Jyoti Kinghorn 
Hepatitis is a term used to describe swelling and inflammation of the liver. Depending on the cause of it, it can be acute and last for a short time, or a chronic long-term condition that progressively gets worse. Symptoms of acute hepatitis include a feeling of malaise, fatigue, nausea, jaundice, dark-colored urine, abdominal pain or discomfort, abdominal swelling, and clay-like stools. Symptoms of chronic hepatitis can take decades to appear but can result in significant liver damage and the development of liver cancer.
The following are the main causes of hepatitis.
1. Viruses
Viral hepatitis is the most common type of hepatitis. It is caused by the hepatitis viruses A, B, C, D, and E. In the U.S., hepatitis A, B, and C are the most common.
Hepatitis A
Prevalence. In the U.S., 5,728 cases of hepatitis A were reported and about 11,500 infections were estimated by the CDC in 2021.
How the disease is spread. Often caused by eating contaminated foods and drinks, this type of hepatitis is contracted by ingesting the Hepatitis A virus. The virus is transmitted through an infected person’s fecal matter. Poor hygiene and foods prepared with contaminated hands or using contaminated water can cause this infection. Since only microscopic amounts of the virus are needed for infection, close personal contact with the infected person can also spread the infection.
Illness and treatment. The symptoms of hepatitis A can range from mild to severe and include malaise, loss of appetite, nausea, and fever. A person may also observe dark-colored urine, diarrhea, and typical jaundice with yellowing of the skin and eyes. In most adults and children, the body can fight off the virus on its own in about a week to 2 months, and no additional treatment is needed.
Vaccination. Effective vaccines that can prevent hepatitis A are available. Infants are given the first dose of the vaccine between 12 and 23 months of age. A second dose is given at least 6 months after the first dose.
Hepatitis B
Prevalence. The CDC estimated about 13,300 new infections of hepatitis B in 2021. They also estimate that 640,000 adults in the U.S. are living with chronic hepatitis B.
How the disease is spread. Hepatitis B spreads when the body fluids such as blood and semen of the infected person enter the body of an uninfected person, even in microscopic quantities. It can be spread sexually by having sex with the infected person. It can also spread by sharing needles, syringes, glucose monitors, etc. Close contact with the infected person’s blood, open sores, or using their razors or toothbrushes can also spread the virus. The virus easily passes from infected pregnant people to their fetuses. The virus does not spread by coughing, sneezing, or kissing.
Illness and treatment. There is no treatment for hepatitis B. The infection is usually acute, and in 90% of the people who get it, it goes away on its own in 4-8 weeks. But about 5% of the people who get it become carriers, and continue to spread it even after they have recovered.
Acute hepatitis B has typical symptoms of jaundice, fatigue, dark-colored urine, etc. To treat it, doctors generally advise infected persons to get lots of rest, good nutrition, and plenty of fluids while closely monitoring their symptoms.
Chronic hepatitis B can be more dangerous, have few symptoms if any, and can damage the liver over time. It is a leading cause of liver cancer.
Vaccination. There are effective vaccines that can prevent hepatitis B. Infants are given their first dose of the hepatitis B vaccine right after birth in their first 24 hours. The second dose is given two months after the first dose, and the third dose is given between 6-18 months of age.
Hepatitis C
Prevalence. In the U.S., the CDC estimated about 69,800 new infections in 2021. They also estimate that 2.2 million adults in the U.S. are living with hepatitis C.
How the disease is spread. Hepatitis C spreads when someone is infected by microscopic amounts of blood from an infected person. It can spread by sharing needles or syringes. It can also spread through unhygienic body piercing or tattoo facilities. It does not spread through coughing, sneezing, or kissing. The virus can spread from an infected mother to the baby as a fetus or during birth.
Illness and treatment. Hepatitis C can have symptoms ranging from mild illness that lasts a few weeks to chronic long-term illness. Less than half of the people who get infected by Hepatitis C can clear the virus from their systems on their own. However, certain antiviral drugs can cure the disease in about 95% of the infected people. In other cases, hepatitis C can damage the liver over time. It is a leading cause of liver cancer and liver transplants.
Vaccination. Currently, there is no vaccine available to prevent hepatitis C.
2. Liver damage from ingested materials
The liver is a critical organ responsible for over 500 vital functions in the body. Its functions include the breakdown of toxic substances. But sometimes the substances ingested can be so toxic that they damage the liver over time causing toxic hepatitis.
Examples of such substances include:
- Excess alcohol consumed for a long period.
- Poisons or chemicals ingested knowingly or accidentally. Examples include paraquat (weed killer) and vinyl chloride (used in making plastics).
- Medications such as statins, antifungal drugs, antiviral drugs, steroids, etc. taken in high doses for long periods.
- Over-the-counter pain relievers. For example, acetaminophen and Nonsteroidal anti-inflammatory drugs (NSAIDs), which are present in over-the-counter drugs such as Tylenol and Motrin, can cause liver damage if taken in more than the recommended dosage on the packaging or when mixed with alcohol or other drugs.
- Dietary supplements that may be harmful, such as those with aloe vera, kava, cohosh, etc.
3. Autoimmunity
This type of hepatitis happens when the body’s immune cells malfunction and attack the healthy liver tissue. This type of hepatitis cannot be prevented. Once identified, the damage to the liver can be slowed down by medications such as prednisone and azathioprine. Prednisone is a steroid drug that has serious side effects when taken long-term including high blood pressure, diabetes, weight gain, and thinning and breaking of bones. Therefore, physicians start with a high dose and then taper it down to where it is the minimum amount the patient requires to stop their hepatitis from progressing.
When the disease is not controlled, patients may develop cirrhosis (irreversible scarring of the liver) and liver failure.
The information provided in our blog posts is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
