Viral hepatitis

What is it?

Viral hepatitis is an infection that causes inflammation and damage of the liver, caused by several viruses that differ in mode of transmission and course of disease (NIDDK).

A and E: temporary infections that usually clear within weeks without intervention. A is transmitted through the stool of an infected person, and E through drinking water contaminated with infected stool or undercooked pork or game. B, C and D: may become chronic; B is transmitted by blood and body fluids and C by blood, while D affects only people who have B infection (NIDDK).

Causes

According to the WHO, hepatitis B is mostly transmitted from mother to child at birth and from early childhood, through blood or body fluids in sexual contact with an infected person, unsafe injections, and exposure to sharp instruments. The NHS adds unsterile needles for acupuncture, tattooing and piercing, and blood transfusion in countries that do not screen blood for hepatitis B.

Risk factors

The WHO notes that about 95% of those infected with B before age five develop chronic hepatitis.

Symptoms

Most newly infected people have no symptoms at first. In acute inflammation these may appear: jaundice (yellowing of the skin and eyes), dark urine, tiredness, nausea and vomiting, and abdominal pain (WHO). The NHS lists: fever, tiredness, upper abdominal pain, nausea, a rash and pale stools, and symptoms usually clear within one to three months.

How is it diagnosed?

Blood tests distinguish acute from chronic infection and assess the severity of disease, and the WHO recommends screening all pregnant women and risk groups. The NIDDK recommends hepatitis C screening at least once for all adults, and B screening for pregnant women and high-risk groups.

Treatment

The treatment categories usually used are listed here; this is not a prescription. The doctor chooses the plan according to each person's condition; do not change any medicine or dose without a specialist.

Acute B infection mostly clears without treatment, and management is limited to relieving symptoms and rest (NHS). Chronic B is treated with antivirals such as tenofovir or entecavir, which may slow the progression of cirrhosis and reduce liver cancer, and most patients need lifelong treatment (WHO). The NIDDK states that early diagnosis and treatment prevent liver damage, especially in C. No doses are given.

Complications

Chronic infection may lead to cirrhosis and hepatocellular carcinoma, and may be fatal (WHO). The WHO points to 1.1 million deaths in 2024, mostly from cirrhosis and liver cancer.

Prevention

A vaccine exists for hepatitis A and B (NIDDK). The B vaccine is given to infants within 24 hours of birth followed by two or three doses, and protects at a rate of nearly 100% for at least 20 years and perhaps for life (WHO). The NHS advises using condoms and not sharing personal items.

Common questions