Viral

Viral Hepatitis

Viral hepatitis is common, and it’s the most common reason for needing a liver transplant. Hepatitis is an inflammation of your liver. It can also have non-viral causes.

Many people who have viral hepatitis don’t know they have it. That’s usually because they don’t have symptoms—and may never have symptoms. Sometimes, hepatitis can go away without treatment. Or, it can be treated with medications. Some forms last your whole life.

Vaccines (shots) can protect you from some kinds of viral hepatitis. The most common types of viral hepatitis are:

Hepatitis A-Hepatitis A is the least dangerous type of viral hepatitis, but it’s highly contagious. It is usually spread by having close contact with someone who is infected, or eating food or drinking water that is contaminated with feces (stool).

Hepatitis A is caused by a virus that is spread by:

•              Eating food that has been improperly handled – someone who has the virus handles your food after using the bathroom without proper hand-washing

•              Eating raw shellfish from water contaminated with sewage

•              Being in close contact with someone who has the virus

•              Having sexual contact with someone who has the virus

Often, hepatitis A improves on its own and you do not need to be hospitalized. It usually doesn’t cause permanent liver damage. However, some people – usually older people – become very ill, need a liver transplant or may die from hepatitis A.

People who are at higher risk for hepatitis A include:

•              People who travel to developing countries with high rates of hepatitis A

•              Men who have sex with men

•              People who are HIV positive

•              People who have oral-to-anal sex

•              People who have contact with sewage

•              People who live or have close contact with a person who has hepatitis A

•              People who live in crowded conditions with poor sanitation

•              Intravenous drug users or non-injected illegal drugs

•              People who receive clotting-factor concentrates as part of medical treatment (hemophilia)

Only about half of the people affected with hepatitis A in the United States have any of the risk factors listed above.

Symptoms

If you have hepatitis A, you may never notice symptoms. When they do happen, symptoms can include:

•              Appetite loss

•              Fatigue

•              Muscle pain

•              Low fever

•              Stomach pain

•              Jaundice (yellowing of skin and eyes)

•              Nausea and vomiting

•              Diarrhea

•              Dark urine or pale feces

If you have symptoms that you cannot explain or that worry you, see your doctor.

Diagnosis

Hepatitis A is diagnosed by a blood test.

Treatment

There is no treatment for hepatitis A. Your liver usually heals itself within a month or two. Your doctor may suggest ways to help with your symptoms.

Until your hepatitis A is gone, you should:

•              Avoid alcohol so your liver can rest

•              Avoid sexual activity to prevent passing the disease to others

•              Avoid cooking for others to prevent passing the disease to them

•              Thoroughly wash your hands after using the bathroom or changing a diaper to prevent spreading the disease

How to prevent hepatitis A

People older than 1 year of age should have a hepatitis A vaccination. It’s an initial shot followed by a booster shot six months later. If you didn’t receive the vaccination as a child, you can get the shots as a teen or adult. It’s especially important to be vaccinated if you have higher risk factors.

Proper hand-washing is important to prevent hepatitis A and keep it from spreading.

If you travel to an area that has hepatitis A outbreaks:

•              Drink bottled water and use it to brush your teeth; if unavailable, boil tap water

•              Ask for beverages to be served without ice

•              Wash and peel fruits and vegetables

•              Avoid eating raw or undercooked meat and fish

Hepatitis B

Hepatitis B is a serious infection that is spread through blood, semen and other body fluids. This includes:

•              Sexual contact

•              Needle sharing

•              Accidental needle sticks

•              Mother to baby during childbirth

About 1.25 million people in the United States have hepatitis B. It is the most common cause of cirrhosis (scarring of the liver) and liver cancer in the world.

Hepatitis B is caused by a viral infection. Many adults who have hepatitis B can recover from it. This is known as an acute infection. Your body gets rid of the virus, usually within six months. If you get the virus as an adult, you usually have an acute infection.

Some people have the infection for longer. This is known as a chronic infection. It can last your whole life. It can lead to liver scarring (cirrhosis), liver failure and liver cancer. If you get the virus as a child, you usually develop a chronic infection.

People Who Are at Risk for Hepatitis B Include:

•              People who have unprotected sex with an infected partner

•              People who have unprotected sex with more than one partner

•              Men who have sex with other men

•              People who have a history of sexually transmitted diseases

•              People who use intravenous drugs

•              People in kidney failure who have hemodialysis (blood filtering)

•              People receiving a transplanted organ infected with hepatitis B virus

•              People who work in jobs that expose them to human blood

•              People who travel to areas with high infection rates (Central and Southeast Asia, Africa, Eastern Europe)

•              People who live with an infected person

Women who are pregnant should be screened for hepatitis B to determine if their babies need treatment to prevent passing the disease to them.

Symptoms

 

If you have hepatitis B, you may never notice symptoms. When they do happen, symptoms can include:

•              Appetite loss

•              Fatigue and weakness

•              Joint pain

•              Fever

•              Stomach pain

•              Jaundice (yellowing of skin and eyes)

•              Nausea and vomiting

•              Diarrhea

If you have symptoms that you cannot explain or that worry you, see your doctor.

Diagnosis

Hepatitis B is diagnosed by blood tests that determine:

•              If you have an active or chronic infection and are able to pass the infection on to others

•              If you have ever had the infection and are immune to getting it again

•              If you are immune to it because you had the vaccine

•              How much virus is in your body; this helps to decide on treatment

 

 

You may need other tests to see how your liver is working. This can include a biopsy (tissue sample) of your liver.

Treatment

Our liver specialists (hepatologists) treat hepatitis B and can help you keep your liver as healthy as possible. If you have an acute (short-lived) infection, you may not need treatment. Your doctor may suggest ways to help relieve symptoms such as nausea and low energy. You may need more blood tests later to make sure the infection is gone.

If you know you have been exposed to hepatitis B, tell your doctor right away. A treatment can be given within 24 hours of exposure to the virus, which may reduce your risk of infection.

Chronic hepatitis B infection is treated with antiviral medication. If your liver has been seriously damaged, you may need a liver transplant.

 

How to Prevent Hepatitis B

There isn’t a cure for hepatitis B. A vaccine (shot) can help prevent it. Most newborns and children in the United States are vaccinated against hepatitis B. Children and adults who have not been vaccinated should do so, especially if they are at risk.

Below are other ways to prevent hepatitis B:

•              Have sex only with partners you know do not have the infection or another sexually transmitted disease.

•              Use a latex or polyurethane condom with any sexual contact.

•              Check areas you travel to for hepatitis B risk and ask your doctor about the vaccine. You need three shots in six months to develop immunity, so plan ahead.

•              Do not share needles. Get help to stop using illegal drugs.

•              Use sterile needles if you give yourself shots.

•              Be careful if you get tattoos and piercings. Make sure equipment is sterile and the facility is reputable.

If you have hepatitis B:

•              Avoid sexual contact. Tell your sexual partners about your infection, and practice safe sex by using latex condoms. This helps lower the risk, but does not make contact completely safe.

•              Tell anyone you have had sexual contact with that you have hepatitis B so they can be tested and avoid spreading it to others.

•              Tell your doctor if you are pregnant so your baby can be treated at birth.

•              Do not donate blood or organs.

•              Do not share syringes or needles.

•              Do not share toothbrushes or razor blades (they can have traces of blood).

 

 

Hepatitis C

Hepatitis C is a serious viral infection that is spread by contact with blood and contaminated needles. It usually is not spread by sexual contact.

Hepatitis C symptoms can be mild. Most people who have it don’t know it until routine tests show liver damage. Hepatitis C can lead to liver scarring (cirrhosis), liver failure and liver cancer. Twenty percent to 30 percent of people who have hepatitis C will develop cirrhosis within 20 to 30 years.

People at Risk for Hepatitis C Include Those Who:

•              Have HIV

•              Have ever used injectable illegal drugs

•              Had blood transfusions or organ transplants before 1992

•              Received clotting-factor concentrates during medical treatment before 1987

•              Have had long-term hemodialysis treatment

•              Were born to a mother who had hepatitis C

•              Work in health care, or who have been exposed to infected skin (accidental needle stick)

•              Have had a tattoo or piercing with unsterile equipment

 

 

Symptoms

If you have hepatitis C, you may never notice symptoms. When they do happen, symptoms can include:

•              Fever

•              Muscle and joint pain

•              Nausea

•              Appetite loss

•              Jaundice (yellowing of skin and eyes)

If you have symptoms that you cannot explain or that worry you, see your doctor.

Diagnosis

Hepatitis C is diagnosed by a blood test. If you are in any of the risk groups, talk to your doctor about having a blood test for hepatitis C. This can include anyone born between 1945 and 1965.

If you have hepatitis C, your doctor will do blood tests to see how much of the virus is in your body. This helps guide treatment. You may need other tests to see how your liver is working. This can include a biopsy (tissue sample) of your liver.

 

 

Treatment

Our liver specialists (hematologists) treat hepatitis C and can help you keep your liver as healthy as possible.

You may not need treatment for hepatitis C. Your doctor may suggest ways to help with symptoms such as nausea and low energy, or recommend an antiviral medication. You may need blood tests later to make sure the infection is gone.

If you have hepatitis C, your doctor may want to be sure you’re vaccinated against hepatitis A and B to prevent getting them and further damaging your liver.

If your liver has been seriously damaged, you may need a liver transplant. For hepatitis C, liver transplant is not a cure. You must continue to take antiviral medication to prevent the new liver from becoming infected.

How to Prevent Hepatitis C

If you have hepatitis C, take steps to protect your health and the health of others:

•              Avoid drinking alcohol

•              Avoid drugs that cause liver damage (your doctor can review your prescription and over-the-counter drugs with you)

•              Cover open wounds

•              Don’t share toothbrushes or razors

•              Don’t donate blood, organs or semen

•              Tell health care workers that you have the virus so they can protect themselves from coming into contact          with your blood

•              Do not use illegal drugs

•              Be careful about tattoo and piercing equipment

•              Practice safe sex; if you have sex, use protection and ask partners about their sexual health

•              Our liver specialists are experienced in treating all types of viral and non-viral hepatitis.

 

Non-Viral

 

Non-viral Hepatitis

Hepatitis is an inflammation of your liver, which can have viral or non-viral causes. Hepatitis can cause scarring on your liver (cirrhosis), liver cancer, liver failure and death.

Types of non-viral hepatitis include:

•              Toxic hepatitis – from substances – chemicals, drugs (prescription and over-the-counter) and nutritional supplements

•              Alcoholic hepatitis – from drinking too much alcohol, which harms the liver

•              Autoimmune hepatitis – when your immune system attacks your liver

Our liver specialists are experienced at treating all types of viral and non-viral hepatitis.

Toxic Hepatitis

You can get toxic hepatitis from taking too much of certain drugs, combining some drugs or from some chemicals. These can inflame, damage and scar your liver and cause liver failure, which is called cirrhosis.

You Are at Higher Risk of Developing Toxic Hepatitis if You

•              Have another kind of hepatitis, especially hepatitis B or C, or another liver disease

•              Drink too much alcohol, especially with medicine

•              Work with industrial toxins

•              Take over-the-counter pain relievers or other drugs

•              Take many medications or take more than is recommended

•              Are older

•              Are female

Symptoms

Symptoms of toxic hepatitis can appear within hours, days or months of exposure, and may go away if you avoid the medicine or chemical that caused it.

Symptoms include:

•              Jaundice (yellowing of skin and eyes)

•              Abdominal pain

•              Nausea and vomiting

•              Weight loss

•              Appetite loss

•              Fatigue

•              Dark-colored urine

•              Itching and rash

Taking too much acetaminophen (such as Tylenol) is an emergency because it can cause liver failure and death. Symptoms of acetaminophen overdose include nausea, vomiting, upper abdominal pain, sweating and coma.

See a doctor if you have signs of toxic hepatitis.

Diagnosis

Your doctor may order blood tests, imaging tests (ultrasound, MRI, CT), a physical exam and, sometimes, a tissue sample (biopsy) from your liver to see if you could have toxic hepatitis. Be sure to show your doctor all drugs and supplements you take.

Treatment

Our liver specialists (hepatologists) have experience treating toxic hepatitis. They can help you keep your liver as healthy as possible.

Toxic hepatitis treatment can include:

•              Stopping the exposure. If your doctor finds the cause of your toxic hepatitis, it is important to avoid it.

•              Taking medication. If acetaminophen caused your toxic hepatitis and you’ve gotten medical care quickly, your doctor may give you medicine to treat it.

•              Having a transplant. If your liver is severely damaged, you may need a liver transplant.

How to Prevent Toxic Hepatitis:

•              Limit alcohol.

•              Take over-the-counter drugs only as needed.

•              Take medicine as directed; do not take more than recommended.

•              Limit the number of medicines you take, if possible. This includes supplements and herbs. Tell your doctor about everything you take at your regular checkups so he or she can tell you if something could be a problem.

•              Do not use alcohol with medications, especially acetaminophen.

•              If you work with hazardous chemicals, avoid coming into contact with them. If you are exposed to a harmful chemical, get emergency care.

•              Keep medications and chemicals away from children.

Alcoholic Hepatitis

Alcohol has liver-damaging toxins. Alcoholic hepatitis is a serious health problem that can occur in people who drink heavily, or even moderately. About 35 percent of alcoholics develop hepatitis. One-third of people with alcoholic hepatitis die within six months of noticing symptoms.

You Are at Higher Risk of Developing Alcoholic Hepatitis if You:

•              Drink too much alcohol

•              Drink too much alcohol and are malnourished

•              Are a binge drinker

•              Are obese

•              Are female

•              Are Hispanic or black

•              Have another type of hepatitis (especially hepatitis C)

•              Drink beer or spirits (as opposed to wine)

Symptoms

Symptoms of alcoholic hepatitis include:

•              Jaundice (yellowing of skin and eyes)

•              Increasing abdominal size due to fluid buildup

•              Abdominal pain

•              Nausea and vomiting

•              Weight loss

•              Appetite loss

•              Malnourishment

•              Confusion and behavior changes

•              Liver and kidney failure

See a doctor if you have symptoms of alcoholic hepatitis or if you cannot control your drinking.

Diagnosis

Your doctor will talk to you about your drinking history and check your liver for damage. You will have blood tests, liver function tests and imaging tests (ultrasound, MRI, CT).

Treatment

Our liver specialists (hepatologists) have experience treating alcoholic hepatitis. They can help you keep your liver as healthy as possible. Alcoholic hepatitis is a serious health problem that will only get worse if you keep drinking. Your doctor can help you find ways to stop drinking.

Your doctor will suggest ways to treat the symptoms of alcoholic hepatitis. It may include taking a drug (corticosteroids) to reduce liver inflammation. If you are malnourished, you may need to be treated in the hospital.

Alcoholic hepatitis causes many complications. One of these is fluid building up between your abdomen (stomach) and spine. The fluid can become infected and can cause abdominal pain and swelling. You may need to have the fluid drained with a procedure called paracentesis (abdominal tap).

If you have advanced alcoholic hepatitis, you may need a liver transplant. Not all medical centers allow people with alcoholic hepatitis to have liver transplants. Most transplant programs require you to quit drinking for at least six months before a transplant and commit to stop drinking permanently to keep your new liver healthy.

How to Prevent Alcoholic Hepatitis

Drinking too much alcohol causes alcoholic hepatitis. To avoid it, drink only in moderation if you drink at all. If you have any risk factors for alcoholic hepatitis, be even more careful about drinking.

If you are diagnosed with alcohol-related hepatitis, you must stop drinking to prevent the disease from getting worse, damaging your liver or causing death.

Autoimmune Hepatitis

Your immune system can attack your liver for unknown reasons, causing inflammation, scarring (cirrhosis), liver cancer and liver failure. Some diseases and certain toxic substances and drugs can cause this to happen.

You Are at Higher Risk of Developing Autoimmune Hepatitis if You:

•              Have another autoimmune disease (such as rheumatoid arthritis or ulcerative colitis)

•              Have a family history of the disease

•              Use certain medications (some antibiotics and cholesterol drugs)

•              Have had an infection (may occur after a bacterial or viral infection)

•              Are female

•              Are a young female (one type is more common in young females)

Symptoms

You may not have any symptoms of autoimmune hepatitis, but symptoms can include:

•              Jaundice (yellowing of skin and eyes)

•              Abdominal discomfort

•              Enlarged liver

•              Nausea and vomiting

•              Fatigue

•              Loss of menstruation

•              Joint pain

•              Appetite loss

•              Itching and rash

•              Abnormal blood vessels on the skin

•              Dark-colored urine

See a doctor if you have signs of autoimmune hepatitis.

Diagnosis

Autoimmune hepatitis is diagnosed by blood tests and, sometimes, a tissue sample (biopsy) from your liver.

Treatment

Our liver specialists (hepatologists) have experience treating autoimmune hepatitis. They can help you keep your liver as healthy as possible.

Treatment focuses on stopping your immune system from attacking your liver. Your doctor will prescribe a drug for this. If your liver is severely damaged, you may need a liver transplant.

Autoimmune hepatitis can cause many complications. One of these is fluid building up between your abdomen (stomach) and spine. The fluid can become infected and can cause abdominal pain and swelling. The fluid may need to be drained with a procedure called paracentesis (abdominal tap).

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