What is hepatitis?

Hepatitis refers to inflammation of the liver. Inflammation is a tissue’s reaction to irritation or injury which generally results in swelling and can cause pain.

There are many causes of hepatitis. Viral hepatitis is caused by a virus and can either be acute (lasting less than six months) or chronic (lasting more than six months). Viral hepatitis can be spread from person to person. Some types of viral hepatitis can be spread through sexual contact.

There are five known hepatitis viruses which are categorized by the letters A through E.

Several viruses are known to cause hepatitis. Common forms of viral hepatitis include:

  • Hepatitis A: According to the Centers for Disease Control and Prevention, there were about 2,007 instances of acute hepatitis A infections in the U.S. in 2016. This form of hepatitis does not lead to a chronic infection and usually has no complications. The liver usually heals from hepatitis A within several months. However, occasional deaths from hepatitis A have occurred due to liver failure, and some people have required a liver transplant for acute hepatitis A infection. Hepatitis A can be prevented by vaccination.
  • Hepatitis B: Around 22,000 new cases of hepatitis B occurred in 2017, and around 900,000 people are living with the disease in the US. Approximately 95% of adults recover from hepatitis B and do not become chronically infected. However, a few cases cause a life-long, chronic infection. The earlier in life hepatitis B is contracted, the more likely it is to become chronic. People can carry the virus without feeling sick but can still spread the virus. Hepatitis B can be prevented by getting a vaccine.
  • Hepatitis C: Hepatitis C is one of the most common causes of liver disease in the U.S., and used to be the number one reason for liver transplant. About 75% to 85% of patients with hepatitis C develop a chronic liver infection. Roughly 2.4 million people in the U.S. are estimated to have chronic hepatitis C infection. It often does not show any symptoms. No vaccine is yet available to prevent hepatitis C.
  • Hepatitis D: Hepatitis D only happens to people who are infected by the hepatitis B virus. If you are vaccinated against hepatitis B, you will be protected against hepatitis D virus.
  • Hepatitis E: This type of hepatitis is spread by ingesting contaminated food or water. Hepatitis E is common throughout the world. Even though vaccines exist, they are not available everywhere.

Healthcare providers might not be able to identify the virus causing hepatitis as one of these. Other viruses, such as CMV, EBV, and HSV can also cause hepatitis.

Most people recover from hepatitis, and the disease is often preventable. However, it is still considered a serious health risk because it can:

  • Destroy liver tissue.
  • Spread easily from person to person.
  • Weaken the body's immune system.
  • Cause the liver to fail.
  • Cause liver cancer.
  • Cause death (in rare cases).

How does someone get or spread hepatitis?

Hepatitis A can be spread through food or drinking water carrying the virus through bits of fecal matter from an infected person. (This is called the fecal-oral route.) You can also get hepatitis A from sexual contact.

A person can get hepatitis B in many ways, including:

  • Having sex with an infected person.
  • Sharing dirty needles.
  • Being in direct contact with infected blood.
  • Getting needle stick injuries.
  • Being transferred from mother to unborn child.
  • Being in contact with an infected person's body fluids.

An infected mother has a high chance of giving hepatitis B to her child during or after birth. All pregnant women should be tested for hepatitis B. Within 12 hours of birth, infants born to mothers with hepatitis B need to receive treatment with hepatitis B antibody and hepatitis B vaccine. This can prevent transmission of hepatitis B from mother to the baby.

A person can get hepatitis C from:

  • Sharing dirty needles.
  • Being in direct contact with infected blood.
  • Getting needle stick injuries.
  • Having sex with an infected person (less common).

Blood products are currently tested for hepatitis B and C, so it is not likely that a person will get hepatitis from receiving them. However, blood transfusions or organ transplants before 1992 might have not been tested for hepatitis (in particular, hepatitis C). If you received a procedure before 1992, you might want to get tested for hepatitis.

Additionally, “baby boomers,” born in the U.S. between 1945 and 1965, are at increased risk of having hepatitis C. If you are part of this group, you should be screened for hepatitis C even in the absence of risk factors listed above. The US Preventive Services Task Force expanded the one-time screening population for hepatitis C to adults from the ages of 18-79, but this recommendation has not been finalized.

You can get hepatitis D from:

  • Being passed from mother to child during childbirth.
  • Having contact with infected body fluids or blood.

You can only get hepatitis D if you have hepatitis B. Hepatitis D is not common in the U.S.

You can get hepatitis E by eating or drinking food or water contaminated with the virus (the fecal-oral route). You can also be infected from under-cooked foods like pork, venison, or shellfish. Hepatitis E is uncommon in the U.S. but can occur after travel to a country where this infection is common. Hepatitis E can be particularly dangerous and even fatal in pregnant women.

What are the symptoms of hepatitis?

The most common symptoms of hepatitis include:

Contact your healthcare provider as soon as possible if you have any or a combination of these symptoms.

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