Viral Hepatitis

Viral hepatitis is liver inflammation due to a viral infection. It may present in acute (recent infection, relatively rapid onset) or chronic forms.

As viral hepatitis becomes more advanced, it may cause one or more of the following symptoms:

  • Loss of appetite
  • Nausea and/or vomiting
  • Fever
  • Dark urine
  • Stomach pain
  • Fatigue
  • Yellowing of the skin and eyes, called jaundice
  • Mood change, forgetfulness
  • Black bowel movements, which indicate bleeding into the intestine

Treatment for hepatitis varies, depending on the type and severity of the disease.

The most common causes of viral hepatitis are the five unrelated hepatotropic viruses:

  • Hepatitis A – caused by hepatitis A virus (HAV) that is transmitted by the fecal-oral route often associated with ingestion of contaminated food. There is no specific therapy for acute hepatitis A infection. Therefore, prevention is the key. An effective vaccine is available and recommended for anyone with liver disease.
  • Hepatitis B – caused by hepatitis B virus (HBV) that is transmitted through blood, tattoos, sexually, or via mother to child by breast feeding. About 25% of people with chronic hepatitis B can be cured with a drug called pegylated interferon-alpha, which is taken as a weekly injection for six months. The alternative is suppression of the virus with oral medications. Suppression is recommended for patients with elevated viral levels and evidence of advancing liver disease.
  • Hepatitis C – caused by hepatitis C virus (HCV) that is transmitted through contact with blood (including through sexual contact if the two parties’ blood is mixed) and can also cross the placenta. The most effective therapy for hepatitis C is a drug combination consisting of pegylated interferon and ribavirin. Pegylated interferon is taken weekly as an injection and ribavirin is a twice daily tablet. The treatment is a form of chemotherapy and the ability to tolerate it varies widely for each person.Liver transplant may be an option for people whose hepatitis progresses to liver failure and who fail to respond to treatment or cannot tolerate treatment. Currently, almost one half of all liver transplants in North America are performed for end-stage hepatitis C.
  • Hepatitis D – caused by the hepatitis D virus (HDV) and can only propagate in the presence of the Hepatitis B virus. Transmission of HDV can occur either via simultaneous infection with HBV or via infection of an individual previously infected with HBV.
  • Hepatitis E – caused by the hepatitis E virus (HEV). HEV has a fecal-oral transmission route.

In addition to the hepatitis viruses, other viruses that can also cause hepatitis include:

  • Herpes simplex
  • Cytomegalovirus
  • Epstein-Barr virus
  • Yellow fever