Do you know the A, B, C, D and E of hepatitis?

Hepatitis is an inflammatory condition of the liver that can be caused by heavy alcohol use, medications, and toxins but often hepatitis is caused by infections from different viruses such as hepatitis A, B, C, D, and E. The liver is a vital organ that filters the blood, processes nutrients, and fights infection. If the liver is inflamed, it cannot function properly. The most common forms of hepatitis in the United States are hepatitis A, B, and C.

Hepatitis A and E typically cause acute infections. Whereas, hepatitis B, C, and D cause acute and chronic infections. Many people are unaware that they may have an infection. Therefore, public awareness about hepatitis, transmission of the virus, prevention, and treatment are extremely important for public health worldwide. Hepatitis affects millions of people around the world and can cause serious health complications if not properly managed. 

With acute infections, symptoms can appear anytime between 2 weeks and 6 months. Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, joint pain, light-colored stools, and jaundice (yellowing of skin and whites of eyes) are all symptoms of an acute hepatic infection. Chronic liver infections can later develop into cirrhosis of the liver or liver cancer. Approximately 354 million people worldwide live with hepatitis B or C.

Anyone who has not been vaccinated or previously infected can get hepatitis A. The hepatitis A virus is transmitted through ingestion of contaminated food or water or from direct contact with a contaminated person. The disease is mostly associated with poor sanitation, poor personal hygiene, unsafe water or food, and oral-anal sex. Almost everyone fully recovers from hepatitis A with lifelong immunity. However, a very small proportion of people with hepatitis A infection could die. There is no specific treatment for hepatitis A and recovery can take weeks or months. 

The spread of hepatitis A can be reduced by having access to safe drinking water and food. Hepatitis A can also be reduced by improving personal hygiene such as washing hands before eating and after going to the bathroom. There are also several commercially available hepatitis A vaccines on the market. 

Hepatitis B

Hepatitis B is most commonly transmitted via mother-baby during pregnancy or during delivery, as well as during contact with bodily fluids or blood from an infected partner during sex, unsafe injections, or exposures to sharp instruments. Hepatitis B can survive outside the body for at least 7 days. As a result, the virus can still cause infection in the body of a person who has not been protected by the vaccine.  In 2019, hepatitis B resulted in an estimated 820,000 deaths, mostly from cirrhosis and liver cancer. About 2.7 million people worldwide who are living with hepatitis B are also infected with HIV. 

Laboratory confirmation is needed to diagnose hepatitis B and to determine an acute or chronic infection. There is no treatment for acute hepatitis B infection but chronic hepatitis B can be treated with medications, including antivirals.  Furthermore, there is a safe and effective vaccine that offers 98-100% immunity.  Safe sex practices such as limiting sexual partners and using barrier protection can also help prevent hepatitis B transmission. 

Hepatitis C

Globally, an estimated 58 million people have chronic hepatitis C infection. Most infections occur from exposure to blood from unsafe injection practices, unsafe health care, un-screened blood transfusions, or sexual practices that lead to exposure to blood. Antivirals can cure more than 95% of persons with hepatitis C. There is no vaccine for hepatitis C.

Hepatitis infection is a global health problem and most people are unaware that they are infected. Please discuss with your personal provider about your risks for hepatitis. 

For more information, please go to www.cdc.gov. 

Denise Hooks-Anderson, MD, FAAFP Family Physician, The St. Louis American Medical Accuracy Editor, can be reached at yourhealthmatters@stlamerican.com.