Inflammation of the Liver

Hepatitis, which refers to any type of inflammation in the liver, can be caused by a number of disorders and can affect the proper function of your digestive tract. Heavy alcohol use (alcoholic hepatitis) is the most common cause of liver injury or hepatitis. Certain medications (such as isoniazid [Laniazid, Nydrazid] to treat tuberculosis, methyldopa to treat high blood pressure, and amiodarone [Cordarone, Pacerone] to treat irregular heart rhythms) result in liver injury in susceptible individuals.

The liver also may be injured and become inflamed by the immune system (autoimmune hepatitis) or from increased iron storage (hemochromatosis).

Viral hepatitis

Viral hepatitis is caused most often by one of five viruses: A, B, C, D, or E. About 25,000 new cases of hepatitis A, 43,000 new cases of hepatitis B, and 17,000 new cases of hepatitis C occur each year in the United States. The other types rarely occur in the United States.

Hepatitis A is spread through contact with saliva or feces of someone who has the virus or ingestion of food or water contaminated with the virus. Hepatitis A is transmitted rarely through sexual contact.

Hepatitis B is transmitted through tainted blood that enters the body via

  • contaminated needles (illegal injection drug use or accidentally being stuck with a used needle)
  • blood transfusions
  • transplants
  • hemodialysis
  • tattooing
  • body piercing
  • acupuncture

You can also become infected when you have sex with someone who has the virus. Vaccines are available to prevent hepatitis A and B.

Hepatitis C is the top cause of chronic liver disease. Like hepatitis B, it is transmitted through infected blood exposure (often linked to illegal injection of drugs) and sexual contact with an infected person.

Symptoms of viral hepatitis

If you have viral hepatitis, it may not cause any symptoms at all, or it can cause vague, flu-like symptoms including fever, fatigue, weight loss, appetite loss, and nausea. Other symptoms can include stomach discomfort, dark urine, and jaundice (yellowing of the skin and whites of the eyes). Symptoms may come on suddenly.

Most people with hepatitis C have no symptoms and are diagnosed when abnormal liver enzymes are identified through a routine blood test. Between 75% and 85% of those with hepatitis C develop chronic disease, and between 5% and 20% may develop cirrhosis within 20 to 30 years of virus exposure.

Diagnosis of viral hepatitis

All three types of hepatitis can be detected with routine blood tests.

Treatment of viral hepatitis

There is no treatment for hepatitis A beyond getting rest and drinking plenty of fluids. Most people recover within two to six months. Most adults with hepatitis B recover within six months. However, about 5% become chronically infected and are at risk for chronic liver disease.

For those with acute hepatitis B (lasting less than six months), treatment isn't usually prescribed. However, if you know you've been exposed, getting the hepatitis B vaccine and hyperimmune globulin (a drug containing large amounts of antibodies to the hepatitis B virus) immediately after exposure can significantly reduce infection risk.

Chronic hepatitis B (lasting longer than six months) can be treated with pegylated interferon, lamivudine (Epivir-HBV), telbivudine (Tyzeka), adefovir (Hepsera), or entecavir (Baraclude). Pegylated interferon is prescribed less often than the other four drugs because of its many side effects.

Chronic hepatitis C is treated with pegylated interferon and ribavirin, which results in clearance of the virus in 30 to 40% of people. Unfortunately, side effects are common with this regimen and include worsening of heart disease, retinal detachment, flu-like symptoms, depression, anemia, and alopecia. If treatment is unsuccessful and the disease progresses, a liver transplant may be necessary.

Publication Review By: H. Franklin Herlong, M.D.

Published: 24 Mar 2011

Last Modified: 14 Oct 2011