Hepatitis is inflammation of the liver.
The disease can be caused by:
Medications that can cause damage to the liver include methyldopa (used uncommonly for high blood pressure), isoniazid for tuberculosis, seizure medications (like valproate and phenytoin), chlorpromazine, amiodarone (for irregular heart rhythm), and certain antibiotics (including trimethoprim-sulfamethoxazole and erythromycin). If you need to take any of these, your doctor may need to check your liver function.
Liver disease can also be caused by inherited disorders such as cystic fibrosis and Wilson's disease, a condition that involves having too much copper in your body (the excess copper deposits in the liver).
Other causes include:
Hepatitis may start and resolve quickly (acute hepatitis), or cause long-term disease (chronic hepatitis). In some instances, progressive liver damage, liver failure, or even liver cancer may result.
The severity of hepatitis depends on many factors, including the cause of the liver damage and any underlying illnesses you have. Hepatitis A, for example, is generally short-lived, not leading to chronic liver problems.
Common risk factors include:
The symptoms of hepatitis include:
Many people with hepatitis B or C do not have symptoms when first infected and can still develop liver failure later. If you have any risk factors for either type of hepatitis, you should be tested periodically.
A physical examination may show yellowing of the skin, an enlarged and tender liver, or fluid in the abdomen (ascites) that can become infected.
Your doctor may order laboratory tests, including:
Your doctor will discuss possible treatments with you, depending on the cause of your liver disease. Your doctor may recommend a high-calorie diet if you are losing weight.
There are support groups for people with all types of hepatitis, which can help you learn about the latest treatments and better cope with having the disease.
The outlook depends on many factors, including the cause of the hepatitis and whether or not you have additional illnesses or conditions that complicate treatment or recovery. Many people recover fully. However, it may take months for the liver to heal.
Eighty percent of those with hepatitis C go on to have chronic liver disease and, possibly, liver failure (cirrhosis) or liver cancer. Hepatitis C is the number one reason for receiving a liver transplant in the United States.
Permanent liver damage, liver failure, or liver cancer can occur. Other complications include spontaneous bacterial peritonitis (when fluid in the abdomen becomes infected), and esophageal varices, which can bleed significantly.
Seek immediate care if you:
Call your doctor if:
The following hepatitis vaccines are available:
A shot of immunoglobulin may also prevent infection. This is true even after you have been exposed:
Other steps to take:
When to get tested for hepatitis:
Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008;359:1486-1500.
Jou JH, Muir AJ. In the clinic. Hepatitis C. Ann Intern Med. 208;148:iTC6-1-ITC6-16.