Forms of Viral Hepatitis
Hepatitis is an inflammation of the liver. Inflammation usually produces swelling, tenderness and sometimes permanent damage. Hepatitis is caused by a number of things including alcohol, drugs, chemicals and viral infections. If the inflammation of the liver continues at least six months or longer, it is called chronic hepatitis. Chronic hepatitis can lead to scarring, also called fibrosis. If a lot of fibrosis develops it is called cirrhosis, which can lead to liver failure. Currently there are at least five different viruses known to cause viral hepatitis.
Sometimes called “infectious hepatitis,” hepatitis A is spread by eating food or drinking water contaminated with human feces. This type of viral hepatitis is not frequently life-threatening.
Sometimes called “serum hepatitis,” hepatitis B can be spread from mother to child at birth or soon after and through sexual contact, contaminated blood transfusions and needles. This form of viral hepatitis may lead to cirrhosis (scarring of the liver) and liver cancer.
Formerly known as “non-A, non-B hepatitis,” hepatitis C is the most common form of viral hepatitis. While it can be spread through blood transfusions and contaminated needles, for a substantial number of patients, the cause is unknown. This form of viral hepatitis may lead to cirrhosis, or scarring, of the liver. Co-infection of hepatitis C in patients who are HIV positive is common; about one-quarter of patients infected with HIV are infected with hepatitis C. Fifty percent to 90 percent of HIV-infected injection drug users are also infected with hepatitis C. Hepatitis C virus infection is more severe in patients with HIV.
This form of viral hepatitis is found most often in intravenous (IV) drug users who are also carriers of the hepatitis B virus. Hepatitis D is spread only in the presence of the hepatitis B virus and is transmitted through the same ways. As hepatitis D occurs in people who have viral hepatitis B, it is a serious health problem, and may increase the severity of symptoms associated with hepatitis B.
This form of viral hepatitis is similar to viral hepatitis A and is found most often in people who live in countries with poor sanitation. It is rare in North America and rarely life-threatening.
Differences Between Acute and Chronic Hepatitis
Acute hepatitis is the initial infection. Acute hepatitis may be mild or severe. If the infection lasts for six months or longer the condition is called chronic hepatitis. Hepatitis A and E do not cause chronic hepatitis. The hepatitis viruses B, C and D can produce both an acute and chronic episode of illness. Chronic hepatitis B and C are serious health problems.
Viral Hepatitis Symptoms
Many cases of viral hepatitis are not diagnosed because the symptoms are vague and similar to a flu-like illness. Sometimes, there are no symptoms at all.
Some individuals with viral hepatitis experience or develop:
- Abdominal discomfort.
- Muscle and joint aches.
- Changes in the color of urine and stools.
Some people with viral hepatitis may develop jaundice, when the skin and whites of the eyes turn yellow. Itching of the skin may occur with jaundice.
What Should I Do If I Have Been Exposed to or Think That I Have Viral Hepatitis?
Call your doctor and schedule an urgent appointment. Your doctor will take a history, do a physical examination and order blood tests to determine your diagnosis.
What Is a Carrier?
A carrier is a person who has hepatitis B, C or D virus in his or her blood. This person may or may not have any symptoms of the disease. Because the virus is in the blood, it can be transmitted to others through intravenous drug use, high-risk sexual behavior and blood transfusions. Blood tests can determine if someone is a carrier.
Treatment for Chronic Viral Hepatitis
After the doctor has determined which type of hepatitis virus is present, treatment programs can be discussed. Some helpful hints for people with chronic viral hepatitis are listed below:
- Review your medical history thoroughly with your doctor.
- Exercise will depend on the presence and degree of fatigue present. If there is no fatigue, there are no restrictions to the amount or type of exercise that can be performed.
- During the acute phase of illness, all alcoholic beverages should be avoided, as should IV needle use and risky sexual behavior.
- A nutritious, well-balanced diet is encouraged.
Will I Need a Liver Biopsy?
Not always. Liver biopsy is a procedure by which a needle is used to remove a small piece of liver to be analyzed under a microscope. This procedure is done to confirm the diagnosis of viral hepatitis and to determine the degree of damage the virus has caused. A liver biopsy is usually not needed to determine the cause of hepatitis.
Will Hospitalization Be Necessary?
Usually hospitalization is not required. If a person cannot keep food or liquids down over a period of time, your doctor may decide that hospitalization is needed.
Treatment of Hepatitis B and C
There are numerous effective anti-viral oral medications now available for hepatitis B. In May 2011, the FDA approved two new oral protease inhibitors for hepatitis C to be used in conjunction with the standard therapy of interferon and ribavirin.