Hepatitis: Defined

OVERVIEW

Viral hepatitis is inflammation of the liver. The condition can be caused by many things, including bacterial infection, liver injury caused by toxins and autoimmune attack on the liver. However, hepatitis is usually caused by a virus. There are a number of different viruses that can cause the condition. The most common hepatitis viruses are hepatitis A, B and C, but the condition can also be caused by the hepatitis D and E viruses.

Some types of hepatitis are mild and may even go away on their own. Other forms are much more serious and require treatment with medications. Hepatitis can be chronic (lifelong) and can lead to complications like cirrhosis (liver scarring), liver failure and liver cancer.

SYMPTOMS

Common symptoms of viral hepatitis include:

  • Jaundice — yellowing of the skin and eyes
  • Fatigue
  • Abdominal pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Diarrhea
  • Low grade fever
  • Headache

All viruses that cause hepatitis attack the liver. This attack on the liver can cause flu-like symptoms and make you generally sick to your stomach. Hepatitis also may lead to more unusual symptoms, such as dark yellow urine or light-colored stools.

People with hepatitis infection may not always show symptoms. But even these people can still pass on the virus.

DIAGNOSIS

Diagnosing hepatitis can be difficult in some cases. That’s because symptoms can be similar to more common conditions, such as the flu, and because some infected people do not show any obvious signs.

If you display symptoms of hepatitis, or suspect you may have contracted the virus, contact your doctor to schedule proper testing. Testing for hepatitis usually involves a blood test to check for the virus or antibodies to the virus.

If your doctor detects hepatitis C virus through a blood sample, he or she may recommend a liver biopsy (removal of small piece of liver tissue) to test for liver disease. Unfortunately, in many cases, liver disease has already caused serious damage by the time it is detected. Therefore, it is important that people who are at high for infection be tested regularly for hepatitis C. The sooner infection is detected, the sooner treatment can start, thus lowering the risk of permanent liver damage.

People are considered high-risk and should be tested for hepatitis C if they:

  • Have had transfusions of blood or blood products before 1991
  • Are on dialysis
  • Have had sexual or intimate contact with anyone infected with hepatitis C
  • Are a healthcare worker exposed to infected people
  • Are currently or were previously an injection-drug user
  • Have abnormal liver tests
  • Are HIV-positive

TREATMENTS

Treatments for hepatitis depend on the type of infection.

Hepatitis A typically improves on its own over a period of several weeks. Doctors usually recommend that people infected with hepatitis A get plenty of rest and stay hydrated until fever and jaundice go away and appetite returns to normal.

Chronic hepatitis B can be treated with medications like interferon alpha and peginterferon, which both work to slow how quickly the virus multiplies in the body. These medications also help to boost the immune system to fight off the infection. Antiviral medications such as lamivudine (Epivir), adefovir dipivoxil (Hepsera), entecavir (Baraclude) and telbivudine (Tyzeka) can also help. Experts recommend that infants born to mothers who have hepatitis B receive hepatitis B immune globulin and the hepatitis B vaccine within 12 hours of birth. Those with acute hepatitis B normally do not require treatment, as the condition is likely to clear up by itself. Those with severe acute hepatitis can be treated with the antiviral medication lamivudine (brand name Epivir).

There are vaccines to protect against both hepatitis A and hepatitis B. Today, it is routine for all kids in the United States to get vaccinated against hepatitis B when they are born and against hepatitis A when they are between 12 months and 24 months old.

There is no vaccine for hepatitis C. Chronic forms of hepatitis C can be treated with peginterferon (PegIntron, Sylatron) combined with the antiviral medication ribavirin (Copegus, Rebetol, Virazole and others). Acute hepatitis C may resolve on its own within a few months, but if it does not, you should speak with your doctor about beginning treatment.

There also are no vaccines for hepatitis D and hepatitis E. Hepatitis E usually clears up on its own after weeks to months, while chronic hepatitis D may require treatment, specifically with pegylated interferon.

CAUSES

Most forms of hepatitis are caused by the hepatitis A, B and C viruses. Hepatitis is also caused by the hepatitis D and E viruses, but they are less common in the United States.

Hepatitis can spread in a variety of ways. The infection can spread through food and water contaminated by feces from an infected individual (hepatitis A and E), infected blood by sharing needles, sexual contact with an infected individual and from mother to child (hepatitis B, C and D).

GETTING HELP

If you have symptoms of hepatitis or are concerned that you may have been infected, visit your doctor. A health professional can run tests to detect hepatitis.

In some places, sexual health clinics offer help to people with hepatitis or who suspect they have hepatitis.

RELATED INFORMATION

How can chronic hepatitis hurt my liver?

The liver is a vital organ to the body. The liver clears poisons and wastes from the blood and helps to control invading infections. It is also responsible for the production of proteins that help in blood clotting and bile absorption of fats and vitamins. The liver is capable of healing itself from some damage; however, too much infection or too big of an invasion can overwhelm it. Chronic forms of hepatitis can lead to the scarring of the liver tissue as well as liver failure and liver cancer. The damage may reach a point at which liver transplant is the only treatment option. One clear symptom of liver damage is jaundice, the yellowing of the skin and eyes.

What else can I do to prevent infection or exposure while traveling?

The CDC recommends all travelers to be proactive, prepared and protected wherever their destination may be. Be proactive by learning about your destination. Know the health risks and what is recommended for foreigners, such as what foods to avoid and dangerous spots to steer clear of. See a doctor before your travels to discuss all the recommended vaccinations and medications. Be prepared by packing smart and planning ahead in case of illness or injury during your trip. Know what to do if you become sick and make sure to release full details of your trip to your doctor before and after so he or she can better prepare and treat you. Be protected by staying alert and aware during your trip. Be very careful about food and water intake. Know what’s safe for foreigners and what’s not. What the locals may be eating may not be safe for you.

LIVING WITH

If you have been diagnosed with any form of hepatitis, limit or avoid drinking alcohol as it puts a strain on the liver. Also, avoid eating fatty foods and follow a low-salt diet.

People infected with hepatitis should follow steps to prevent spreading the disease to others. Those infected with hepatitis B or C should have regular blood tests and check-ups. They also should use a condom during any penetrative sex.

Other ways to prevent the spread of hepatitis include never sharing needles, syringes or mixing spoons for injection drug use and avoiding sharing toothbrushes, shaving razors or anything else that might be contaminated with infected blood.