The A, B, Cs of Hepatitis
Causes, symptoms, diagnosis, and treatment of hepatitis,
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
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
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.