Symptoms
Sometimes there are no symptoms of
hepatitis in the first weeks after infection -- the acute phase. But when they
occur, the symptoms of hepatitis A, B, and C may include fatigue, nausea, poor
appetite, belly pain, a mild fever, or yellow skin or eyes (jaundice.) When
hepatitis B and C become chronic, they may cause no symptoms for years. By the
time there are any warning signs, the liver may already be damaged.
Many people with hepatits go
undiagnosed, because the disease is mistaken for the flu or because there are
no symptoms at all. The most common symptoms of hepatitis are:
- Loss of appetite
- Fatigue
- Mild fever
- Muscle or joint aches
- Nausea and vomiting
- Abdominal pain
Less common symptoms include:
- Dark urine
- Light-colored stools
- Jaundice (yellowing of the skin and whites of the eyes)
- Generalized itching
- Altered mental state, stupor, or coma
- Internal bleeding
Hepatitis
A
Hepatitis A is highly contagious and
can spread from person to person in many different settings. It typically
causes only a mild illness, and many people who are infected may never realize
they are sick at all. The virus almost always goes away on its own and does not
cause long-term liver damage.
Hepatitis A usually spreads through
contaminated food or water. Food can be tainted when it's touched by an
infected person who did not wash his hands after using the bathroom. This
transfers tiny amounts of infected stool to the food. Raw shellfish, fruits,
vegetables, and undercooked foods are common culprits in hepatitis A outbreaks.
The virus can also spread in daycare centers if employees aren't careful about
washing hands after changing diapers.
A prime risk factor for hepatitis A is
traveling to or living in a country with high infection rates. You can check
the CDC's travel advisories to learn about recent outbreaks. Eating raw foods
or drinking tap water can increase your risk while traveling. Children who
attend daycare centers also have a higher risk of getting hepatitis A.
Hepatitis
B
Many adults who get hepatitis B have
mild symptoms for a short time and then get better on their own. But some
people are not able to clear the hepatitis B virus from the body, which causes
a long-term infection. Nearly 90% of infants who get the virus will carry it
with them for life. Over time, chronic hepatitis B can lead to serious problems
such as liver damage, liver failure, and liver cancer.
You can get hepatitis B through contact with the blood or
body fluids of an infected person. In the U.S., hepatitis B is most often
spread through unprotected sex. It's also possible to get hepatitis B by
sharing an infected person's needles, razors, or toothbrush. And an infected
mother can pass the virus to her baby during childbirth. Hepatitis B is not
spread by hugging, sharing food, or coughing.
Anyone can get hepatitis B, but people who have multiple
sex partners or inject illegal drugs have a higher risk. Other risk factors
include being a health care worker who is exposed to blood or living with
someone who has chronic hepatitis B.
Hepatitis
C
About 25% of people who get hepatitis C
defeat the virus after an acute infection. The rest will carry the virus in
their body for the long term. Chronic hepatitis C can cause very serious
complications, including liver failure and liver cancer. Fortunately, there are
ways to manage the virus and reduce its impact on the liver.
Hepatitis C spreads through infected blood. In the U.S.,
sharing needles or "works" to inject drugs is the most common cause
of infection. Getting a tattoo or body piercing with an infected needle is
another means of exposure. A mother may pass the virus to her child at birth.
In rare cases, unprotected sex spreads hepatitis C, but the risk appears small.
Having multiple sex partners, HIV, or rough sex seems to increase risk for
spreading hepatitis C.
People who have injected illegal drugs at any time, even
one time, many years ago, could be walking around with chronic hepatitis C.
Because there are often no symptoms, many former drug users may not realize
they have the infection. People who received a blood transfusion before 1992
also have an elevated risk. Prior to that year, donated blood was not screened
for the hepatitis C virus.
How
Is Hepatitis Diagnosed?
Chronic hepatitis can quietly attack the liver for years
without causing any symptoms. Unless the infection is diagnosed, monitored, and
treated, many of these people will eventually develop serious liver damage.
Fortunately, blood tests can determine whether you have viral hepatitis, and if
so, which kind.
What
If You Test Positive?
If you test positive for viral
hepatitis, you can take steps to protect the ones you love. For hepatitis A,
wash your hands frequently. For hepatitis B and C, avoid sharing your nail
clippers, razor, or toothbrush. Make sure everyone in your household gets the
hepatitis B vaccine. An important step is to see a specialist to discuss your
treatment options.
Treatment:
·
Hepatitis A
Hepatitis A almost always goes away on
its own, and no medication is needed. If nausea is a problem, try eating
several small meals throughout the day instead of three large ones. Drink
water, juice, or sports drinks to stay hydrated. And avoid strenuous exercise
until you're feeling better.
·
Chronic Hepatitis B
The goal of treating chronic hepatitis
B is to control the virus and keep it from damaging the liver. This begins with
regular monitoring for signs of liver disease. Antiviral medications may help,
but not everyone can take them or needs to be on medication. Be sure to discuss
the risks and benefits of antiviral therapy with your doctor.
·
Chronic Hepatitis C
The most common treatment for chronic hepatitis C is a
combination of antiviral medications called interferon and ribavirin. Interferon is given as a
shot and ribavirin is a pill. Studies suggest this combination can cure or
control hepatitis C in about half of patients. But it can cause serious side
effects. In addition, not everyone needs treatment. Your doctor will explain
your options based on how active the virus is.
Monitoring
Chronic Hepatitis
Careful monitoring is the cornerstone
of managing chronic hepatitis B and C. Your doctor will order regular blood
tests to check how well your liver is working. Ultrasounds and CT scans can also
reveal signs of liver damage. If the virus is not causing any liver problems,
you may not need treatment. But it's important to have regular tests to watch
for changes. Complications are easiest to treat when found early.
Complications:
·
Cirrhosis
One of the most common complications of
chronic hepatitis is cirrhosis. This is a scarring of the liver that can be
detected with a biopsy. Cirrhosis makes it difficult for the liver to do its
job and can lead to liver failure, a life-threatening condition. Symptoms
include fatigue, nausea, weight loss, and swelling in the belly and legs. In
severe cases, patients may experience jaundice and confusion.
·
Liver Cancer
Viral hepatitis is the top cause of
liver cancer, so people with chronic hepatitis B or C need monitoring even if
you feel "fine." Blood tests can detect proteins that suggest the
presence of liver cancer. Ultrasounds, CT scans, and MRIs can reveal abnormal
lesions in the liver (seen here in green).
A biopsy is needed to determine if these areas are cancerous. Tumors that are
found early may be surgically removed. But most liver cancers are difficult to
treat.
Liver
Transplant
The liver is a vital organ that aids in
metabolism, digestion, detoxifying, and the production of many proteins
needed by the body. If a large part of the liver is damaged beyond repair, it
will no longer be able to perform these important jobs. People cannot live
without a working liver. In this case, a liver transplant may be the best hope.
This option provides the patient with a healthy liver from a donor.
Hepatitis
A and B Vaccines
There are vaccines to protect against
hepatitis A and B. The CDC recommends hepatitis A vaccination for all children
ages 12 to 23 months and for adults who plan to travel or work in areas
with hepatitis A outbreaks. People with chronic hepatitis B or C should also
get the hepatitis A vaccine if they don't already have immunity to hepatitis A.
The hepatitis B vaccine is recommended for all infants at birth and for adults
who have any of the risk factors we discussed earlier. There is no vaccine for
hepatitis C.
Protecting
Your Liver
If you have chronic hepatitis, there
are steps you can take to keep your liver resilient. Avoid alcohol, which can
cause additional liver damage. Check with your doctor before taking any
medications or supplements, because some are tough on the liver or may not be
safe in people with liver disease. Most importantly, keep your appointments for
regular monitoring. By watching for any changes in your liver, you and your
health care provider can stay one step ahead of the virus.
