Viral Hepatitis

ExitCare ImageHepatitis is an inflammation of the liver. It can be caused by many different things, including several different viruses. These viruses are named hepatitis A, B, C, D, and E. All these viruses can cause short-term (acute) hepatitis. The hepatitis B, C, and D viruses can also cause long-standing (chronic) hepatitis. Chronic hepatitis infection is prolonged and sometimes lifelong. Other viruses may also cause hepatitis but have not yet been discovered.

SYMPTOMS

Some people have no symptoms. Others may have:

  • Fatigue.

  • Abdominal pain.

  • Loss of appetite.

  • Nausea.

  • Vomiting.

  • Low-grade fever.

  • Yellowing of the skin (jaundice).

HEPATITIS A

Disease Spread

Primarily through food or water contaminated by feces from an infected person.

People at Risk

  • Travelers to any area of the world with poor sanitation.

  • People living in areas where hepatitis A outbreaks are common.

  • People who live with or have close contact with an infected person.

  • During outbreaks:

  • Daycare children and employees.

  • Men who have sex with men.

  • Injection drug users.

  • People who eat raw or undercooked shellfish (oysters, clams, mussels).

  • People who live or work in institutions.

Prevention

  • Receive the hepatitis A vaccine.

  • Avoid tap water, ice cubes made from tap water, and uncooked or inadequately cooked foods when traveling to areas with poor sanitation.

  • Avoid eating raw or undercooked shellfish.

  • Practice good hygiene and sanitation.

Treatment

Hepatitis A usually resolves on its own over several weeks.

HEPATITIS B

Disease Spread

  • Through contact with infected blood.

  • Through sex with an infected person.

  • From mother to child during childbirth.

People at Risk

  • People who have sex with an infected person.

  • Men who have sex with men.

  • Injection drug users.

  • Children of immigrants from disease-endemic areas.

  • Infants born to infected mothers.

  • People who live with an infected person and are exposed to that person's blood.

  • Healthcare workers exposed to blood.

  • Hemodialysis patients.

  • People who received a transfusion of blood or blood products before July 1992 or clotting factors made before 1987.

Prevention

  • Receive the hepatitis B vaccine.

  • Healthcare workers need to avoid injuries and wear appropriate protective equipment such as gloves, gowns, and face masks when performing invasive medical or nursing procedures.

  • After exposure to infectious blood, if you were not previously and successfully vaccinated, receive a gamma globulin shot (HBIG), hepatitis B vaccine, or both.

Treatment

Acute hepatitis B usually resolves on its own. For chronic hepatitis B, drug treatment is available and advised for many, but not all patients. All patients who have chronic hepatitis B infection should be carefully monitored by a caregiver over time.

HEPATITIS C

Disease Spread

  • Through contact with infected blood.

  • Through sex with an infected person.

  • From mother to child during childbirth.

People at Risk

  • Injection drug users.

  • People who have sex with an infected person.

  • People who have multiple sex partners.

  • Healthcare workers exposed to blood.

  • Infants born to infected mothers.

  • Hemodialysis patients.

  • People who received a transfusion of blood or blood products before July 1992 or clotting factors made before 1987.

  • People born between 1945 and 1965.

Prevention

  • There is no vaccine for hepatitis C. The only way to prevent the disease is to reduce the risk of exposure to blood that is contaminated with the virus. This means avoiding behaviors like sharing drug needles or sharing personal items like toothbrushes, razors, and nail clippers with an infected person.

  • Healthcare workers need to avoid injuries and wear appropriate protective equipment, such as gloves, gowns, and face masks when performing invasive medical or nursing procedures.

Treatment

For acute hepatitis C, treatment may be recommended if it does not resolve within 2 to 3 months. For chronic hepatitis C, drug treatment is available and advised for many, but not all patients. All patients who have chronic hepatitis C infection should be carefully monitored by a caregiver over time.

HEPATITIS D

Disease Spread

Through contact with infected blood. This disease happens only in people who are already infected with hepatitis B or who become infected with hepatitis B and hepatitis D at the same time.

People at Risk

Anyone infected with hepatitis B. Injection drug users who have hepatitis B have the highest risk. People who have hepatitis B are also at risk if they have sex with a person infected with hepatitis D or if they live with an infected person. Also at risk are people who received a transfusion of blood or blood products before July 1992 or clotting factors made before 1987.

Prevention

  • Receive the hepatitis B vaccine if you are not already infected.

  • Avoid exposure to infected blood.

  • Avoid exposure to contaminated needles.

  • Avoid exposure to an infected person's personal items (toothbrush, razor, nail clippers).

Treatment

The combination of hepatitis D and hepatitis B infection usually causes very serious and progressive liver disease. Because of this, drug treatment is almost always recommended. Treatment regimens are the same as those recommended for the hepatitis B infection.

HEPATITIS E

Disease Spread

Through food or water contaminated by feces from an infected person. This disease is common in Asia, Africa, the Middle East, and Central America.

People at Risk

  • Travelers to areas of the world where hepatitis E infection is common.

  • People living in areas where hepatitis E outbreaks are common.

  • People who live with an infected person.

Prevention

A vaccine for hepatitis E is not yet available. Currently, the only way to prevent the disease is to reduce the risk of exposure to the virus. This means avoiding tap water, ice cubes made from tap water, and uncooked or inadequately cooked foods when traveling to hepatitis E endemic areas with poor sanitation.

Treatment

Hepatitis E usually resolves on its own over several weeks to months.

OTHER CAUSES OF VIRAL HEPATITIS

Some cases of viral hepatitis cannot be attributed to the hepatitis A, B, C, D, or E viruses. This is called non A-E hepatitis. Scientists continue to study the causes of non A-E hepatitis.