6 things you need to know about viral hepatitis

You may think viral hepatitis – a potentially serious liver infection – is something most of us don’t need to worry about. But according to the World Health Organization, an estimated 354 million people worldwide, or 4 percent of the global population,¹ are living with hepatitis B or C. And almost 90% of people with viral hepatitis don’t even know they have it.² That’s because symptoms don’t always show up until after the liver has already been damaged.

To help protect yourself and others, it's important to understand the details about hepatitis, including what you can do to treat it if you're infected. 

They are known by the letters A, B, C, D and E. Some types are more common than others. In the United States, hepatitis C has increased dramatically in the last decade. New cases are four times higher than they were 10 years ago, according to the Centers for Disease Control and Prevention. ³ In 2020, there were about 66,700 new hepatitis C cases — more than the new cases of hepatitis A and B combined.⁴ Hepatitis D and E are rare in the United States but very common in other parts of the world.

Hepatitis can cause a number of symptoms, including:⁵

• Abdominal pain
• Dark urine
• Fatigue
• Fever
• Jaundice (yellowing of the skin and eyes)
• Light-colored stools
• Loss of appetite
• Nausea

This virus is spread through food and water that is contaminated with fecal matter, along with direct or close physical contact.⁶ Contamination with food can happen during the growing, harvesting, handling, and even after cooking process. People infected with hepatitis A are usually sick for a few weeks to months. It will usually go away on its own.⁶

If a person has hepatitis A, “we closely monitor their liver function, and most cases don’t require any treatment,” says Tzu-Hao (Howard) Lee, M.D., an assistant professor of hepatology at Baylor College of Medicine.

Hepatitis B primarily spreads through infected blood, semen and other bodily fluids.  It can also pass to an infant during pregnancy or delivery. Hepatitis B infections can be short-term with mild symptoms, but some people develop more severe, symptoms and some develop chronic, longer-lasting infections. ⁵

This type of the virus spreads through direct blood-to-blood contact. It’s often passed through sharing contaminated equipment, such as needles and syringes. About half of people who are infected develop a chronic form of hepatitis. ⁵

Hepatitis D is also spread through contact with blood or bodily fluids. The big difference is that hepatitis D occurs only in people who’ve already been infected with the hepatitis B virus.⁷

The hepatitis E virus is uncommon in the United States. It’s mostly spread through eating raw or undercooked pork, venison, wild boar meat or shellfish. In less developed countries, it often spreads through drinking water contaminated with fecal matter.⁸

You can lower your risk of developing hepatitis a few different ways: ⁹

• Get vaccines to protect yourself from both hepatitis A and B
• Never share personal items like toothbrushes or razors with other people, along with medical needles and equipment that hasn’t been sterilized
• Wash your hands frequently⁹
• If you are sexually active, use condoms

The hepatitis A vaccine is given to children ages 12 months to 18 years and high-risk adults.¹⁰ High-risk adults are international travelers, men who have sex with men, intravenous drug users, people experiencing homelessness and those who are exposed to hepatitis risk on the job (such as hospital workers).¹¹

The hepatitis B vaccine is suggested for everyone younger than 60 and for older adults who are at risk of catching a hepatitis virus.¹⁰ (Vaccination against hepatitis B also protects you against hepatitis D, if you’ve never had hepatitis B.)

Talk with your doctor about which vaccines are safe and recommended for you.

If you develop chronic hepatitis B, your doctor may prescribe an antiviral medication.¹²

“Most patients need lifelong therapy,” Dr. Lee says. “But once they start, these medications are very good at suppressing the virus.”

There is no vaccine available to protect against hepatitis C. But unlike hepatitis B, it can be cured. ¹³ “We don’t get to use the word ‘cure’ a lot in medicine, but we do with hepatitis C due to the advancements in direct-acting antiviral therapy,” says Rachel Melson, D.N.P., a nurse and advisory committee member for the National Viral Hepatitis Roundtable. 

If you contract the virus, your doctor will prescribe a combination of different antiviral medications. Unlike decades ago, today’s treatments last only 8 to 12 weeks.¹⁴ They also have very few side effects; some people experience none at all. “With treatment, people can totally get rid of the hepatitis C virus from the body,” Dr. Lee says. 

Although viral hepatitis is by far the most common form, there are other ways you can develop the condition.¹⁵

• Alcoholic hepatitis: This is caused by heavy alcohol use.
• Toxic hepatitis: Exposure to certain chemicals, poisons, medicines and supplements can lead to this type of hepatitis.
• Autoimmune hepatitis: When your immune system attacks your liver, autoimmune hepatitis can occur.

Knowing some key facts about hepatitis can help you protect yourself. And ask your doctor about getting vaccinated. As with many illnesses, it may be an easy way to get an extra level of defense.