Hepatitis is a serious liver disease that affects millions of Americans. Get the facts on hepatitis types, causes, and treatments.
Hepatitis means inflammation of the liver, and it is most often caused by viral infections. Some types of hepatitis will cause discomfort but eventually go away, while others, like chronic hepatitis C, can be deadly.
Viral types of hepatitis — A, B,C, D, and E — are contracted in various ways. Other non-viral causes of hepatitis relate to toxic exposures and autoimmune disease.
Hepatitis C is the leading cause of liver cancer and also the number one reason for liver transplants in the United States. More than 1.2 million Americans are affected by hepatitis B, and over 3 million have chronic hepatitis C, though many don't know they are infected.
“The liver is responsible for filtering from the bloodstream harmful substances such as dead cells, toxins, fats, hormones, and a yellowish substance called bilirubin, a byproduct of the breakdown of old red blood cells,” says Rashmi Gulati, MD, medical director of Patients Medical in New York City.
“If the liver is inflamed, tender, and enlarged, it becomes unable to function normally. As a result, toxins that would normally be filtered out by the liver build up in the body, and certain nutrients are not processed and stored as they should be.”
Types of Hepatitis
Hepatitis C is the most serious of the more common viral types, says Dr. Gulati. Hepatitis C causes more than 16,000 U.S. deaths annually, according to the Centers for Disease Control and Prevention (CDC).
“About 85 percent of hepatitis C infections lead to chronic liver disease,” Gulati says. “The virus causes slowly progressing, but ultimately devastating damage to the liver.”
Both hepatitis A and B also can be dangerous. “Hepatitis A virus can cause acute liver disease, but can heal within a few months. It can cause high spiking fevers and is more severe in adults than in children,” says Gulati.
“Hepatitis B virus has an 85 percent recovery rate, while 15 percent develop cirrhosis or cancer of the liver.”
Of the rarer viral types, hepatitis D sometimes appears in conjunction with hepatitis B, making for a deadly combination. Hepatitis E is more common outside the United States and appears to put pregnant women at the greatest risk.
Toxic hepatitis is not caused by a virus, but occurs as a result of exposure to toxins like drugs and alcohol. And autoimmune hepatitis happens when the body’s immune system goes awry and attacks its own liver without the presence of a virus.
How Hepatitis Is Transmitted
Hepatitis A is usually spread from person to person or by ingesting food or water that is contaminated with the virus. In some cases, raw shellfish from polluted waters can also spread the disease.
Hepatitis B and C are usually spread through infected blood or other bodily fluids.
Doctors, dentists, and nurses, as well as staff and patients at blood banks, dialysis clinics, and pathology laboratories, are at a greater risk of developing these kinds of hepatitis due to accidental blood exposure.
Drug users who share needles are at high risk of contracting hepatitis B and C, as are those who have unprotected sex with an infected person.
Signs and Symptoms of Hepatitis
If you contract hepatitis, it may present in a way that is similar to a nasty bout of a flu, says Dr. Gulati. Common symptoms of hepatitis include:
- Appetite loss
- Muscle aches
- Joint pains
Other warning signs to look out for include dark urine, light, clay-colored stools, abdominal discomfort, and jaundice, the yellowing of the whites of the eyes or the skin due to an accumulation of bilirubin.
If you have hepatitis, a simple blood test will show elevated liver enzymes. Additional blood tests can help identify which virus, if any, is to blame.
What To Do About Hepatitis
If you have hepatitis A or B, in most cases you’ll get better with a doctor’s care and supportive treatment without specific anti-viral treatments.
Hepatitis C and other chronic forms will probably affect your life more profoundly, but you can do a lot to manage the condition and keep it under control.
If someone in your home has hepatitis, it is also important to take appropriate precautions to avoid spreading the disease.
For hepatitis A, handwashing is extremely important. For hepatitis B and C, care should be taken to avoid contact with the blood of the infected individual, even the microscopic amounts that hide in toothbrushes and on razors, so never share these items.
New antiviral medications can cure hepatitis C infections for over 90 percent of patients.
Treatment can suppress or even eradicate hepatitis C. Older treatments for hepatitis C are combination antiviral therapy with pegylated interferon and ribavirin.
The treatment came with difficult side effects, and was effective for only about 40 to 80 percent of patients, depending on the type of hepatitis C they carried.
Newer drugs approved by the FDA in 2013 and 2014 are more effective, curing the viral infection for 90 percent of patients or more. New antiviral medications to treat hepatitis C include simeprevir (Olysio) and sofosbuvir (Sovaldi), and combination therapies include Harvoni and Viekira Pak.
Vaccinations are available for hepatitis A and B for at-risk individuals, such as health care workers.
“For hepatitis A, vaccination for those patients with risk of exposure or known exposure can prevent transmission of the disease,” says Kimberly Brown, MD, chief of the division of gastroenterology and hepatology at Henry Ford Hospital in Detroit.
“Patients who live with someone with hepatitis B, have a sexual partner with hepatitis B, are born to a mother with hepatitis B, or are health care workers should be vaccinated [against hepatitis B]. Since there is no vaccination for hepatitis C, patients need to be aware that avoiding blood-to-blood contact with infected individuals is critical.”
The best approach is to take all precautions to avoid hepatitis. This includes avoiding sexual or blood contact with someone who may be infected and discussing your concerns with your doctor if you feel that you may be at risk.