Viral Hepatitis is a condition that affects an estimated 354 million people globally,6 but hepatitis itself is a general term referring to inflammation or swelling of the liver.2 Hepatitis can be caused by a variety of disorders, substances, and infections, and severity may depend on the cause.1
Because hepatitis can have several root causes, understanding the symptoms and types is important for mitigating your risk and making healthy decisions.
The Liver
Your liver is the body’s largest solid organ and is located under the ribs on the right side of the body. Many bodily functions rely on the liver, and serious issues can arise if it isn’t in good working order. Some jobs the liver is responsible for include cleaning toxins and harmful substances from the blood, disposing of old red blood cells, bile production, metabolizing nutrients, clotting protein production, blood volume regulation, and glycogen storage for energy. 7
Two parts comprise the liver: a large right lobe, and smaller left lobe. These are made up of thousands of smaller lobules and blood vessels that allow blood to flow through the liver and be filtered.7
Hepatitis Symptoms
Hepatitis can vary in severity based on cause and progression of inflammation, and can include the following symptoms:2
· Fatigue or exhaustion
· Nausea and vomiting
· Lack of appetite
· Abdominal discomfort and pain
· Light or clay-colored stool
· Dark urine
· Fever
· Joint pain
· Jaundice (yellow skin or eyes)
If left untreated, hepatitis can progress to the point of permanent damage to the liver. Contact a healthcare professional if you experience any of the above symptoms.2
Causes of Hepatitis
Viral infection is the most well-known cause of Hepatitis, or liver inflammation, but it can have many sources, including but not limited to:1
· The body’s immune system attacking the liver
· Fatty liver
· Liver damage due to substances such as poison, alcohol, and in rare cases, illicit drugs
· High doses of medications like acetaminophen
· Viral infections such as Hepatitis A, B, and C
· Bacterial infections
Viral Hepatitis Variants
Viral Hepatitis is found in 5 different variants: A, B, C, D, and E, with the most common being A, B, and C. A healthcare professional can administer blood tests to ascertain levels of liver enzymes in the blood and measure liver function. If they suspect hepatitis, additional tests may be performed to detect the viral variants.2
· Hepatitis A Virus (HAV) is most commonly caused by ingesting contaminated fecal matter. It’s a milder infection and although it can pose a threat to immunocompromised patients, will resolve itself without treatment in most cases.8 Treatment will typically entail supportive care and relieving symptoms for healthy individuals while their body fights the infection, or antivirals for high-risk patients.2
· Hepatitis B Virus (HBV) is primarily transmitted via contact with the bodily fluids, such as blood or semen, of infected individuals.8 It can also be passed from pregnant patients to their child during birth. HBV can cause both short-lived and chronic infections, and in some cases lead to cirrhosis (severe scarring of the liver) or even liver cancer.8 Because the severity of HBV symptoms can vary, some individuals may experience no symptoms for years in chronic cases, despite continuous liver damage from the infection.2
· Hepatitis C Virus (HCV) symptoms may not present until it has already affected the liver significantly, making it a common cause of liver damage, cancer, and liver failures leading to transplantation.8 Treatments for this variant often utilize antiviral medications with the goal of viral levels below detection in the blood, known as a Sustained Virologic Response (SVR). 2
· Hepatitis D Virus (HDV), also known as delta hepatitis, is different from other variants in that it is a satellite virus. This means it doesn’t make its own viral shell but consists only of genetic material. Without a shell, it is not capable of causing an infection on its own, and only occurs in those already infected with hepatitis B virus (HBV). Hepatitis D can worsen health outcomes for patients with HBV and can be best prevented by early detection and treatment of HBV.2
· Hepatitis E Virus (HEV) is similar to HAV in its infection method, being primarily transmitted through contaminated food and water, especially in regions with poor sanitation measures. HEV is also a milder variant and can often be resolved without treatment in healthy individuals. It can however still pose a risk for immunocompromised individuals and those taking immunosuppressants, such as recent transplant recipients.2
Non-Viral Hepatitis Causes
Non-viral hepatitis refers to any form of liver inflammation and swelling that is not caused by a viral infection. Non-viral cases can be more difficult to determine the root cause, and severity may vary. These are the most common types of non-viral hepatitis:2
· Autoimmune Hepatitis occurs then the body’s own immune system attacks the liver, causing inflammation and potential damage, and extended use of immunosuppressants is often needed for treatment. While specialists don’t know exactly what causes this type of hepatitis, genetic and environmental factors are thought to play a role.2
· Alcoholic Hepatitis is brought on by excessive drinking over a prolonged period of time.1 Since the liver is responsible for metabolizing alcohol, alcohol abuse can lead to inflammation and damage. Treating alcoholic hepatitis is achieved by abstaining from alcohol and making changes to diet.2
· Drug-Induced Hepatitis can be caused by an adverse reaction to prescription medications, over-the-counter medications, or herbal supplements. Finding and stopping the medication that is causing the problem is a typical treatment, along with symptom management.2
· Ischemic Hepatitis is inflammation resulting from a lack of blood flow to the liver and is also known as “shock liver.” This form of hepatitis can be a complication of several conditions that lead to low blood pressure, such as heart failure, severe infections, and surgical procedures. Treatment takes the form of resolving the root cause and providing care to manage symptoms and improve liver function. 2
· Metabolic Disorders such as Wilson’s Disease can lead to inflammation and damage in the liver.2 Also known as Metabolic Dysfunction-Associated Steatohepatitis (MASH), this type of hepatitis is often associated with excess storage of fat in the liver. Healthy lifestyle changes can halt progress and reverse effects of MASH if damage is not yet severe.9
Who is at risk for Hepatitis?
Individuals at risk for hepatitis are as numerous as its variants, and different conditions and behaviors will increase risk for different inflammation causes. The following groups may be at greater risk for hepatitis:
· People born in a country with a medium-to-high prevalence of viral hepatitis are at greater risk for HBV10
· Illicit drug users are at an increased risk for Hepatitis A, B, and C, especially those who inject.3
· Sexually active individuals are more likely to be exposed to HBV, particularly partners of HBV positive individuals and people with multiple partners in the past 6 months.4
· People infected with HIV are more likely to experience severe infections when exposed to viral hepatitis, and HIV shares many infection risk factors with hepatitis.5
Mitigating risks Subheads
The best prevention for Hepatitis A and B is vaccination. 8 Other viral variants like Hepatitis C, D, and E do not have vaccines currently available, and it is best to avoid high-risk behaviors for transmission. Some of these behaviors include: 8
· Sharing or reusing needles
· Having unprotected sex
· Drinking unsanitary water or water from questionable sources
Non-viral hepatitis is often preventable, and you should avoid the following unhealthy behaviors that may put undue strain on your liver:2
· Alcohol abuse
· Taking greater than the recommended dose of medications
· Sedentary lifestyle and poor diet
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