A Guide to Hepatitis

Hepatitis A, hepatitis B, and hepatitis C are three distinct forms of viral hepatitis. Though they all affect the liver, they have different causes, symptoms, and treatments. Laboratory tests can be used to determine which type of hepatitis you have.

Hepatitis A

Hepatitis A is a highly contagious infection that affects the liver. It is spread by fecal matter and is commonly transmitted by the following methods:

• Eating food prepared by someone who has the virus and doesn’t wash their hands properly after using a toilet.  
• Drinking water that is contaminated.
• Eating raw shellfish from water that is contaminated with sewage.  
• Coming into close contact with someone who has the virus, even if they don’t exhibit any symptoms.
• Having sexual intercourse with someone who has the virus.

In mild incidents of hepatitis A , patients do not usually require treatment. Though the inflammation caused by the infection can disrupt liver function, most people who contract the disease make a full recovery without suffering permanent liver damage.

Signs and Symptoms

Not everyone who contracts hepatitis A develops noticeable symptoms. And symptoms may not appear until after you’ve been infected for a few weeks. Symptoms of hepatitis A can include:

• Feeling tired
• Abdominal discomfort, especially around the liver
• Nausea and vomiting
• Clay colored bowel movements
• Low appetite
• A mild fever
• Joint pain
• Dark urine
• Jaundice

Treatment

Your body is capable of clearing hepatitis A on its own, though you should take care to get enough rest so that your body can fight the infection. If nausea makes it difficult for you to eat, try snacking or taking in liquids such as soup, juice, or milk to get the calories you need. Remember that your liver is responsible for filtering toxins from your blood. You can avoid putting too much strain on your liver by abstaining from drinking alcohol and talking to your doctor about any medications that you may already be on.

Hepatitis B

Hepatitis B is caused by the hepatitis B virus (HBV). This form of hepatitis can be spread by bodily fluid. Saliva, blood and semen are in particular are a vector. The common methods of transmission include: 

• Having unprotect sex with an infected partner whose bodily fluids come into contact with your body.
• Sharing needles that have been contaminated with HBV-infected blood. Intravenous drug users are at a high risk of contracting hepatitis B.
• For health care workers, getting accidentally pricked by a needle that contains human blood is a concern.
• Mothers infected with hepatitis B can pass the virus to their newborn babies during birth. In most cases, vaccinating newborns can prevent the transmission of the disease.   

The infection caused by HBV can cause lasting damage to your liver, increasing your risk of liver cancer, cirrhosis of the liver, or liver failure. Most adults who are infected with hepatitis B recover fully, even in severe cases. Children under the age of five who contract hepatitis B are more likely to suffer from chronic hepatitis B, meaning that it takes more than six months for symptoms to clear up, though some adults also contract chronic hepatitis B. In some cases, chronic infections go unnoticed until liver disease develops.

Symptoms

Symptoms range from mild to severe, and may appear up to four months after you come into contact with the disease. They include:

• Feeling tired and weak
• Nausea and vomiting
• Abdominal pain
• No appetite
• Fever
• Dark urine
• Joint pain
• Jaundice

Treatment

If you know you’ve been exposed to hepatitis B, you should call your doctor as soon as possible. You may have been vaccinated against hepatitis B, but if you aren’t sure, receiving a special injection within 12 hours of coming into contact with the virus can help to protect you from contracting the disease. You should also get a vaccine.

When hepatitis B isn’t chronic, your doctor may prescribe rest, proper nutrition, and fluids. Chronic hepatitis B is usually treated with medication. In cases where serious damage has been done to the liver, a liver transplant may be required.

Hepatitis C

Like hepatitis A and B, hepatitis C is an infection that affects the liver. It is caused by the hepatitis C virus (HCV). In contrast to other forms of hepatitis, the vast majority of people who have hepatitis C don’t show any symptoms. They may not know that they have the disease until they liver damage appears years later. Hepatitis C is spread through contact with blood contaminated with the virus, and is most often transmitted through needle sharing related to illegal drug use.

Symptoms

In most cases, hepatitis C infections do not cause symptoms until years after the initial exposure. However, the following symptoms may occur one to three months after exposure in a small fraction of those infected:

• Feeling tired
• Nausea
• Stomach pain
• Low appetite
• Fever
• Dark urine
• Joint pain
• Jaundice

Years after exposure, other symptoms may appear. They are the result of damage to the liver caused by the virus and may include:

• Itchiness
• Bruising and bleeding easily
• Accumulation of fluid in the abdomen
• Swelling in the legs
• Weight loss
• Confusion, sleepiness, or slurred speech
• Spider-like blood vessels visible under the skin

Treatment

Unlike hepatitis A and B, there is no vaccine against hepatitis C. The infection is usually treated with antiviral medications, which should help to clear the virus from your system. These medications must be taken for a period of 24-72 weeks, and have serious side effects, including flu-like symptoms, depression, and a loss of red or white blood cells. Many people end their treatment because of the severe side effects.

Recent developments in hepatitis C treatment combine new antiviral medications with existing ones for fewer side effects and shorter treatment times. As advances continue to be made, it’s best to consult a specialist in the field when considering treatment options.

In cases of extreme damage to the liver, a liver transplant may be recommended. However, liver transplants can’t cure hepatitis C. You will have to continue to take antiviral medication after the transplant, since the infection is likely to appear in your new liver.