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The ABCs Of Hepatitis

Your liver – the largest organ in your body – helps you digest food, store energy, and filter out toxins. But a viral disease, hepatitis, can interfere with these critical functions. And put your health at risk.

Some hepatitis infections are relatively short-lived, or acute. Others can be long-lasting, or chronic, and lead to liver failure, cancer, and even death. So, knowing how hepatitis is transmitted, diagnosed, and treated – and how to avoid infections – will benefit your health.

The word hepatitis means inflammation of the liver. Hepatitis is most commonly caused by a virus, and five types of viral hepatitis have been identified: hepatitis A, B, C, D, and E. The most common types of viral hepatitis in the U.S. are hepatitis A, hepatitis B, and hepatitis C.

Know Hepatitis By the Letter

The types of viral hepatitis vary in their causes and effects:

Hepatitis A is the least common of the three most common forms of the disease in the U.S. – with about 2,500 cases reported each year. Hepatitis A is typically transmitted by contact with infected feces, or through food and water that has been contaminated by an infected person's stool. You’re most at risk if you travel to countries without modern sanitation, have sexual contact with an infected person, use illegal drugs (even non-injected drugs), or live with someone who has hepatitis A.

People who contract hepatitis A usually get better within a few weeks and have no lasting liver damage.

Hepatitis B is mainly spread by contact with an infected person's blood, semen, or other body fluids. It can be transmitted through sex with an infected person, by sharing infected needles or other medical equipment, and by sharing infected personal items such as a toothbrush or razor. And hepatitis B can be passed from mother to baby at birth.

The severity of hepatitis B ranges from a mild illness, lasting a few weeks, to a serious life-long condition. An estimated 850,000 to 2.2 million Americans live with chronic hepatitis B. More than 19,000 new infections are reported each year. Hepatitis B can lead to chronic liver disease, including cirrhosis (deterioration and scarring of the liver), liver failure, and liver cancer.

Hepatitis C spreads through the blood of an infected person – primarily by way of shared needles and syringes. Hepatitis C can also pass through sexual contact and from an infected mother to her baby. Before new screening procedures introduced in 1992, hepatitis also spread through blood transfusion and organ transplant. Between 2.7 and 3.9 million people live with chronic hepatitis C in the U.S., with about 30,500 new infections reported each year.

About 75 to 85 percent of people infected with hepatitis C develop a chronic infection, which can result in long-term health problems, even death. Hepatitis C is the leading cause of liver cancer in the U.S. and the leading indicator for liver transplantation.

Hepatitis D, rarely seen in the U.S., affects only those infected with hepatitis B. Hepatitis D is spread through contact with infected blood or other fluids — the same for hepatitis B. Hepatitis D can be acute or chronic. Chronic hepatitis D can lead to cirrhosis, liver failure, and liver cancer.

Hepatitis E, rare in the U.S., is common in developing parts of the world – often spread through water supplies contaminated by an infected person's stool. Most instances of hepatitis E are acute, and patients usually get better without treatment after a few weeks. In rare instances, hepatitis E can become chronic, but only in people with weakened immune systems.

The most common types of viral hepatitis in the U.S. are hepatitis A, hepatitis B, and hepatitis C.

What Are the Symptoms Of Hepatitis?

Hepatitis is hard to diagnose and is commonly missed, says Leelmohan Ravikumar, MD.

He explains, "You can have flu-like symptoms, all the way to complete liver failure, which is life-threatening. A lot of times patients will complain of diffuse pain to the area. They can also have nausea, vomiting, diffuse abdominal pain.

“The most common warning sign that doctors see, and we're very concerned about, is jaundice, which is yellowness or paling of the skin, paleness of the eyes, which is a sign that the liver is actually under stress and unable to process some of the toxins the body normally does." 

Dr. Leelmohan Ravikumar talks about signs and symptoms of hepatitis.

Click play to watch the video or read video transcript.

Often, people with acute or chronic hepatitis have no symptoms and don't know that they are infected. If acute symptoms occur, they usually show up from two to six weeks after infection. Chronic symptoms can develop over decades. Symptoms of acute hepatitis can vary from person to person, but they can include:

• Jaundice
• Nausea/vomiting
• Loss of appetite
• Fever
• Tenderness in the upper-right part of the belly
• Sore muscles/joint pain
• Itchy hives on skin

The symptoms of chronic hepatitis are similar, and they're often mild. They include:

• Loss of appetite
• Extreme tiredness
• Low fever
• Pain in the upper belly
• Jaundice
• Symptoms of chronic liver disease

How Is Hepatitis Diagnosed?

Your health care provider will take a complete medical history, perform a medical exam, and likely order diagnostic tests that will zero in on the health of your liver. Depending on the doctor's clinical findings, these tests could include liver enzyme and function tests, an ultrasound or other scan of your liver, blood and genetic testing focused on hepatitis, and a liver biopsy.

How Is Hepatitis Treated?

Treatment will vary depending on the type of hepatitis you have, your age, overall health, the extent of the disease, and your treatment preferences.

Acute hepatitis may be treated with supportive care for symptoms, such as rest, eating healthy foods, and avoiding alcohol. And, in some cases, antiviral drugs.

Chronic hepatitis treatment may include antiviral drugs, corticosteroids, and abstinence from alcohol. Modern treatments for hepatitis C have a high cure rate.

How To Prevent the Spread Of Hepatitis

As with many diseases, stemming the spread of hepatitis begins with good hygiene habits. Other preventive measures include: 

• Vaccination. Hepatitis B vaccine is typically given to newborns and small children as part of their normal health care. A vaccine for hepatitis A can be given to people at risk, such as when traveling to a developing country. No vaccines are available for hepatitis C, D, or E (though the hepatitis B vaccine can protect against hepatitis D).
• Antibodies. If you've been exposed to hepatitis, you might be given an antibody preparation to help protect you from the disease.
• Injected drugs. Don't share or reuse needles or syringes.
• Safe sex. Practice safe sex, including use of a condom.
• Personal items. Don't share personal items such as razors and toothbrushes. 
• Tattoos. If you get a tattoo, patronize a licensed, reputable facility.
• Blood supply screening. Blood used in transfusions is screened for hepatitis B and C.

Source: Leelmohan Ravikumar, MD, Troy Primary Care Physicians; Centers for Disease Control and Prevention; National Institute of Diabetes and Digestive and Kidney Disease

Leelmohan Ravikumar, MD

Upper Valley Family Medicine

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