Hepatitis: Causes, Types, Symptoms, and Treatment
Many people are aware of a condition known as hepatitis. But most do not know what risks it could post to health or their extent.
There are different types of hepatitis and the symptoms they produce may also differ. You can learn more about the types, particularly the most common ones, in this article. Also, learn about the causes of these disorders, how they spread and what you can do to combat them.
What is Hepatitis?
Hepatitis is a term that describes an inflammation of the liver. Inflammation is your body’s natural response to an injury or irritation, but, in this case, it is a cause of concern.
Your liver helps with the processing of nutrients from the food you consume. It assists in getting rid of infections and removing potentially harmful agents from your blood.
When this organ becomes inflamed, as seen in hepatitis, it becomes less able to perform its functions effectively. This often leads to redness, swelling, and pain. More serious health issues are also possible.
Hepatitis can be acute or chronic. This depends on whether the disorder lasts for less than six months or longer. Acute cases can resolve without any intervention or progress to the chronic form.
Hepatitis affects people throughout the world. It often occurs as large outbreaks and epidemics. The diseases are more common in countries with poor sanitation. However, outbreaks are still seen in the United States.
How Do People Get Hepatitis?
Viruses are the most common causes of hepatitis. This is why you may see medical experts talk more about viral hepatitis.
People usually get it from the intake of food and water contaminated by fecal matter. The infection also commonly spreads through sexual intercourse, but it can be transmitted through the following means as well:
- Sharing of sharp objects, such as needles and syringes, contaminated by the blood of an infected person
- Sharing of toothbrush and other personal items with an infected person
- Transfer from mother to baby in the womb or during childbirth
People can also have hepatitis virus infection through blood transfusions. But this is less likely to happen these days, especially in a developed country like the U.S.
Other possible causes of hepatitis include:
- Other infections
- Certain medications
- High alcohol consumption
- Autoimmune disorders
- Non-alcoholic steatohepatitis (NASH)
Common Forms of Hepatitis
Viral hepatitis is the most common type in America and around the world. There are several viruses that can cause an infection. The main ones are:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hepatitis D
- Hepatitis E
Of these types, hepatitis A, B and C are the most common ones.
This is probably the least problematic of all three most common hepatitis viruses. It is also the least common of all three.
Hepatitis A, which people typically have from consuming contaminated foods and drinks, doesn’t lead to chronic infection. It rarely produces complications and typically resolves within two months.
There are about 4,000 new cases of hepatitis A infection each year, according to the Centers for Disease Control and Prevention (CDC).
People tend to be affected by this particular virus the most across the globe. The estimate has it that roughly 343 million worldwide had chronic hepatitis B in 2015. The CDC claims that about 21,000 new infections are reported in the U.S. annually.
The virus spreads in body fluids, such as semen and blood. Sexual intercourse and recreational (intravenous) drug use are, therefore, two of the most common ways how people get hepatitis B.
This infection can last for a few weeks or months. Those affected mostly recover within six months. But it can also become a chronic condition.
Estimated 142 million people worldwide were believed to have hepatitis C virus (HCV) in 2015. CDC says that about 2.4 million people are living with it.
Some other sources say more than three million people have chronic hepatitis C infection in the U.S. There are more than 40,000 new cases diagnosed every year as well.
There are numerous forms of the virus. But Type 1 is the most common in America. It spreads through infected blood.
HCV can resolve in weeks to months, but also carries the risk of becoming a life-long infection. You may not notice any symptoms, even though it poses a great threat to your liver.
Persons born between 1945 and 1965 in America – the “baby boomers” – are among those at significant risk of having hepatitis C.
Signs and Symptoms
The signs you notice when having hepatitis may depend on the type. Also, symptoms of acute cases will be different from chronic in some regards.
However, among the most common symptoms of this disease are:
- Loss of appetite
- Dark urine
- Yellowing of the whites of the eyes and skin, a condition known as jaundice
- Joint pain
- Abdominal pain
- Light or clay-colored stool
Leg swelling and weight loss are among the symptoms of chronic hepatitis. Long-term infection can lead to serious damage to your body.
In certain cases, there are no signs and symptoms at all and one may get diagnosed with hepatitis during a routine check-up.
How Much of a Threat is Hepatitis?
Most people who have hepatitis do not experience serious damage to their health. But some others are not so lucky.
Acute cases caused by type B, D and E viruses as well as drug or autoimmune diseases can lead to the death of liver cells in high number. This is a condition known as fulminant hepatitis.
Possible complications from this rare disorder include disorientation, abnormal blood coagulation, sepsis, kidney failure, and bleeding in the stomach and intestines.
According to the CDC, up to 25 percent of those who have chronic infections develop liver issues. These include significant liver damage (cirrhosis), scarring and liver failure. Liver cancer is another possible complication.
Chronic hepatitis can weaken your immune system, making it difficult to fight off other infections.
Between 1 and 5 percent of patients will die as a result of cirrhosis or liver cancer, according to CDC estimates.
Diagnosis and Screening
Doctors take different things into consideration when diagnosing hepatitis. They consider the medical history of a patient as well as signs and symptoms of an infection. Questions would also often be asked pertaining to sexual history and substance use.
You will usually need to have blood work. There are a number of blood tests that your doctor may order to find out whether you have hepatitis. They include complete blood count, blood chemistry, serology, and nucleic acid testing.
Tests can reveal the levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The levels of these liver enzymes are often high in cases of hepatitis, even when there are no symptoms.
Liver biopsy and imaging, such as ultrasound or MRI, may also be used for diagnosis.
If you feel uncomfortable with undressing for tests or having a swab taken, you could consider STDCheck for confidential testing.
You only need to provide a blood sample. A lab technician would then subject this to an FDA-approved enzyme immunoassay (EIA) test or an antibody test. Results are usually ready in a day or two.
Periodic screening is helpful for avoiding issues with viral hepatitis, especially types B and C. This can enable early detection and treatment.
If you belong to any of the following groups, you need screening:
- People with no access to clean water or lacking in good hygiene practices
- Recreational drug users
- Travelers to areas known to be endemic to hepatitis
- People living with or having sexual contact with an infected person
- HIV positive individuals
- Persons born in the U.S. from 1945 to 1965
- People receiving immunosuppressive treatments
- Patients receiving long-term hemodialysis
- Children born to mothers having hepatitis
- Those in the medical profession
This is not an exhaustive list of people that should be routinely tested for hepatitis. Screening for types B and C are mostly recommended.
Treatment of Hepatitis
There is no recommended treatment for acute hepatitis. The vast majority of patients recover without the use of any medications.
Only supportive care may be needed for acute cases. The usual measures include providing patients with proper nutrition. Intravenous hydration may also be given.
Patients with acute hepatitis rarely require hospital admission. This is more likely to happen in older persons and those with co-morbidity.
Chronic hepatitis B
With chronic hepatitis B, the treatment goal is to inhibit viral replication. Patients will be under regular monitoring to detect any signs of liver disease progression on time.
There are drugs that can help to treat people with hepatitis B successfully. Approved and common ones in the U.S. include:
Entecavir – This is arguably the most effective antiviral drugs currently available for the treatment of hepatitis B. It is well-tolerated and less likely to lead to resistance. For this reason, it is often the first-line treatment for this viral infection.
Tenofovir – This nucleotide analog is another first-line treatment for chronic hepatitis B. It is potent and gives little room for resistance to develop. Tenofovir is also used for treating people with HIV.
Other approved treatments include lamivudine, pegylated interferon (PEG IFN), and injectable interferon alpha, which was the first to be approved for treatment in the U.S.
Chronic hepatitis C
People who have acute hepatitis C are more likely to develop a chronic case, compared to those who have hepatitis A or B.
Direct and indirect-acting antivirals are often used for dealing with chronic cases. Treatments typically last 2-3 months and more than 90 percent of patients recover with minimal adverse reactions.
The following are the classes of drugs that are commonly used for impeding viral replication:
- NS3/4A protease inhibitors, such as simeprevir and telaprevir
- NS5A inhibitors, including daclatasvir and ledipasvir
- NS5B polymerase inhibitors, such as sofosbuvir and dasabuvir
These drugs are often used in different combinations of two or more, depending on the genotype of patients. For example, doctors combine ledipasvir and sofosbuvir.
There is no effective treatment for hepatitis D yet. Hepatitis E patients have been treated in the same way as those with type A.
For the other types of hepatitis, healthcare providers mainly work to address the underlying causes.
A liver transplant may be an option in cases where the liver has suffered significant and irreversible damage.
Vaccination Against Hepatitis Infection
Thankfully, it is possible for you to prevent some forms of viral hepatitis by getting vaccinated.
It is currently possible to immunize yourself against hepatitis A, B, and D. But there are no vaccines for viral hepatitis C and E.
All children who are at least one-year-old need to receive the hepatitis A vaccine, according to CDC guidelines. Children who are younger than 19 years should get the hepatitis B vaccine.
People who have previously not received these vaccines or who think they are at risk of having the infections are also advised to receive them.
Hepatitis can do serious harm to your health and even lead to death. You might have it and not be aware of it. Therefore, screening is vital, especially if you belong to any of the groups at risk.
Good oral hygiene, appropriate handling of sewage, and safe sex practices are among veritable means of prevention. You should also maintain healthy habits, including reducing your alcohol intake.
But if you already have hepatitis, there are drugs that can help you get better. Your chance for full recovery improves more the earlier you detect it. Majority of patients get better with treatment.
Special care is required if you have hepatitis C. Acute form of this viral infection is significantly more likely to progress to a chronic form, compared to other common types. This comes with the risk of more frightening complications, including liver cancer and death.
- What is Viral Hepatitis? | Division of Viral Hepatitis
- Viral Hepatitis (A, B, C) Symptoms & Treatment | Cleveland Clinic