Hepatitis: Types, Causes, Symptoms, Treatment

What is hepatitis?

Hepatitis is inflammation of the liver. Liver inflammation is swelling that develops when tissues of the liver are injured or infected. It is the liver tissue’s reaction to irritation or injury, which generally results in swelling and can cause pain.

It can damage your liver and can adversely affect how well your liver functions. The liver is an important organ, which performs vital functions. It metabolizes nutrients, filters the blood, and protects your body from infections.

Hepatitis can be an acute infection or a chronic infection. The acute form lasts for less than six months, while the chronic inflammation lasts for more than 6 months.

As explained below, hepatitis is caused by five different viruses. The most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

Some types cause only acute infections while other types can cause both acute and chronic infections.

Acute hepatitis is short-term and lasts for less than 6 months. The chronic form is long-term and lasts more than 6 months.

Hepatitis A causes only acute infection. Both the B and C viral infections can cause acute and chronic hepatitis. However, hepatitis C is more likely to become chronic than hepatitis B.

Hepatitis can also be caused by non-viral reasons. Heavy alcohol use, certain toxins, some drugs, and certain medical conditions can cause liver inflammation.

What causes hepatitis?

There are different types of hepatitis, with different causes:

• Viral hepatitis is the most common type. It can be caused by any of the five viruses – hepatitis viruses A, B, C, D, and E of which viruses A, B, and C are the most common.
• Alcoholic hepatitis is caused by heavy consumption of alcohol
• Toxic hepatitis can be caused by specific toxins, chemicals, medicines, or supplements
• Autoimmune hepatitis is a chronic type, in which your body’s immune system attacks the liver, leading to chronic inflammation and serious damage to liver parenchyma.

Common types of viral hepatitis

Several viruses are known to cause hepatitis. Common viral forms include:

Hepatitis A

This type of hepatitis is an acute form, does not become chronic, and usually causes no serious harm. The liver mostly recovers from this viral infection within a few months with lifelong immunity.

However, rarely, viral hepatitis A has led to liver failure and liver transplant has been indicated in some cases. The hepatitis A vaccine is safe and effective and can prevent this viral infection.

The hepatitis A virus (HAV) is transmitted through the consumption of food and water contaminated with this virus or through direct body contact with an infectious person.

The increased risk of this viral A infection is associated with a lack of safe drinking water and poor sanitation and hygiene.

According to WHO estimates in 2016, 7134 persons died from hepatitis A worldwide.

Hepatitis B

Hepatitis B is a serious liver viral infection caused by the hepatitis B virus (HBV). It is mostly an acute infection, lasting for less than six months. Approximately 95% of people recover from this form and the condition does not become chronic.

However, the infection can become chronic in some people, lasting for more than six months. The complications of chronic hepatitis B include liver failure, liver cancer, or cirrhosis. The risk of it becoming chronic is higher if you get the virus B infection early in life.

People without symptoms can spread the virus such as through sexual contact, sharing needles, and from the infected pregnant mother to the baby during childbirth. You can prevent hepatitis B by taking its vaccine.

There were 22,000 new cases of hepatitis B in 2017, and around 900,000 people are living with this infection in the United States.

Hepatitis C

Hepatitis C is an inflammation of the liver caused by the hepatitis C virus. It is one of the most common causes of liver disease in the U.S. About 75% to 85% of the cases become chronic.

Among these chronic cases, the risk of cirrhosis ranges from 15% to 30% within 20 years. Roughly, 2.4 million people in the U.S. are estimated to be suffering from chronic hepatitis C infection.

The most common ways of its spread are sexual contact, blood transfusion, and injection drug use. People with viral C often do not show any symptoms. No vaccine is yet available to prevent hepatitis C.

Hepatitis D

Hepatitis D develops in people who are infected by the hepatitis B virus. It can be acute or can become a long-term, chronic infection.

It spreads through contaminated blood and the sharing of needles. The Hepatitis B vaccine offers protection against the hepatitis D virus.

Hepatitis E

Hepatitis E is caused by infection with the hepatitis E virus (HEV). This type of viral hepatitis spreads through the consumption of contaminated food or water. The E virus infection is common throughout the world. Its vaccines are not available everywhere.

Every year about 20 million HEV infections occur worldwide, of which an estimated 3.3 million are symptomatic.

How does viral hepatitis spread?

Viral hepatitis can spread from person to person in various ways.

Hepatitis A can spread through consumption of food or drinking water contaminated with fecal matter from an infected person. You can also get hepatitis A from sexual contact.

Hepatitis B can spread through the following ways:

• Sexual contact with an infected person
• Sharing contaminated needles
• By direct contact with infected blood
• From the infected pregnant mother to the fetus.
• Through contact with an infected person’s body fluids

Hepatitis C can spread through the following ways:

• Sharing contaminated needles
• Through direct contact with infected blood
• Sharing contaminated needles
• Less commonly through sexual contact with  an infected person

Blood products are presently tested for hepatitis B and C, so it is unlikely that a person will get infected with these viruses from receiving blood.

What are the symptoms of hepatitis?

Some people with hepatitis do not have symptoms and therefore are not aware that they are infected.

In an acute infection, symptoms can develop anytime from 2 weeks to 6 months after exposure to the virus. Symptoms of chronic viral hepatitis can take decades to build.

If you do have symptoms, they may include:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Pain in the right side of the abdomen
• Dark-colored urine
• Clay-colored bowel movements
• Jaundice, yellowing of your skin and eyes

What complications can hepatitis cause?

Most people recover from hepatitis, and the disease is often preventable. However, it is still considered a serious health risk because chronic hepatitis can cause the following complications:

• Destroy liver tissue
• Weaken the body’s immune system.
• Cause the liver failure
• Cause liver cancer
• Rarely, it can cause death

However, early diagnosis and treatment of chronic hepatitis may prevent these complications.

How is hepatitis diagnosed?

Healthcare providers might be unable to identify the virus responsible for your hepatitis.

To diagnose hepatitis, your healthcare provider:

• Will ask about your symptoms and medical history
• Will do a physical exam
• Will order blood liver function tests, including tests for viral hepatitis
• Might do imaging tests such as an ultrasound, CT scan, or MRI
• We may need to do a liver biopsy to get a precise diagnosis and check for liver damage

What are the treatments for hepatitis?

Treatment for hepatitis depends on its type and whether it is acute or chronic.

Mild acute viral hepatitis often goes away on its own. For supportive care, you need to

• Take rest
• Get enough fluids
• Follow some dietary restrictions, such as having a high protein, high carbohydrate, and low-fat diet.
• You should avoid alcohol.
• Avoid sexual activity
• Stay well hydrated

In more serious cases, you might need to get treatment in a hospital. Specific drugs are given for the different types of hepatitis.

Hepatitis A treatment

People who test positive for hepatitis A are usually treated through supportive care for symptomatic relief.

• Acute hepatitis B is treated with supportive care.
• Chronic hepatitis B will require supportive care and the following:

Treatment of acute and chronic hepatitis C

• Hepatitis in its acute form requires only supportive care.
• Chronic hepatitis C always requires treatment, which typically consists of direct-acting antiviral (DAA) tablets for 8 – 1 2 weeks. The pills can cure more than 95% of people and side effects are minimal

Can hepatitis be prevented?

There are different ways you can adopt to prevent or lower your risk for viral hepatitis. You cannot, however, prevent autoimmune hepatitis.

• Get yourself vaccinated against hepatitis A and B as recommended.
• Use a condom during sex.
• Do not use shared needles to take drugs or make tattoos.
• Practice good personal hygiene such as thoroughly washing hands with soap and water regularly.
• Do not share any items with an infected person.
• Drink bottled water when traveling to ensure clean non-contaminated water.
• Build up your immunity with good nutrition, regular physical activity, and getting good sleep.
• If you drink alcohol, stay within safety limits. It is best to avoid it altogether.
• Avoid smoking.

Is there a vaccine for hepatitis?

There are vaccines for hepatitis A and B and you can prevent these A and B  with currently available vaccines that are safe and effective. The hepatitis B vaccine offers 95-100% protection against the B virus.

A combined vaccine that protects both hepatitis A and B is also available.

Vaccines against hepatitis B should protect you against hepatitis D also. There is no FDA-approved vaccine against hepatitis E, but such vaccines are available in some countries.

There is no vaccine to protect you against hepatitis C.