Viral hepatitis is a liver infection caused by viral infection, and may be mild or severe. Most often, it is caused by one of three unrelated viruses, called Hepatitis A, Hepatitis B, Hepatitis C, but may be caused by one of several other viruses.
Hepatitis C is the most common blood-borne infection in the United States.
Hepatitis A is food-borne, self-limiting immunizing, acute not chronic. Hepatitis B, C is blood-borne, acute or chronic, may be asymptomatic, or flu-like illness (fatigue, aches).
Symptoms common to hepatitis A, B, and C include:
- Abdominal tenderness or pain, especially in the area of the liver on your right side inside the lower ribs
- Loss of appetite
- Dark urine
- Muscle and joint pain
- Yellowing of skin and eyes (jaundice)
Other symptoms of Hepatitis A are low fever, vomiting, and itching. It may have no symptoms at all, and usually last less than two months.
Most children with Hepatitis B and some adults have no symptoms at all. Hepatitis C's symptoms, if any, tend to be mild and flu-like until the liver has been severely damaged.
Causes and Prevention
Hepatitis A is caused by the Hepatitis A virus, usually ingested with a tiny amount of fecal matter from:
- Someone with Hepatitis A using the toilet, not washing his/her hands carefully, and handling food
- Drinking contaminated water
- Eating sewage-contaminated raw shellfish
- Contact with an infected person
- Rarely, blood transfusion
Risk factors include being in places with high incidence of Hepatitis A, male homosexual activity, and use of illegal drugs. People with chronic liver disease (including Hepatitis B and C) should be immunized against Hepatitis A.
Hepatitis B is caused by the Hepatitis B virus (HBV), passed in bodily fluids by:
- Sexual contact
- Sharing needles and accidental needle sticks
- Transmission from mother to child during childbirth
Risk factors include polygamous unprotected sex, unprotected sex with someone with HIV, male homosexual activity, having certain sexually transmitted diseases, sharing needles, having dialysis for kidney disease, and being in a place with high incidence of Hepatitis B, like Africa, parts of Asia, and Eastern Europe.
Hepatitis B and C are caused by the hepatitis B and C viruses (HBV and HCV), carried by contaminated blood in:
- Blood transfusions before improved screening in 1992
- Shared needles
- Rarely, transmission during childbirth
- Rarely, sexual contact
Risk factors include exposure to infected blood, taking illegal drugs, being HIV-positive, having a piercing or tattoo in an non-sterile environment, long-term dialysis treatment, and being born to a mother with Hepatitis B or C.
Hepatitis A is detected with a blood test.
Since Hepatitis B and C often begin damaging the liver years before exhibiting symptoms, healthy people with risk factors are often screened for them. If you have one or more of the risk factors listed above, ask your WellStar physician about having a hepatitis screening.
The HBV test indicates whether you can pass the virus to others, whether you're immune to HBV (either from having recovered from it or from immunization), and whether you have ever had a Hepatitis B infection. The Hepatitis C test helps determine whether you have Hepatitis C, the quantity of Hepatitis C virus in your blood, and the genetic type of your Hepatitis C virus.
If you have Hepatitis B or C, you may undergo more tests to gauge the severity of your HBV infection and the damage to your liver, possibly including further blood tests and a liver biopsy. Although it is not always clear what caused the infection, it is generally useful to have some idea of when infection likely occurred.
No treatment exists for Hepatitis A. The vast majority of patients recover on their own in a month or so with no permanent damage and lifetime immunity. In the meantime, you will have less energy, will have to manage your nausea, and should rest your liver by avoiding alcohol. Discuss any medications you are taking with your WellStar physician.
If you have been exposed to Hepatitis B, an injection of Hepatitis B immune globulin within 24 hours will help protect you from developing Hepatitis B. If you contract Hepatitis B, your WellStar physician. will determine whether it is acute or chronic. If it is acute, you may recover on your own. Your WellStar physician. will recommend another Hepatitis B test to confirm its disappearance. If you have chronic Hepatitis B, your WellStar physician. may recommend antiviral medications to reduce its ability to harm your liver. In very severe cases, your liver may be damaged enough that you require liver transplantation.
Treatment for Hepatitis C is not always necessary. If your liver abnormalities are not severe, your WellStar physician. may recommend only follow-up blood tests to monitor your liver function. When Hepatitis C is treated, it is with antiviral medications, usually a combination taken over several weeks. If the first course does not remove the HCV, a second may be recommended. These antivirals may have side effects, such as depression and flu-like symptoms, and may need to be delayed or stopped.
In severe cases of Hepatitis B and C, liver transplant may be an option, but even this is not a cure, as the infection is likely to recur.