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more articles by Rogers, Steven Alan , MD  |  author's bio

The A, B, Cs of Hepatitis

The A, B, Cs of Hepatitis

Causes, symptoms, diagnosis, and treatment of hepatitis,

By Steven Rogers, M.D.

Hepatitis is a general term meaning “inflammation of the liver,” however, there are several specific types of hepatitis with various causes, symptoms, and treatments. Because people are often confused about this potentially life-threatening disease, the following information will delineate the differences among the most common types of hepatitis in this country.

There are three major forms of hepatitis: acute, chronic, and fulminant, or full-blown. Acute hepatitis is common and is often caused by a viral infection. Symptoms include fever, muscle aches, and jaundice. Medications such as Tylenol, chemical exposure, and alcohol abuse can also cause acute hepatitis. With proper medical treatment, patients typically recover in a few weeks.

Although several viruses can cause an acute illness, only hepatitis type B and C cause chronic infection. People with chronic hepatitis may have been exposed years before but usually have no symptoms other than mild fatigue. Often this form of hepatitis is discovered during a routine physical examination. Physicians are extremely concerned about chronic hepatitis because over time it can lead to scarring of the liver, cirrhosis, and liver cancer. In this country, an estimated 2-4 million people have chronic hepatitis C and another million suffer from chronic hepatitis B.

Fulminant hepatitis is rare, but very serious. It can be caused by hepatitis virus type A, B, or C; medications; poisonous mushrooms; and certain spider bites. In full-blown hepatitis, the liver is not functioning well due to significant cell damage and often times the treatment is a liver transplant.

There are many viruses that inflame the liver but hepatitis A, B, and C are the most common types in this country.

Hepatitis Type A

While hepatitis type A can make you feel acutely ill, it generally does not lead to long-term liver problems. It is transmitted by eating food that has been contaminated with fecal material; this can occur when infected food service workers do not follow proper hand-washing procedures after using the bathroom. The incidence of type A hepatitis is declining in this country due to proper hygiene. An effective vaccine is available that can prevent infection and should be considered in several groups including: travelers to high-risk regions (Africa, Asia, Central America); employees at day care centers; and individuals who care for people with severe developmental disabilities.

Hepatitis Types B and C

The hepatitis B virus is present in blood and other body fluids, and it is most often spread through sexual contact, transfusions, needle sticks (including tattooing), and IV drug use. There is a safe vaccine for hepatitis B and we recommend that children receive it along with the other standard childhood immunizations. Adults at higher risk for exposure should also be immunized, including health care workers, people with HIV, those on kidney dialysis, and anyone whose spouse has been exposed to hepatitis. Some people inherit hepatitis B from their infected mothers, often resulting in chronic liver disease by middle age. However, people exposed later in life may never develop chronic liver disease.

Hepatitis C is a chronic infection that over time is likely to result in chronic liver disease. In the majority of cases, hepatitis C is transmitted by blood but in about one-third of all cases, we don’t know the cause. Because type C can go undetected for decades, it is difficult for patients to remember that maybe they shared a toothbrush in college or borrowed nail clippers that were slightly contaminated with blood. There is no vaccination for type C.

Currently chronic hepatitis B and C are treated with Interferon, a drug that kills the virus and stimulates the immune system. It may be used in combination with another virus-fighter called Ribavirin. There are new medications on the horizon, but they are still experimental. In cases where the liver is failing, liver transplants are considered.

Dr. Rogers is board certified in internal medicine and specializes in gastroenterology and liver diseases. He is on the medical staff of Cayuga Medical Center and in practice with Gastroenterology Associates of Ithaca, where he can be reached at (607) 272-5011.

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