Your liver is located in the right upper area of your abdomen. It performs many critical functions that affect metabolism throughout your body, including:
- bile production, which is essential to digestion
- filtering of toxins from your body
- excretion of bilirubin (a product of broken-down red blood cells), cholesterol, hormones, and drugs
- breakdown of carbohydrates, fats, and proteins
- activation of enzymes, which are specialized proteins essential to body functions
- storage of glycogen (a form of sugar), minerals, and vitamins (A, D, E, and K)
- synthesis of blood proteins, such as albumin
- synthesis of clotting factors
According to the Centers for Disease Control and Prevention (CDC), approximately 4.4 million Americans are currently living with chronic hepatitis B and C. Many more people don’t even know that they have hepatitis.
Treatment options vary depending on which type of hepatitis you have. You can prevent some forms of hepatitis through immunizations and lifestyle precautions.
Types of viral hepatitis
Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally transmitted hepatitis.
Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.
Hepatitis A is caused by an infection with the hepatitis A virus (HAV). This type of hepatitis is most commonly transmitted by consuming food or water contaminated by feces from a person infected with hepatitis A.
Hepatitis B is transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, containing the hepatitis B virus (HBV). Injection drug use, having sex with an infected partner, or sharing razors with an infected person increase your risk of getting hepatitis B.
It’s estimated by the CDC that 1.2 million people in the United States and 350 million people worldwide live with this chronic disease.
Hepatitis C comes from the hepatitis C virus (HCV). Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact. HCV is among the most common bloodborne viral infections in the United States. Approximately 2.7 to 3.9 million Americans are currently living with a chronic form of this infection.
Also called delta hepatitis, hepatitis D is a serious liver disease caused by the hepatitis D virus (HDV). HDV is contracted through direct contact with infected blood. Hepatitis D is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B. It’s very uncommon in the United States.
Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply. This disease is uncommon in the United States. However, cases of hepatitis E have been reported in the Middle East, Asia, Central America, and Africa, according to the CDC.
Many people with hepatitis experience either mild or no symptoms. When symptoms appear, they can do so from 15 to 180 days after infection. This applies to all types of hepatitis.
The initial phase of hepatitis is called the acute phase. The symptoms are similar to mild flu, and may include:
- Jaundice hepatitis
- Jaundice is a symptom of hepatitis.
- loss of appetite
- mild fever
- muscle or joint aches
- slight abdominal pain
- weight loss
The acute phase is not usually dangerous, but in certain people, it can result in acute liver failure and death. It may also progress to a chronic infection. This is most likely with HBV or HCV.
As the disease progresses, chronic hepatitis can lead to progressive liver failure, resulting in jaundice, swelling of the lower extremities, confusion, and blood in the feces or vomit.
The following may occur:
- dark urine
- itchy skin
- light-colored feces
- yellow skin, whites of the eyes, and tongue
Patient outcomes after the acute phase depend on various factors, especially the type of hepatitis. Some people will not know they have chronic hepatitis until liver failure occurs.
As the symptoms of the different types of hepatitis are similar, the type and severity of hepatitis may only be diagnosed through laboratory tests.
A doctor will perform a physical examination and ask for a medical history to assess whether a patient has been exposed to a likely cause of hepatitis.
If a patient recently traveled abroad, they may have HAV. If they have had unprotected sex, they may have HBV.
If hepatitis is suspected, the following tests can confirm a diagnosis:
- Blood tests: These can detect whether the body is producing antibodies to fight the disease, and they can assess liver function by checking the levels of certain liver proteins and enzymes.
- Nucleic acid tests: For hepatitis B and C, an HBV DNA or HCV RNA test can confirm the speed at which the virus is reproducing in the liver, and this will show how active the disease is.
- A liver biopsy: This can measure the extent of liver damage and the possibility of cancer.
- Paracentesis: Abdominal fluid is extracted and tested, to identify the cause of fluid accumulation.
- Elastography: This measures the liver's stiffness by emitting sound waves.
- Surrogate markers: A type of blood test to assess the development of cirrhosis and fibrosis.
The three most common types of viral hepatitis are all caused by viral infections.
Hepatitis A is caused by consuming food or water infected with the hepatitis A virus (HAV), often while traveling abroad. The virus can also be transmitted through anal-oral contact during sex or by injecting drugs.
Hepatitis B is caused by the hepatitis B virus (HBV) and is spread through contact with infected blood, semen, and some other body fluids. It can be a sexually transmitted disease (STD).
Hepatitis C mostly results from percutaneous infection, occurring when the HCV virus gets under the skin. It is usually spread through injected narcotics, needle-stick injuries, and a lack of infection control in healthcare settings.
HCV cannot be caught from contact with feces, and sexual transmission is less common than in other types.
Alcohol, medicines, obesity, and chemical exposure do not cause types A, B, or C, but they may aggravate inflammation and make symptoms worse.
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