Hepatitis: What Causes This Serious Liver Ailment?

Your second-largest and hardest-working organ, your liver, can be attacked by a type of inflammation that, if left unchecked, can trigger an array of problems.


Symptoms of liver damage is not limited to hepatitis.

Hepatitis is the top ailment often associated with liver health. It is an inflammation of the liver generally caused by viral infection. An inflamed liver becomes swollen and tender, which can impair or permanently damage the organ.

The hepatitis viruses are identified as A, B, C, D, and E. Any of these viruses can cause short-term (less than six months) inflammation of the liver. Hepatitis A, B, and C may cause no symptoms or just flu-like symptoms, such as fatigue, nausea, fever, loss of appetite, stomachache, and diarrhea. Some people have dark-yellow urine, light-colored stools, or yellowish eyes and skin. Hepatitis A, B, and C can be detected with a blood test. Certain medications, such as acetaminophen (Tylenol), can cause drug-induced hepatitis.

Risk Factors for Chronic Hepatitis

Chronic hepatitis B and hepatitis c take the heaviest toll on Asians, Pacific Islanders, and African-Americans in the United States. Infection with these viruses account for nearly half of all liver transplants.

Hepatitis A is spread by personal contact or consuming food or water contaminated with human saliva or feces from someone infected with the virus. This is a problem in parts of the world with poor sanitary conditions, so travelers in such regions are at risk. Daycare workers and men who have sex with men are also at risk. Hepatitis A can be prevented with a vaccine.

Hepatitis B can be contracted through contact with the blood, semen, or other body fluid of an infected person. People who travel to countries where hepatitis B is common are at risk of infection but there is a vaccine to prevent infection. Hepatitis B infection can resolve on its own without any treatment. However, sometimes the infection is chronic and can lead to serious liver damage, like cirrhosis.

Hepatitis C is transmitted through contact with the blood of an infected person. This generally occurs when drug users share needles. Hepatitis C is not spread by casual contact. People who had blood transfusions before 1992 are at risk because prior to that there was no test to check blood for the virus. The infection may resolve itself within a few months, but about 75 percent of patients become chronic.

An estimated 3.2 million Americans have chronic hepatitis C. In fact, one out of 33 people—”baby boomers,” born between 1945 and 1965—have the disease and many don’t know they have it. This prompted the Centers for Disease Control and Prevention (CDC) to consider routine screening in this population.

Hepatitis Treatment

There is no vaccine to prevent hepatitis C. However, there are treatments. Weekly injections of peginterferon (Peg-Intron, Pegasys) and the oral drug ribavirin (Copegus, Rebetol) for up to 48 weeks is the usual treatment. Drug side effects can include fever, chills, headache, muscle and joint aches, rapid heart rate, fatigue, hair loss, skin rash, nausea, irritability, and depression.

Two newer drugs being used along with peginterferon and ribavirin are boceprevir (Victrelis) and telaprevir (Incivek). They have been shown to boost cure rates and, in some patients, to reduce treatment time.

Obesity raises the risk for failure for this treatment. Weight loss along with treatment for underlying cause may increase the chances for successful treatment.

Hepatitis D is transmitted through contact with blood from a person infected with the hepatitis D virus. However, it only occurs in people who are already infected with hepatitis B. Hepatitis D can be treated with the drug alpha but there is no vaccine to prevent it.

There are numerous advocacy and support organizations for hepatitis at this link.

Originally published in 2016 and regularly updated.

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Matthew Solan

Matthew Solan has served as executive editor of Harvard Men's Health Watch since 2016. He was previously executive editor for UCLA Health's Healthy Years and was a regular contributor to … Read More

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