Hepatitis

What is hepatitis?

Hepatitis is inflammation in your liver. Inflammation is your body’s response to an infection or injury. Many things can injure your liver and trigger hepatitis. Certain viral infections cause hepatitis. But you also can develop it if you have diseases that affect your liver or you’re exposed to toxins like chemicals, alcohol or drugs.

The condition may cause symptoms that happen suddenly and then go away within six months (acute hepatitis). But you may have hepatitis that doesn’t go away and slowly gets worse. This is chronic hepatitis.

Types of hepatitis

There are several types of hepatitis. Each type can be acute or chronic. Some types are more common than others:

• Viral hepatitis. This is the most common type of hepatitis. There are several types of viral hepatitis. The most common ones in the U.S. are hepatitis A, hepatitis B and hepatitis C. Hepatitis D and hepatitis E aren’t as common.
• Toxic hepatitis. This is hepatitis you can get from exposure to chemicals. Alcohol-induced hepatitis and drug-induced hepatitis are other types of toxic hepatitis. Toxic hepatitis can be acute or chronic.
• Autoimmune hepatitis. This chronic hepatitis is rare. It happens when your immune system attacks liver tissues by mistake.

What are the symptoms of hepatitis?

Hepatitis can be sneaky. You may not notice changes in your body right away. When you do, you may notice symptoms like:

• Diarrhea
• Fatigue
• Feeling weak or generally uncomfortable
• Fever (if you have a viral infection)
• Nausea or loss of appetite
• Pain on the right side of your upper belly

You may have other symptoms if you have chronic hepatitis that does more damage to your liver. Chronic hepatitis symptoms include:

• Confusion, disorientation or drowsiness (hepatic encephalopathy)
• Dark-colored pee and light-colored poop
• Itchy skin (pruritus)
• Yellowish skin or a yellow tint to the whites of your eyes (jaundice)

What causes hepatitis?

Many things can cause hepatitis. The most common cause is exposure to viruses. Health conditions that damage your liver can cause hepatitis. So can exposure to toxins like alcohol, drugs — including medications — and chemicals.

How is viral hepatitis transmitted (spread)?

Some of the ways viral hepatitis can spread include:

• Bodily fluids. Hepatitis B can spread through saliva, semen and vaginal fluids. You can be infected with hepatitis B by having unprotected sex with someone who has the virus. Chronic hepatitis B can be spread from a parent to a child during birth.
• Contaminated blood. Hepatitis B, C and D can spread through contact with blood from someone who has the virus. This typically happens when people share needles for intravenous drug use.
• Food poisoning. You can get hepatitis A or E if you eat food or drink water that contain the viruses.

What other conditions cause hepatitis?

Any disease that affects your liver can cause hepatitis. Conditions that may cause hepatitis are:

• Cholestasis. This condition causes bile to back up in your liver, causing inflammation.
• Cytomegalovirus (CMV). Herpes viruses cause CMV. It can lead to liver issues (CMV hepatitis) if you have a weak immune system.
• Epstein-Barr virus. This very contagious virus often causes acute hepatitis and can lead to chronic hepatitis.
• Hemochromatosis. Primary hemochromatosis is a rare genetic condition that causes your body to absorb too much iron.
• Metabolic dysfunction-associated steatotic liver disease (MASLD). In this condition, you have excess fat in your liver, causing hepatitis.
• Wilson disease. This rare genetic condition happens when you have too much copper in your body. High copper levels in your liver cause inflammation.

What are the complications of hepatitis?

Severe or persistent hepatitis can lead to:

• Cirrhosis. This is scarring in your liver from chronic hepatitis. This scarring happens when your liver tries to repair damage that disease causes. Cirrhosis of the liver is severe liver disease.
• Liver cancer. Hepatocellular carcinoma (HCC) is the most common form of liver cancer. Studies show that cirrhosis (scarring of liver) that hepatitis B and hepatitis C viruses cause account for about half of all cases of hepatocellular carcinoma.
• Liver failure. This is when your liver stops working. Acute viral hepatitis that attacks your liver may cause liver failure. Cirrhosis (scarring of your liver) from chronic hepatitis can cause liver failure.
• Portal hypertension. In this condition, scar tissue from cirrhosis keeps blood from moving through a major vein in your liver.

How do healthcare providers diagnose hepatitis?

They’ll ask about your symptoms and do a physical examination. They’ll ask about your medical history. They may do the following tests:

• Liver function tests
• Imaging tests including a nuclear liver and spleen scan or elastography
• Liver biopsy

How is hepatitis treated?

Many things can cause hepatitis. There’s no single way to treat it. In general, treatments include:

• Lifestyle changes. Changes like avoiding alcohol, eating a variety of fruits and vegetables and getting extra rest help with the symptoms of hepatitis A and acute hepatitis B.
• Antivirals. This is treatment for chronic hepatitis B. Antivirals can’t cure it. But taking them reduces the risk that you’ll spread hepatitis B to someone else and decreases the chances of causing complications. You’ll need to take these medications for the rest of your life.
• Direct-acting antivirals (DDA). These drugs can cure hepatitis C. They target proteins that viruses use to infect cells in your body.
• Liver transplant. You may need a liver transplant if chronic hepatitis B leads to liver failure.

Is there a cure for hepatitis?

That depends on the type of hepatitis that you have. For example, hepatitis A often goes away without medical treatment. Direct-acting antivirals can cure hepatitis C. And a liver transplant may cure chronic hepatitis B. If you have hepatitis, ask your healthcare provider to explain what you can expect after treatment.

Can hepatitis be prevented?

You can help prevent hepatitis by:

• Getting vaccinated. Vaccines are available to help prevent viral hepatitis A and B.
• Practicing good hygiene. Wash your hands after you use the bathroom, and before and after you handle food.
• Using medications as directed. If you have a substance use disorder, treatment can help prevent toxic hepatitis.

What’s the outlook for hepatitis?

Many things can affect what you can expect if you have hepatitis. For example, acute hepatitis A often goes away without treatment. On the other hand, chronic hepatitis B is a lifelong disease. If you have it, you’ll always need to take medication.

How do I take care of myself?

If you have hepatitis, the best thing you can do is to take care of your liver. Here are some tips:

• Avoid alcohol. Drinking more than 1.5 to 2 ounces of alcohol a day can lead to toxic substances building up in your liver.
• Eat well. Fill your plate with lean protein, fruits and vegetables. The Mediterranean diet is an example of a food plan that supports liver health.
• Manage your mental health. Living with long-term disease like chronic hepatitis can be stressful. Stress management techniques can help.

When should I seek care?

Talk to your healthcare provider if you notice changes in your body that could mean hepatitis is getting worse. Watch for symptoms like:

• New pain in your belly
• Fatigue
• Loss of appetite
• Unexpected weight loss

I have hepatitis. How do I keep it from spreading?

Hepatitis spreads in different ways and over different periods of time. For example, if you have acute hepatitis A, you can spread the disease before you even know you’re sick and for a few weeks after your symptoms start. But if you have chronic hepatitis B, you’re contagious for the rest of your life. You may need to take medication to reduce the risk you’ll pass the virus on to someone else. Your healthcare provider will explain how you can reduce that risk.