Hepatitis

While you may hear that alcohol use, unprotected sex or sharing infected needles are often linked to hepatitis, those aren’t the only things that can trigger liver inflammation.

Viral hepatitis

Often, viruses are to blame. Viral hepatitis can spread from person to person. You may have:

• Hepatitis A: Illness from this virus can last up to two months. It’s highly contagious. And while it might have noticeable symptoms, it usually doesn’t cause long-term complications.
• Hepatitis B: This virus can become an ongoing (chronic) illness that can cause long-term liver damage. It’s most often transmitted by body fluids.
• Hepatitis C: Infected needles are the most frequent way this virus starts. You may not notice any symptoms until it progresses to liver failure. It also can be a chronic condition.
• Hepatitis D: This virus only affects people infected by hepatitis B. This “superinfection” can doubly stress your liver and cause liver failure.
• Hepatitis E: Viruses in contaminated food or water can trigger this type of liver inflammation. It’s uncommon in the U.S., but you could get it if you travel to a place where it’s common.

Autoimmune hepatitis

Viruses aren’t the only reasons you may get hepatitis. Sometimes, your body’s immune system (which fights off invaders like viruses and bacteria) gets confused. And it thinks your liver is an enemy. It then attacks your liver, which can trigger autoimmune hepatitis.

Toxic hepatitis

Your liver filters toxins from your bloodstream and helps move them out of your body. But it can become overloaded. And you may get toxic hepatitis from chemical exposure, taking too many medications like acetaminophen (Tylenol^®), certain antibiotics or drinking too much alcohol (alcohol-induced hepatitis).

While toxic hepatitis can be a reaction to a single overindulgence and stop when regular exposure ends, it can also become a chronic condition — and cause scarring and permanent liver damage (cirrhosis). This is a risk of chronic alcohol use.

Steatotic liver disease

Excess fat can build up in your liver. This is called steatotic liver disease (previously known as fatty liver disease). One common cause is alcohol use (alcohol-related liver disease, or ALD). Fat can also accumulate in your liver in the absence of alcohol use. This is most often seen in people with some combination of obesity, diabetes, high blood pressure and elevated blood lipids.

When this happens, you may be diagnosed with metabolic dysfunction associated steatotic liver disease (MASLD). A small number of people with MASLD will develop an aggressive form, called metabolic dysfunction associated steatohepatitis (MASH).

Hepatitis sometimes has no symptoms. Your provider may spot signs of it, like elevated liver enzymes, during routine blood tests. Other times, you may have pain in the upper right side of your belly (abdomen) or a fever. You may not feel like eating or have joint pain. Or if it’s more severe, you may even notice your skin and eyes look yellow (jaundice).

The first step in treating hepatitis is to find out what’s causing it so we can pinpoint what kind you have. The best way to do this is to spend time getting to know you, understanding your symptoms and doing a physical exam and testing.

What to expect at your first visit

Your story is important to us. We want to know how you’ve been feeling. We’ll ask if you’ve had symptoms and for how long and how they’ve affected your life. We’ll also want to know if you’ve had any testing for liver problems and if anyone in your family has had a liver condition or other health problems.

Next, you’ll get a physical exam so your provider can check your overall health and look for signs of hepatitis or other health conditions. They’ll also order tests to help them find out what’s causing your symptoms and pinpoint a correct diagnosis.

Testing for hepatitis

When building a treatment plan for hepatitis, it’s important to know what’s causing it and what type it is. So, you’ll have one or more tests to help our team learn more about what’s going on. You may have a combination of blood and imaging tests like:

• Comprehensive metabolic panel (CMP).
• Liver function tests.
• Lipid panel.
• Acetaminophen level test.
• Abdominal ultrasound.
• CT scan.
• MRI.
• Elastography.
• Liver and spleen scan.
• Liver biopsy.

Meet Our Hepatitis Team

You’ll have a handpicked team of experienced healthcare providers to guide your care, build a personalized treatment plan and keep an eye on your progress. These may include:

• Gastroenterologists.
• Hepatologists.
• Radiologists.
• Pathologists.
• Nurse practitioners.

Your hepatitis treatment depends on the type you have. Your providers will use your test results and medical history to create a care plan that focuses on you and your needs.

There are hepatitis A and B vaccine injections that protect you from these infections. But if you do have the virus, there are different ways to treat each kind of viral hepatitis:

• For hepatitis A, we’ll keep a close eye on how your liver works as you recover. You’ll want to rest, drink plenty of fluids and avoid things that stress your liver, like alcohol, smoking and medications not prescribed by your providers.
• If you contract hepatitis B in adulthood, this infection may make you ill for a few days (or weeks) but usually gets better on its own. If the virus stays around for six months or longer, it’s called chronic hepatitis B. In this case, antiviral medications may be recommended to reduce or eliminate liver damage.
• Hepatitis C rarely causes symptoms and often doesn’t go away on its own. Fortunately, a short course of treatment will eliminate this virus.

Autoimmune hepatitis treatments

We use medications to treat this kind of hepatitis. You may take:

• Corticosteroids like Prednisone^®.
• Immunosuppressants like azathioprine (Imuran^®).

These medications can reduce inflammation and keep your immune system from attacking your liver.

Toxic hepatitis treatments

Your liver can heal itself by replacing its cells (regeneration) — if they aren’t too damaged. So, the main way to treat toxic hepatitis is to avoid exposure to what’s causing it — chemicals, prescription medications, nutritional supplements, alcohol and recreational drugs. It may take several weeks to notice any improvement.

Metabolic dysfunction-associated steatohepatitis treatment

The goal of treating MASH is to reduce the amount of fat in your liver so it can heal. You can do this by:

• Losing weight.
• Managing blood sugar.
• Eating a heart-healthy diet.
• Exercising regularly.

Some studies also show that drinking more than two cups of caffeinated coffee daily can help prevent your liver from stiffening or scarring from MASH.

Liver transplantation for hepatitis

If the hepatitis is severe or doesn’t respond to other treatments, your providers may recommend a liver transplant from a deceased donor or a living liver donor. Your care team will go over all surgery options with you if they feel it’s the best treatment.

Taking the Next Step

Your liver works hard to help move toxins out of your body. But, like any part of your body, it can get hurt. And when this happens, inflammation, or hepatitis, can set in. The good news is that hepatitis is usually treatable because your liver can grow new, healthy cells if it’s not too damaged. If you’re diagnosed with this condition, we take the time to listen to and answer your questions. We’ll figure out what’s causing the hepatitis and plan the best treatment for you.