Types

Each type has different characteristics and is transmitted in different ways, but symptoms tend to be similar.

The three  main types of hepatitis are known as hepatitis A, B, and C. Each is caused by a different virus. All three types can be acute, lasting for 6 months or less, and types B and C can be chronic, lasting for longer.

Hepatitis A

In the United States (U.S.), 1,390 cases of hepatitis A were reported in 2015.

It is often mild, and most people make a full recovery, after which they are immune and therefore protected from the virus in the future. However, if it progresses, symptoms can be severe or life-threatening.

People in parts of the world with poor sanitation are particularly at risk of contracting HAV.

There are safe and effective vaccines that protect against this virus.

Causes, symptoms, and treatment of hepatitis A

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Hepatitis B

Hepatitis B can be transmitted when a person:

• has unprotected sexual intercourse with an infected person
• shares a needle with an infected person, often for illegal drug or steroid use
• has a tattoo created with unsterilized needles
• is accidentally pricked, for example, health workers dealing with sharp objects
• shares personal items, such as a toothbrush or razor, with an infected person
• is bitten by someone who is infected

An infected mother can pass the virus on to her infant when breast-feeding.

The liver of a person infected with hepatitis B swells. Severe damage can result.

HBV infection can become chronic. This can lead to complications, including scarring of the liver, or cirrhosis. It can also cause a type of cancer known as hepatocellular carcinoma.

In 2015, 887,000 deaths worldwide were linked to HBV, mostly as a result of complications such as these.

In the U.S., there were 3,370 reported cases of HBV, but the Centers for Disease Control and Prevention (CDC) estimate that the real figure may be around 21,900.

There is not currently a cure for HBV. However, the incidence rate has dropped in countries where the vaccine is available, and this vaccine is 95 percent effective against the infection.

There is a safe and effective vaccine that can protect against HBV.

Everything you need to know about hepatitis B

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Hepatitis C

HCV can lead to liver damage and swelling. Around 1 in 4 people with HCV get cirrhosis, and this can lead to liver cancer.

Donated blood is now tested for HCV, but people who received organ transplants or blood donations before testing became part of the donation process may be at risk.

Other at-risk groups include healthcare workers who are exposed to sharps, users of intravenous drugs, and infants born to mothers with HCV.

The number of cases of HCV in the U.S. rose nearly threefold between 2010 and 2015 when 2,436 cases were reported. However, the CDC estimate that 33,900 infections occurred in 2015, including those not reported.

What's to know about viral hepatitis?

Hepatitis refers to an inflammation of the liver cells and damage to the liver. There are different types and causes, but the symptoms can be similar.

The liver's functions include detoxifying the blood, storing vitamins, and producing hormones. Hepatitis can disrupt these processes and create severe health problems throughout the body.

At least five viruses can cause hepatitis. The three most common are hepatitis viruses A, B and C. Infection with any of these three can be fatal.

Other types of hepatitis can result from overconsumption of alcohol or an autoimmune condition. This article will look at hepatitis A, B, and C. These are forms of hepatitis transmitted by a virus.

In the United States, the incidence of hepatitis A has been falling for the last 20 years, but acute hepatitis C has seen an increase of 44 percent between 2011 and 2012.

Complications of hepatitis

Chronic hepatitis B or C can often lead to more serious health problems. Because the virus affects the liver, people with chronic hepatitis B or C are at risk for:

• chronic liver disease
• cirrhosis
• liver cancer

When your liver stops functioning normally, liver failure can occur. Complications of liver failure include:

• bleeding disorders
• a buildup of fluid in your abdomen, known as ascites
• increased blood pressure in portal veins that enter your liver, known as portal hypertension
• kidney failure
• hepatic encephalopathy, which can involve fatigue, memory loss, and diminished mental abilities due to the buildup of toxins, like ammonia, that affect brain function
• hepatocellular carcinoma, which is a form of liver cancer
• death

People with chronic hepatitis B and C are encouraged to avoid alcohol because it can accelerate liver disease and failure. Certain supplements and medications can also affect liver function. If you have chronic hepatitis B or C, check with your doctor before taking any new medications.

Tips to prevent hepatitis

Hygiene

Practicing good hygiene is one key way to avoid contracting hepatitis A and E. If you’re traveling to a developing country, you should avoid:

• local water
• ice
• raw or undercooked shellfish and oysters
• raw fruit and vegetables

Hepatitis B, C, and D contracted through contaminated blood can be prevented by:

• not sharing drug needles
• not sharing razors
• not using someone else’s toothbrush
• not touching spilled blood

Hepatitis B and C can also be contracted through sexual intercourse and intimate sexual contact. Practicing safe sex by using condoms and dental dams can help decrease the risk of infection. You can find many options available for purchase online.

Vaccines

The use of vaccines is an important key to preventing hepatitis. Vaccinations are available to prevent the development of hepatitis A and B. Experts are currently developing vaccines against hepatitis C. A vaccination for hepatitis E exists in China, but it isn’t available in the United States.

How hepatitis is treated

Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic.

Hepatitis A

Hepatitis A usually doesn’t require treatment because it’s a short-term illness. Bed rest may be recommended if symptoms cause a great deal of discomfort. If you experience vomiting or diarrhea, follow your doctor’s orders for hydration and nutrition.

The hepatitis A vaccine is available to prevent this infection. Most children begin vaccination between ages 12 and 18 months. It’s a series of two vaccines. Vaccination for hepatitis A is also available for adults and can be combined with the hepatitis B vaccine.

Hepatitis B

Acute hepatitis B doesn’t require specific treatment.

Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly because it must be continued for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment.

Hepatitis B can be prevented with vaccination. The CDC recommends hepatitis B vaccinations for all newborns. The series of three vaccines is typically completed over the first six months of childhood. The vaccine is also recommended for all healthcare and medical personnel.

Hepatitis C

Antiviral medications are used to treat both acute and chronic forms of hepatitis C. People who develop chronic hepatitis C are typically treated with a combination of antiviral drug therapies. They may also need further testing to determine the best form of treatment.

People who develop cirrhosis (scarring of the liver) or liver disease as a result of chronic hepatitis C may be candidates for a liver transplant.

Currently, there is no vaccination for hepatitis C.

Hepatitis D

No antiviral medications exist for the treatment of hepatitis D at this time. According to a 2013 study, a drug called alpha interferon can be used to treat hepatitis D, but it only shows improvement in about 25 to 30 percent of people.

Hepatitis D can be prevented by getting the vaccination for hepatitis B, as infection with hepatitis B is necessary for hepatitis D to develop.

Hepatitis E

Currently, no specific medical therapies are available to treat hepatitis E. Because the infection is often acute, it typically resolves on its own. People with this type of infection are often advised to get adequate rest, drink plenty of fluids, get enough nutrients, and avoid alcohol. However, pregnant women who develop this infection require close monitoring and care.

Autoimmune hepatitis

Corticosteroids, like prednisone or budesonide, are extremely important in the early treatment of autoimmune hepatitis. They’re effective in about 80 percent of people with this condition.

Azothioprine (Imuran), a drug that suppresses the immune system, is often included in treatment. It can be used with or without steroids.

Other immune suppressing drugs like mycophenolate (CellCept), tacrolimus (Prograf) and cyclosporine (Neoral) can also be used as alternatives to azathioprine for treatment.

How hepatitis is diagnosed

History and physical exam

To diagnose hepatitis, first your doctor will take your history to determine any risk factors you may have for infectious or noninfectious hepatitis.

During a physical examination, your doctor may press down gently on your abdomen to see if there’s pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam.

Liver function tests

Liver function tests use blood samples to determine how efficiently your liver works. Abnormal results of these tests may be the first indication that there is a problem, especially if you don’t show any signs on a physical exam of liver disease. High liver enzyme levels may indicate that your liver is stressed, damaged, or not functioning properly.

Other blood tests

If your liver function tests are abnormal, your doctor will likely order other blood tests to detect the source of the problem. These tests can check for the viruses that cause hepatitis. They can also be used to check for antibodies that are common in conditions like autoimmune hepatitis.

Ultrasound

An abdominal ultrasound uses ultrasound waves to create an image of the organs within your abdomen. This test allows your doctor to take a close at your liver and nearby organs. It can reveal:

• fluid in your abdomen
• liver damage or enlargement
• liver tumors
• abnormalities of your gallbladder

Sometimes the pancreas shows up on ultrasound images as well. This can be a useful test in determining the cause of your abnormal liver function.

Liver biopsy

A liver biopsy is an invasive procedure that involves your doctor taking a sample of tissue from your liver. It can be done through your skin with a needle and doesn’t require surgery. Typically, an ultrasound is used to guide your doctor when taking the biopsy sample.

This test allows your doctor to determine how infection or inflammation has affected your liver. It can also be used to sample any areas in your liver that appear abnormal.

Common symptoms of hepatitis

If you have infectious forms of hepatitis that are chronic, like hepatitis B and C, you may not have symptoms in the beginning. Symptoms may not occur until the damage affects liver function.

Signs and symptoms of acute hepatitis appear quickly. They include:

• fatigue
• flu-like symptoms
• dark urine
• pale stool
• abdominal pain
• loss of appetite
• unexplained weight loss
• yellow skin and eyes, which may be signs of jaundice

Chronic hepatitis develops slowly, so these signs and symptoms may be too subtle to notice.