What’s to know about viral hepatitis?

Hepatitis involves inflammation of the cells of the liver, and liver damage. There are various types and causes of hepatitis, however the symptoms may be similar.

The liver is essential for the removal of toxins from the blood, vitamin storing, and hormone production. However, hepatitis can interfere with those processes.

At least five viruses have the potential to cause hepatitis. Hepatitis A, B , and C are among the three most common. Infection can lead to life-threatening complications with any of these three viruses.

Each type has different characteristics, and there are different ways of transmission, but the symptoms appear to be similar.

This article covers the various types of hepatitis, including their symptoms, treatments and outlooks.

Hepatitis A

A lady having nausea and low appetite.
A person with hepatitis A may experience nausea and low appetite.

The Centers for Disease Control and Prevention ( CDC) reports that about 6,700 new infections of hepatitis A occur in the United States each year.

Overall, over the past 20 years , the number of U.S. cases has declined — largely due to immunization — but sometimes outbreaks occur.

Hepatitis A is usually transmitted through contaminated food or water. It is common in many countries, particularly those without efficient sanitation systems.

Symptoms include:

  • jaundice
  • abdominal pain
  • nausea
  • low appetite

Most people don’t feel symptoms at all, however. Usually those who do make a full recovery in a few weeks to several months. After this, they have immunity to it. Children under the age of 6 generally show no symptoms.

Hepatitis A can be fatal, in rare cases. There are, however, safe and effective vaccines which protect against this virus.

Treatment

There is no cure for hepatitis A, but therapy can help manage symptoms. Alcohol avoidance can help recovery but most people recover without intervention.

Hepatitis B

Hepatitis B infection is usually acute, or short-term, but can get chronic — especially in children.

Long-term complications, such as hepatitis cancer or cirrhosis, can affect some 15–25% of people with chronic hepatitis B. There is no cure, but treatment has the potential to help manage the condition.

The CDC estimates there are currently around 862,000 people living with hepatitis B in the U.S.

The virus can transmit through:

  • having unprotected sexual intercourse
  • sharing needles
  • having a tattoo with unsterilized needles
  • sustaining accidental skin pricks with medical equipment
  • sharing personal items, such as a toothbrush or razor
  • breastfeeding, if the mother has the virus

The symptoms are similar with those of other hepatitis types. These include jaundice and abdominal pain.

There is a safe and efficient vaccine that can protect humans from infection of hepatitis B. The number of cases in countries where the vaccine is available has decreased significantly.

Treatment

LThere is no cure for hepatitis B but symptoms can be treated by compassionate treatment. A doctor may prescribe antiviral medication in cases of chronic illness, and they will monitor the liver regularly to check for damage over time.

A person also should avoid alcohol throughout treatment and recovery.

Hepatitis C

Hepatitis C is a blood-borne virus that typically transmits by sharing needles or other equipment associated with medications.

Other people at risk include healthcare workers who are dealing with sharps and children whose mothers have the virus.

It may be a short-term illness, but a chronic long-term infection can grow up to 85 percent of people.

An individual does not have any symptoms, and about half of people living with the virus may not know they do. They can pass it on to someone else without knowing it.

The CDC reports that there are about 44,300 new cases of hepatitis C per year and that there are actually about 2,4 million people living with this virus in the U.S. As of 2010 , the number has grown.

Treatment

The body will eliminate the virus over time in about 25 percent of people. But in some it may remain in the body and become chronic.

Unless chronic hepatitis develops a doctor will not treat hepatitis C, according to the CDC. Then, for 8–12 weeks, they may prescribe an oral medication course, during which nine out of 10 people will no longer have symptoms.

Combination therapy in certain individuals with some strains of the virus may kill the virus.

Like other forms of hepatitis, alcohol should be avoided by people with hepatitis C.

Symptoms

Many people with hepatitis have moderate symptoms, or no. They will do this 2 weeks to 6 months after infection if signs do show. This applies to all types of hepatitis.

Acute hepatitis

A person can experience symptoms similar to those of mild flu during the acute, or initial, phase of a hepatitis infection including:

  • fatigue
  • pale stools
  • a loss of appetite and weight
  • a fever
  • muscle or joint aches
  • nausea and vomiting
  • abdominal pain
  • jaundice, or a yellowing of the eyes
  • itchy skin
  • malaise, or a general feeling of being unwell

The acute phase is typically not harmful but can cause chronic infection and serious liver problems over time. It may take decades to make these appear.

An individual with chronic hepatitis may experience progressive liver failure, with symptoms that may include:

  • jaundice
  • swelling of the lower extremities
  • confusion
  • blood in the feces or vomit

Some symptoms of jaundice include:

  • dark urine
  • hives
  • itchy skin
  • light colored feces
  • yellow skin, whites of the eyes, and tongue

Diagnosis

The symptoms of the different forms of hepatitis are similar, but laboratory testing will determine the particular form that a person has.

A doctor will conduct a physical examination and ask questions about the potential exposure to hepatitis that a person may have.

They may suggest testing with blood or nucleic acid. Blood testing can detect antibodies and determine liver function, and nucleic acid tests — for hepatitis B and hepatitis C — can confirm the rate at which the virus reproduces in the liver, indicating how active it is.

Prevention

Ways of avoiding transmission of hepatitis will depend on type.

Experts recommend regular screening for hepatitis B and C for those at higher risk. Even during pregnancy doctors regularly test for hepatitis B and C.

The following sections will discuss forms of prevention by type.

Hepatitis A

Hepatitis A mostly spreads through infected food and water.

Some ways of preventing infection include:

  • washing the hands carefully after using the bathroom and before eating
  • ensuring that food is fully cooked and appropriately stored
  • drinking only bottled water when traveling
  • avoiding or peeling fruits and vegetables that may have been washed or grown in contaminated water

A person may wish to ask their doctor about the hepatitis A vaccine, especially if they are traveling to an area where the virus is prevalent.

Hepatitis B and C

To minimize the risk of transmission:

  • A person should talk openly with any sexual partners about any viruses they may have.
  • Use a barrier method, such as a condom, during sex.
  • Only use previously unused, clean needles.
  • Avoid sharing toothbrushes, razors, and manicure instruments.
  • Check that any tattoo or acupuncture equipment is sterile.

People with a high risk of hepatitis B exposure may ask their doctor about a vaccination but there is no hepatitis C vaccine.

Anyone who thinks they may have any type of hepatitis should seek medical assistance, as a doctor can advise on how to reduce the risk of complications and avoid transmitting the virus.

The risk of contracting a hepatitis B or C infection is higher in people with HIV. This may also have a more serious effect, as the body is less able to combat the infection.

To reduce their risk of infection with hepatitis and complications, HIV patients should:

  • take precautions to prevent infection and transmission of hepatitis
  • attend all health checks
  • adhere to their treatment plan

Immunization may prevent hepatitis A and B but it does not prevent hepatitis C. Treatment for hepatitis B and C is available but not for A.

Outlook

Several factors that influence the result include a person’s form of hepatitis, and whether or not they have symptoms and seek treatment.

Some people don’t know they have untreated hepatitis until there’s a liver failure.

Different forms of hepatitis have varying chances of recovery. For instance:

  • Hepatitis A: This type normally resolves within 2 months without having any long-term effects, and the person will have lifelong immunity afterward.
  • Hepatitis B: Most adults recover within 90 days and have lifelong immunity. However, 90% of infants, 20% of older children, and 5% of adults develop a chronic infection. This can lead to severe complications, such as liver cancer or cirrhosis.
  • Hepatitis C: The infection is chronic in 75–85% of people who have it, and 1–5% of people will experience life threatening complications. Treatment is available, but 15–25% of people will recover without it.

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