Important note: The information display here is intended for educational purposes and is for

general treatment orientation. It is not intended, nor should it be interpreted, as medical

advice or medical instructions or to replace your doctor’s advice. You are advised to consult
your own medical doctor(s) for all matters involving your health and medical care.

HEPATITIS

Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients,
filters the blood, and fights infections. When the liver is inflamed or damaged, its function
can be affected. Heavy alcohol use, toxins, some medications, and certain medical
conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the world,
the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

Viral hepatitis is a silent world pandemic. In fact, hepatitis B and hepatitis C are 3.5–5 times
more prevalent than human immunodeficiency virus. Unfortunately, the significance of viral
hepatitis as a public health problem is often ignored by public.

Viral hepatitis can lead to cirrhosis, liver failure, and liver cancer, but infection is often silent
and symptomless until the development of significant liver disease, which can occur years
after the initial infection. As such, infection frequently goes undetected. Approximately one-
third of people with chronic hepatitis B infection and three-quarters of people with chronic
hepatitis C infection are unaware that they are infected.

Lack of knowledge of one's infection status means that people fail to seek needed care and
treatment. This lack of treatment can lead to serious consequences, as 15%–25% of people
with hepatitis B infection and an estimated 37% of people with hepatitis C infection will die
as a result of their infection if they do not receive needed treatment.

In the US, infection with hepatitis C is the more common cause of HCC, while in Asia and
developing countries, hepatitis B is more common. People infected with both viruses have a
high risk of developing chronic hepatitis, cirrhosis, and liver cancer. The risk is even higher if
they are heavy drinkers (at least 6 alcoholic drinks a day).

HBV and HCV can spread from person to person through sharing contaminated needles
(such as in drug use), unprotected sex, or childbirth. They can also be passed on through
blood transfusions, although this is very rare in the United States since blood products are
tested for these viruses. In developing countries, children sometimes contract hepatitis B
infection from prolonged contact with family members who are infected.

HBV is more likely to cause symptoms, such as a flu-like illness and jaundice (a yellowing of
the eyes and skin). But most people recover completely from HBV infection within a few
months. Only a very small percentage of adults become chronic carriers (and have a higher
risk for liver cancer). Infants and small children who become infected have a higher risk of
becoming chronic carriers.
HCV, on the other hand, is less likely to cause symptoms. But most people with HCV develop
chronic infections, which are more likely to lead to liver damage or even cancer.

Other viruses, such as the hepatitis A virus and hepatitis E virus, can also cause hepatitis. But
people infected with these viruses do not develop chronic hepatitis or cirrhosis, and do not
have an increased risk of liver cancer.

Symptoms
In most cases, people with infection have no symptoms of the disease, or their symptoms
are so mild they do not see a medical care provider about them. Symptoms of hepatitis
include the following:
 Fatigue (tiredness)
 General feeling of being unwell (malaise)
 Flu-like symptoms (e.g., headaches, muscle aches, low-grade fever)
 Lack of appetite, weight loss
 Nausea and vomiting, abdominal pain
 Jaundice (new or uncharacteristic yellow tinge to skin and mucus membranes)
 Diarrhea
 Itching of the skin
 Dark-colored urine
 Pale bowel movements

Prevention
Vaccination is the most effective way to prevent HBV infection. The consensus panel
recommends HBV vaccination for the following adults:
 People who are infected with HCV
 People who are sexually active with or who share a household with a person with
infectious HBV
 People who inject drugs
 People with occupational exposure to blood (e.g., medical care workers, dentists)
 People who attend or work at institutions for people with developmental disabilities
 Hemodialysis patients or those with end-stage renal disease
 People who are infected with HIV
 Anyone with liver disease
 Anyone who lives in or travels to countries with high rates of HBV
 Adults in correctional settings

References:
1. CDC Department of Health & Human Services, Centers for Disease Control and
Prevention, Division of Viral Hepatitis. Hepatitis. General information. J Pract Nurs
2010;60:5-6.
2. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B
infection. Geneva: World Health Organization, March 2015.
3. Zarrin A, Akhondi H. Viral Hepatitis. Treasure Island (FL): StatPearls Publishing;
2022.