If you’re one of the millions of people in America who have hepatitis or you have a loved one with hepatitis, then you know it can be a challenging diagnosis. The viral infection can be contracted in a number of different ways, and once it’s present in the body, it often lies dormant for some time. When it becomes active, it leads to symptoms such as yellowing of the skin (jaundice) or eyes (scleral icterus), fever, loss of appetite, fatigue, stomach pain and more, according to the Cleveland Clinic.
What is hepatitis?
When the hepatitis virus infects the body and becomes active, it attacks the liver, the Cleveland Clinic says. Inflammation is how the liver reacts to this attack, which can lead to many serious symptoms. Over time, it can lead to liver failure.
Some forms of hepatitis are acute and go away on their own. Other forms, however, are chronic. If you don’t receive treatment for these types of hepatitis, they can cause liver failure. And some of these forms of hepatitis infect the body without any noticeable symptoms.
How do you get it?
Hepatitis develops through exposure to the hepatitis virus, but how you get it can vary by hepatitis type, according to the U.S. Centers for Disease Control and Prevention (CDC). Still, some commonalities exist between the different types. For example, having unprotected sex or sharing needles with an infected person is a common way of spreading hepatitis. Drinking water or eating food infected with the virus is another way to get some types. Some children are born with hepatitis if their mother is infected.
Types of hepatitis
The lettering system used to identify hepatitis types corresponds to the different viruses that can cause hepatitis, the CDC says. Each type of hepatitis presents some subtle differences in symptoms and how it’s transmitted from person to person.
This is one of the least common forms of hepatitis in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This is largely due to a hepatitis A vaccine that became available in 1995. However, rising rates of homelessness and needle-based drug use have caused the numbers of people with hepatitis A to rise slightly in the last few years.
Hepatitis A is transmitted by contact with an infected person’s stool. People who have unprotected sex or use illegal drugs are at higher risk. You are also more at risk for hepatitis A if you travel to developing countries where sanitation is poor and clean water is limited or if you care for someone with the disease. Hepatitis A usually does not cause chronic, long-term problems like the other forms of hepatitis. In most cases, the symptoms of diarrhea, fatigue, fever and joint pain tend to go away within a few weeks.
This type is more common than hepatitis A, according to the NIDDK. Some 2.2 million people in the United Sates are estimated to have the disease. Many of these infections occurred before 1991, when doctors began recommending the hepatitis B vaccine. Some who have the hepatitis B virus get an acute short-term infection, just like hepatitis A. Others develop a chronic infection that doesn’t go away on its own.
Hepatitis B is spread through body fluids; those who have unprotected sex and share needles for drugs are most at risk. Health care workers or people who travel in developing countries are also at a greater risk of getting it. The acute symptoms of hepatitis B are similar to hepatitis A. However, if left untreated, it can ultimately lead to cirrhosis of the liver, liver failure and even liver cancer. Luckily, treatments for hepatitis B are better than ever before.
Hepatitis C is the most common form of hepatitis in the United States, affecting 2.7 to 3.9 million people, the NIDDK says. Though it can cause an acute, short-term infection, about 80 percent of those who acquire the virus go on to develop the chronic, long-lasting form of hepatitis C.
Hepatitis C is spread through contact with an infected person’s blood. In the United States, the most common way of getting infected is by injecting illegal drugs, or though unprotected sex, tattoos or body piercings. Being born to a mother with hepatitis C also puts you at risk. The potential symptoms of and treatments for hepatitis C are similar to those for hepatitis B. The condition can ultimately lead to cirrhosis and liver failure if left untreated. It also puts you at an increased risk of getting liver cancer.
If you were born between 1945 and 1965, your doctor may recommend hepatitis C screening to ensure that you don’t have the disease. This is because many people born during this time period may have been put at risk due to different medical treatment standards years ago.
Of the five categories of hepatitis virus, hepatitis D may have the most unique trait: It can only infect someone who also has the hepatitis B virus, according to the NIDDK. This makes hepatitis D a rare infection, particularly in the United States. But when it does occur along with hepatitis B, it can cause severe symptoms.
Hepatitis D is spread by contact with infected blood. If you get infected with hepatitis B and D at the same time, this is known as a co-infection, which typically causes an acute illness that goes away with time. If a person develops hepatitis B and then gets hepatitis D later, however, this is known as a superinfection. Most people with a superinfection develop chronic hepatitis that can ultimately lead to liver failure if untreated.
Like hepatitis A, hepatitis E typically causes only an acute, or short-term, infection. Researchers used to think hepatitis E was rare in the United States and more common in developing nations, but recent research has found that almost 20 percent of the population has had the illness at some point, the NIDDK says. In the United States, hepatitis E infection tends to be mild and not cause any symptoms.
In developing countries, hepatitis E tends to cause severe infections and is particularly a risk for pregnant women. It tends to spread through contaminated water or food and causes symptoms such as nausea, vomiting, fatigue, poor appetite, jaundice and abdominal pain.
For acute cases of hepatitis, the infections will typically resolve on their own after a few weeks, according to the NIDDK. Your doctor may recommend supportive care in the form of rest, eating a healthy diet and getting plenty of fluid while you recover.
For chronic cases of hepatitis, particularly hepatitis B and C, newer drugs known as direct-acting antivirals have vastly improved outcomes. These drugs cause fewer side effects than older hepatitis medications and have significantly higher cure rates, NIDDK says. If there is any drawback to these medications, it’s that you typically have to take them for eight to 24 weeks to cure chronic hepatitis, and the medications can be costly. Many insurance companies, states, drug companies and nonprofit organizations offer programs to help pay for the medications.
You can reduce your chances of getting hepatitis in many cases with the right lifestyle choices. These include avoiding illegal drug use, particularly with needles, and not having unprotected sex with multiple partners. Practicing good hygiene, avoiding close contact with the personal items of an infected person, and taking precautions when traveling to undeveloped countries are other steps you can take to prevent infection, the Cleveland Clinic says. Vaccines to protect against hepatitis A and B are also available, and a hepatitis C vaccine is currently in the works.
- Hepatitis: Viral hepatitis A, B, and C, Cleveland Clinic, 2019, https://my.clevelandclinic.org/health/diseases/4245-hepatitis-viral-hepatitis-a-b--c
- The ABCs of Hepatitis, CDC, 2016, https://www.cdc.gov/hepatitis/resources/professionals/pdfs/abctable.pdf
- Hepatitis: Viral hepatitis A, B, and C: Prevention, Cleveland Clinic, 2019, https://my.clevelandclinic.org/health/diseases/4245-hepatitis-viral-hepatitis-a-b--c/prevention
- Hepatitis A, National Institute of Diabetes and Digestive and Kidney Diseases, 2019, https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-a
- Hepatitis B, National Institute of Diabetes and Digestive and Kidney Diseases, 2019, https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-b
- Hepatitis C, National Institute of Diabetes and Digestive and Kidney Diseases, 2019, https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-c#vaccine
- Hepatitis D, National Institute of Diabetes and Digestive and Kidney Diseases, 2019, https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-d#vaccine
- Hepatitis E, National Institute of Diabetes and Digestive and Kidney Diseases, 2019, https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-e#vaccine