C, D, and E.
• Hepatitis A: This type is commonly spread through contaminated food and water. It’s usually contracted from food that was handled by someone who didn’t wash their hands after going to the bathroom. Not washing your hands after changing a baby’s diaper or having sex with an infected person can also cause it. Hepatitis A is always acute but can occasionally cause severe liver failure.
• Hepatitis B: The virus that causes hepatitis B lives in bodily fluids, such as blood and semen. It’s usually spread through sexual contact with someone who’s infected. It can also be contracted by using the razor or toothbrush of someone who has the virus, touching their open sores, or sharing needles with them. If a pregnant person has hepatitis B, they need to get their baby treated within 12 hours after birth to prevent the child from getting it. Hepatitis B becomes chronic in 90 percent of infants but only 2 to 6 percent of adults.
• Hepatitis C: This type is usually spread by sharing needles and other drug-injection equipment. Less commonly, it can be spread through sexual contact, sharing razors or toothbrushes with an infected person, or from unsanitary equipment used for tattoos or body piercings. Hepatitis C becomes chronic in about 75 to 80 percent of the people who get it.
• Hepatitis D: This is the most severe type of hepatitis, but it can only be contracted by people who already have hepatitis B. This type of hepatitis is spread through contact with infected blood or bodily fluids. That can happen by sharing needles, having unprotected sex, or during childbirth. Hepatitis D can be extremely stressful on the liver, causing lifelong symptoms and damage.
• Hepatitis E: This type is most prevalent in countries with poor sanitary conditions. Hepatitis E is not common in the United States and most people who get it fully recover.
Other types of hepatitis
Other types of hepatitis besides viral hepatitis include:
• Toxic hepatitis: This type of hepatitis results from exposure to chemicals, medications, and supplements. It can be acute or chronic.
• Alcoholic hepatitis: This is caused by drinking too much alcohol. This type of hepatitis can seriously damage the liver, and even lead to death, if alcohol use continues.
• Autoimmune hepatitis: This type occurs when the immune system attacks the liver. There is currently no cure, but it can be managed.
Symptoms and diagnosis
Hepatitis symptoms include:
• Loss of appetite
• Weight loss
• Nausea and vomiting
• Pain and bloating in the belly area
• Dark urine and pale or clay-colored stools
• Diarrhea
• Fatigue
• Joint pain
• Mild fever
• Itching
• Jaundice (a yellowing of the skin or eyes)
Someone with hepatitis may experience no symptoms. In other cases, the symptoms may be so mild that many people attribute them to something else. For those who do get symptoms, they usually appear:
• Two to six weeks after contracting hepatitis A
• Three months after contracting hepatitis B, although they can appear anywhere within six weeks to six months after infection
• Six to seven weeks after get hepatitis C, although they may be noticeable in two weeks to six months
Tests are done to determine if someone has hepatitis A, B, or C. Tests for alcoholic hepatitis include liver function tests, liver biopsies, and ultrasounds. Blood tests and liver biopsies can detect autoimmune hepatitis. Those and other tests, as well as an exposure history, are used to diagnose toxic hepatitis.
Prevention
Preventing hepatitis involves vaccination, avoiding risky behaviors, and limiting exposure to alcohol and toxins.
For hepatitis A, the Centers for Disease Control and Prevention (CDC) recommends children get one vaccine dose when they’re 12 to 23 months old and a second dose at least six months after that. Children, adolescents up to 18 years old, and adults who haven't been vaccinated are also encouraged to get the hepatitis A vaccine. Newborns should receive the hepatitis B vaccine, with the recommendation extending to children up to 18 years old, adults between 19 and 59 years of age, and older adults (60+) who are at high risk of infection.
The CDC also recommends the vaccine for children and adolescents through 18 years and adults who haven’t received it. The CDC recommends the hepatitis B vaccine for all newborns; children up to age 18; adults 19-59 years of age; and adults 60 and older who are at high risk for infection.
Treatment
Hepatitis A and E usually go away on their own. Both infections can usually be treated by resting and drinking plenty of fluids, as well as avoiding alcohol and certain medications.
People with chronic hepatitis B will likely meet with their doctor every six to 12 months to check for signs of liver disease or cancer. They may also be put on an antiviral medication.
You may be prescribed antiviral medication for hepatitis C, but your doctor also may decide you don’t need medication.
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Hepatitis D can be treated in some people by a medication called interferon. However, a liver transplant may be needed if the infection has caused severe damage.
For toxic hepatitis, treatment primarily involves limiting or eliminating exposure to the substance causing the hepatitis. However, additional care, including hospitalization or even a liver transplant, may be required depending on how much the liver damage has occurred.
Treatment for alcoholic hepatitis involves stopping alcohol use, reducing the symptoms, and halting the disease’s progression.
Treatment for autoimmune hepatitis typically begins with a large dose of corticosteroids followed by doses that taper off over time.
Hepatitis is a liver inflammation that can become chronic and lead to serious complications. Knowing what symptoms to watch for, getting the recommended vaccinations, and avoiding risky behaviors are key to prevention and catching the virus early when it’s most treatable.