Liver Disease

Virus-Induced Liver Disease / Hepatitis

What is hepatitis?

Hepatitis is the inflammation of the liver, resulting in liver cell damage and destruction.

Hepatitis can be categorized in two groups:

acute hepatitis
chronic hepatitis

There are 5 main types of the hepatitis virus that have been identified, including...

Hepatitis A - This type of hepatitis is usually spread by fecal-oral contact, including:

touching an infected person's stool
consuming food made by someone who touched infected stool
drinking water made dirty by infected stool -- a problem in developing countries
having anal sexual intercourse with an infected person

Hepatitis B - This type of hepatitis spreads mainly through contaminated blood and blood products, sexual contact, and contaminated intravenous needles. Hepatitis B can lead to chronic hepatitis, cirrhosis, liver cancer, liver failure, and death.

Hepatitis C - The symptoms of this type of hepatitis are generally less severe than hepatitis B. Hepatitis C spreads through contaminated blood or blood products, sexual contact, and contaminated intravenous needles. With some cases of Hepatitis C, no mode of transmission can be identified.

Hepatitis D - This form occurs together with hepatitis B, making the hepatitis B infection worse.

Hepatitis E - This form is similar to hepatitis A and occurs most frequently in underdeveloped countries.

What is acute hepatitis?

Acute hepatitis is quite common in the US: 20 to 30 cases reported per 100,000 people each year.

Causes:
Common causes of acute hepatitis may include:

infection with a virus (viral hepatitis A, B, C, D, or E)
overdose of drugs (such as acetaminophen)
chemical exposure (such as dry cleaning chemicals)

Symptoms:
Acute hepatitis usually starts with flu-like symptoms. The following are the most common symptoms of acute hepatitis. However, each individual may experience symptoms differently:

jaundice
nausea
vomiting
loss of appetite
fever
tender in the right, upper abdomen
sore muscles
joint pain
itchy red hives on skin

The symptoms of acute hepatitis may resemble other conditions or medical problems. Consult a physician for diagnosis.

Diagnosis:
In addition to a complete medical history and medical examination, diagnostic procedures for acute hepatitis may include:

specific laboratory tests
liver function tests

Treatment:
Specific treatment for acute hepatitis will be determined by your physician's based on:

your overall health and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Treatment varies, depending on the type of acute hepatitis (viral versus non-viral). Most people recover without treatment. Severe acute hepatitis may require hospitalization.

People who have had acute viral hepatitis may become chronic carriers of the disease. Proper precautions need to be taken to prevent the spread of the disease.

What is chronic hepatitis?

Some people do not recover fully from acute hepatitis and develop chronic hepatitis, as the liver continues to sustain more damage and inflammation. Hepatitis is considered chronic if symptoms persist longer than six months. Chronic hepatitis can last years.

Different forms of:

alcohol-induced chronic hepatitis - continued damage throughout the liver from heavy alcohol consumption.
chronic active hepatitis - an aggressive inflammation and destroyer of liver cells, which usually leads to cirrhosis.
chronic persistent hepatitis - a milder inflammation of the liver, which usually does not lead to cirrhosis.

Causes:
Certain viruses and drugs may cause chronic hepatitis in some people, but not in others. Some common causes include:

viral hepatitis
heavy alcohol consumption
autoimmune disorder (when the body attacks its own tissues)
reaction to certain medications
metabolic disorder (such as hemochromatosis or Wilson's Disease)

Symptoms:
Symptoms for chronic hepatitis are usually mild. Although the liver damage continues, its progression is usually slow. The following are the most common symptoms of chronic hepatitis. However, each individual may experience symptoms differently. Some individuals may experience no symptoms, while others may experience the following:

feeling ill
poor appetite
fatigue
low fever
upper abdominal pain
jaundice

symptoms of chronic liver disease (such as enlarged spleen, spider-like blood vessels in skin and fluid retention)
The symptoms of chronic hepatitis may resemble other conditions or medical problems. Consult a physician for diagnosis.

Diagnosis:
In addition to a complete medical history and medical examination, diagnostic procedures for chronic hepatitis may include:

specific laboratory tests
liver function tests
liver biopsy to determine severity of inflammation, scarring, cirrhosis and underlying cause

Treatment:
Specific treatment for chronic hepatitis will be determined by your physicians based on:

your overall health and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Treatment of chronic hepatitis depends on the underlying cause of the disease. The goal of treatment is to stop damage to the liver and alleviate symptoms.

Treatment may include one/more of the following:

Antiviral Agent - When caused by hepatitis B or C, inflammation of the liver may be stopped with the antiviral agent interferon-alpha.

Corticosteroids - Corticosteroids may be used to treat chronic liver disease caused by an autoimmune disorder. Inflammation is suppressed, but scarring of the liver may continue.

Discontinuation of certain drugs - When chronic hepatitis is caused by certain drugs, discontinuing those drugs usually clears up any symptoms.

Preventing the spread of viral hepatitis:

Proper hygiene is the key to preventing the spread of many diseases, including hepatitis. Other preventive measures include:

vaccinations - A hepatitis B vaccine is routinely given to toddlers as part of their immunization schedule. A hepatitis A vaccine is available for people at risk for contracting the disease while traveling. (There are no vaccines for hepatitis C, D, or E at this time.)
blood transfusion - Blood transfusions are routinely screened for Hepatitis B and C to reduce the risk of infection.
antibody preparation - If a person has been exposed to hepatitis, an antibody preparation can be administered to help protect them from contracting the disease.

This page was last updated on: February 6, 2008.

For patient inquiries, call 1-800-492-5538 or click here to make an appointment.