Medically reviewed by Ayanna Lewis, M.D.
July 28, 2022, is World Hepatitis Day.
Did you know that more than half the people living with hepatitis don’t know they have it? We reached out to Ayanna Lewis, M.D., a gastroenterologist and member of HealthyWomen’s Women’s Health Advisory Council, to find out what people should know about this viral infection.
Viral hepatitis is a viral infection that causes inflammation and damage to the liver.
There are five common types of viral hepatitis. Most people have heard of hepatitis A, B and C — but there are also two others: hepatitis D and E.
Hepatitis A is found in the stool of an infected person and is most often spread through contaminated food or water. Hepatitis B is transmitted through hepatitis B infected blood or other bodily fluids, such as semen.Hepatitis C is spread through exposure to hepatitis C-infected blood.Hepatitis D only occurs in people who are also infected with hepatitis B.Hepatitis E is rare and is spread through food or water that has been contaminated by the virus found in an infected person’s stool.
Not surprisingly, the more well-known types of hepatitis — A, B and C — are the most common. Of the three, hepatitis C was the most common in 2019.
The risk factors for getting viral hepatitis are closely related to how it’s spread. Hepatitis A spreads by eating or drinking contaminated food or water. Working or traveling in countries where the virus is common that have poor food safety practices is a common risk factor.
Hepatitis B and hepatitis C are both transmitted through contaminated blood. Common risk factors for these types include sharing needles during IV drug use, having a job that exposes you to potentially contaminated blood, or being born to an infected mother. Hepatitis B can also be spread through other bodily fluids such as semen. So, engaging in unprotected sex is a risk factor for hepatitis B.
Hepatitis A symptoms include gastrointestinal problems like nausea, vomiting, diarrhea, abdominal pain and loss of appetite. Other possible symptoms are low-grade fever, fatigue, dark urine, joint pain, jaundice (yellowing of the skin and whites of the eyes), clay-colored stool or intense itching. Hepatitis B and hepatitis C infections often have no symptoms, but when symptoms do appear, they are similar to those of hepatitis A.
Because hepatitis infections often have no symptoms, you can have them for years without knowing. This can lead to disastrous consequences, such as cirrhosis, which is severe liver disease, or even liver cancer.
Today, all donated blood is screened for hepatitis B and hepatitis C. And the Centers for Disease Control and Prevention (CDC) recommends screening all adults over 18 for hepatitis C at least once in their life. It also recommends screening for hepatitis B in at-risk populations. Doctors diagnose hepatitis based on symptoms, a physical exam, blood tests, imaging (ultrasonography, CT scans), and when necessary, a liver biopsy.
Treatment for viral hepatitis varies by the type and stage of the infection. Hepatitis A infections usually go away on their own within two months. It is important to get plenty of rest, hydration and good nutrition when healing. In contrast, hepatitis B and hepatitis C may become chronic conditions lasting six months or more. These can lead to liver disease. If caught within 12 hours of exposure, hepatitis B can be treated with an injection of immunoglobulin (an antibody). The hepatitis B vaccine should also be given if the person has not been vaccinated. People with chronic infections may need treatment for the rest of their lives to reduce the risks of developing liver disease and infecting others. However, in the last decade, there have been exciting breakthroughs in the treatment of hepatitis C infections using direct-acting antiviral drugs, which can cure the infection within 8-12 weeks with fewer side effects than the older treatments.
Unfortunately, there are no vaccines for hepatitis C, D or E. However, safe and highly effective vaccines that protect against hepatitis A and hepatitis B do exist, and they are a part of the CDC’s recommended child and adolescent immunization schedule. Adults who did not get vaccinated during childhood may also get the vaccines. For guidance on when it might be appropriate, see the CDC’s adult immunization schedule and consult your primary care provider.
Yes, hepatitis is inflammation of the liver tissue, and there are other non-viral forms of hepatitis. They include autoimmune hepatitis, ischemic hepatitis, alcoholic hepatitis, hepatitis from a drug-induced liver injury, and hepatitis that is the result of other infections.
A hepatitis flare-up most often refers to patients with chronic hepatitis B infections who experience a sudden increase in liver inflammation. This is usually the result of a change in the body’s immune defenses against hepatitis B. An example is reactivation of hepatitis caused by medications that suppress the immune system, such as chemotherapy, antirejection drugs and corticosteroids. Depending on the cause of the flare-up, antiviral therapies might be used for treatment. In the case of autoimmune hepatitis, flare-ups could be a result of an overactive immune response. In those cases, medications that suppress the immune system may be needed.