Liver Disorder Hepatitis

The most common causes of liver inflammation are hepatitis A (HAV) and related viruses. At least six different types of hepatitis viral infection have been identified. Some are quite rare, some are acute and some are serious chronic diseases that can cause extensive liver damage. All should be taken seriously.

Hepatitis A (HAV)

Hepatitis A is a common disease: one third of American people show signs that they were infected at some point and are now immune. You can catch HAV only once. The disease does not cause chronic complications, although 15 percent of infected people display symptoms for up to nine months.

HAV is spread through contact with human feces. You contract it orally through contaminated sources such as food or water, or through contact with an infected person. Symptoms include jaundice, fatigue, nausea, diarrhea, fever, stomach pain and a loss of appetite.

People who engage in anal sex are at high risk for HAV infection. Proper hygiene and hand washing is the best way to prevent the spread of HAV. A vaccine for HAV is available.

Hepatitis B (HBV)

HBV is a serious disease that can lead to lifelong infection, cirrhosis (scarring of the liver), cancer and even death. Symptoms are similar to HAV, but also include vomiting and joint pain. About 125 million people in the United States suffer from chronic HBV. Some 15 to 25 percent of people with chronic HBV die from liver damage caused by the disease.

HBV is spread through direct contact with infected blood or body fluids. It is often spread sexually, or by injecting illegal drugs. The disease can also be passed from mother to child during birth. Medical researchers are investigating the possibility that HBV infection increases the chance of hepatitis C and HIV infections.

HBV vaccines are available. In addition, limiting sexual partners, practicing safe sex and avoiding illegal drug use can lower a person’s risk of infection. People infected with HBV should not donate blood, organs or tissues.

Unlike HAV, Hepatitis B can be treated. Drugs such as Interferon, Lamivudine, and Dipivoxil are generally prescribed. If these medications fail, a liver transplant is the final possibility.

Hepatitis C (HCV)

No vaccine is available for HCV which, like HBV, is spread though contaminated blood or body fluids. HCV is chronic in approximately 75 to 80 percent of cases. Seventy percent of chronic cases also suffer liver disease or cirrhosis. Symptoms include jaundice, fatigue, abdominal pains, loss of appetite, nausea and dark urine. Chronic HCV can be treated with the drugs interferon and ribavirin, which are often used in combination.

You are at a higher than normal risk for HCV if any of the following apply to you:

  • You have used injected illegal drugs. Most HCV infections occur among intravenous drug users.
  • You had a blood transfusion or organ transplant prior to 1992, or used blood-based clotting products prior to 1987.
  • You suffer from some type of liver disease.
  • You have had long-term kidney dialysis.

Hepatitis D (HDV)

HDV is a virus that requires the presence of HBV to reproduce. For that reason, it is often transmitted with HBV. Like HBV, intravenous use of illegal drugs and unprotected sexual contact increases the risk of infection. Incidents of aggressive HBV infection or the sudden worsening of HBV symptoms indicates possible HDV infection.

Hepatitis E (HEV)

HEV is uncommon in the US, but the risk increases in countries where water treatment and public sanitation systems are primitive. The disease is transmitted through food and water contaminated with human feces. No vaccine is available. When in countries where the risk is high, avoid drinking tap water and maintain good personal hygiene and sanitation habits. The infection generally resolves itself after a few months.

Hepatitis F and G

Isolated cases of HFV and HGV have been reported, mostly in the United States, Europe and India. Recorded diagnosis of the diseases is rare, and little is known about the two viruses other than that they exist.

Autoimmune Hepatitis

When the body’s immune system malfunctions and attacks the liver, autoimmune hepatitis occurs. Autoimmune hepatitis is not a viral infection, although symptoms resemble HAV. Women appear to be more susceptible, accounting for 70 percent of all cases. Without treatment, liver disease and cirrhosis can occur.

The condition is treated with a combination of steroids and the medication azathioprine. Medications are reduced in potency over several months to reduce the chances of unwanted side effects.

Resources

American Academy of Family Physicians. (updated 2003). Cirrhosis and portal hypertension.

American Liver Foundation. (2003). The liver: A primer.

Beers, M. H.,