At a glance:
- Hepatitis in an inflammatory condition of the liver
- Hepatitis causes liver damage over time, increasing the risk of cirrhosis (scarring of the liver), liver cancer or liver failure
- Infectious hepatitis is caused by viral infection
- There are five types of infectious hepatitis - A, B, C, D and E
- Noninfectious hepatitis can be caused by a number of factors, including excess alcohol consumption, exposure to toxins and autoimmune disease
- Hepatitis A, B and C exist in Australia, with B and C being the more common forms. Alcohol related hepatitis is also common
- Immunisation exists for hepatitis A and B, as does an effective cure for hepatitis C
What is Hepatitis?
The liver is a critical organ for metabolism located to the upper right of your abdomen. It performs a number of vital functions including producing bile (essential for digestion), synthesising a number of blood proteins and clotting factors as well as filtering toxins from the body.
Hepatitis is an inflammatory condition of the liver that impairs liver function. The inflammation is typically caused by a viral infection, but can also be caused by autoimmune disease , alcohol consumption, drug use or exposure to toxins.
Depending on the cause of the inflammation, hepatitis is broken into two categories - infectious and noninfectious.
Infectious hepatitis is classified into five categories: A, B, C, D and E. Hepatitis A, B and C are the most common forms of infectious hepatitis in Australia. All forms of infectious hepatitis are classified as National Notifiable Diseases in Australia, meaning that the government must be notified of all diagnosed cases.
- Hepatitis A - an acute, short term infection. Instances of Hepatitis A have dropped sharply in Australia over the last few decades due to improved clean water supply and indigenous immunisation programs.
- Hepatitis B - a chronic disease transmitted through bodily fluids.
- Hepatitis C - a blood borne infection.
- Hepatitis D - Hep D can either occur as a co-infection with Hep B or as a “superinfection” in people infected with Hep B. Hepatitis D is rare in Australia and typically only occurs in countries with high rates of hepatitis B.
- Hepatitis E - Hepatitis E is similar to hepatitis A in that it is a short term illness. Usually occurring in developing countries, Hep E is more severe but less transmissible than Hep A. Hepatitis E is especially dangerous to pregnant women.
- Other viruses - A number of other viruses, such as Epstein-Barr (glandular fever) may also cause hepatitis.
Noninfectious hepatitis is caused by drug or alcohol use, exposure to toxins or autoimmune response.
Symptoms of Hepatitis
The severity and duration of symptoms depends on the underlying cause. Typical symptoms include
- Abdominal pain or discomfort
- Bruising easily
- Dark urine
- Fatigue or lethargy
- Fever
- Jaundice - a yellow hue in the skin and eyes
- Joint pain
- Loss of appetite
- Nausea and vomiting
- Swelling
Although these symptoms are common for all forms of hepatitis, there are many people with both infectious and noninfectious hepatitis who are asymptomatic or have minimal symptoms.
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What Causes Hepatitis?
As hepatitis is an umbrella term used to describe conditions that cause inflammation of the liver, a number of different types of infection, viruses, or noninfectious can cause hepatitis.
Hepatitis A (HAV)
Hepatitis A is caused by exposure to the hepatitis A virus (HAV). The typical vector for this infection is via water, food or objects contaminated by the faeces of someone with the hepatitis A virus. Hepatitis A can also be sexually transmitted.
Hepatitis A is typically a short term infection and may last a few weeks. Having a hepatitis A infection grants a lifelong immunity to further Hep A infection but not for other forms of hepatitis.
Hepatitis B (HBV)
The Hepatitis B virus is transmitted through the bodily fluids (blood, urine, semen, vaginal secretions, saliva) of someone infected with the virus entering the bloodstream of someone uninfected. Sharing needles and unprotected sex are two of the main vectors for infection. Hepatitis B can also be passed from mother and child in the womb, during birth or shortly after birth.
People exposed to the hepatitis B virus risk developing long-term hepatitis B, a chronic, lifelong infection. Children and babies infected with hepatitis B are far more likely to develop long-term hepatitis B than someone infected as an adult.
Around 350 million people worldwide are living with hepatitis B. In Australia the number of people living with chronic hepatitis B is just over 226,000.
Hepatitis C (HCV)
Hepatitis C is a blood borne virus that is spread when the blood from an infected person enters the bloodstream of someone uninfected. The most common vector for hepatitis C infection is the sharing of needles.
Unless treated, hepatitis C can develop into chronic hepatitis C, a lifelong condition that can lead to severe liver conditions such as cirrhosis (scarring of the liver) or liver cancer.
There are around 150,000 Australians living with chronic hepatitis C.
Hepatitis D (HDV)
The hepatitis delta virus (hepatitis D) is transmitted through direct contact with the bodily fluids of someone infected with hepatitis D. It may also be passed from a mother to child in the womb or during birth. The hepatitis delta virus can only multiply in the presence of the hepatitis B virus, so you can only contract hepatitis D if you are already infected with hepatitis B.
Hepatitis D can be either acute or chronic, lasting a few weeks or developing into a lifelong condition. Chronic hepatitis D develops gradually over time and may be asymptomatic for months. The longer someone has hepatitis D the more severe the possible complications, such as cirrhosis or liver cancer.
Hep D is rare in Australia but is more common in areas with high rates of hepatitis B, such as South America, West Africa, Russia, Central Asia and the Pacific Islands.
Hepatitis E (HEV)
The hepatitis E virus is transmitted when someone eats or drinks something contaminated with the fecal matter of an animal or person already infected with hepatitis E. Due to the method of transmission, hepatitis E is rare outside of developing countries without adequate clean water supplies.
Much like hepatitis A, hepatitis E has no chronic form and is a short term infection usually lasting a few weeks. The symptoms of hepatitis E may be more severe than hepatitis A, and the virus is especially dangerous to pregnant women. Pregnant Australian women are advised not to travel to areas with hepatitis E, including parts of Africa, the Middle East and Central America.
Alcohol Related Hepatitis
As the name suggests, developing alcoholic hepatitis is directly related to heavy alcohol consumption. This form of hepatitis is common in Australia. The condition is frequently acute and develops in response to binge drinking. If a person with alcohol related hepatitis continues to use alcohol, they are at high risk for developing cirrhosis.
Toxic Hepatitis
Misuse of medication, supplements or exposure to toxins or poison can lead to toxic hepatitis. Common causes of toxic hepatitis include:
- Over the counter pain relievers - aspirin, ibuprofen, naproxen
- Prescription medications - a number of prescription medications can cause liver damage
- Herbs and supplements - such as aloe vera, black cohosh, cascara and kava
- Industrial chemicals - exposure to a wide range of industrial chemicals, including dry cleaning solvents, some pesticides and chemicals used in plastic manufacture can all cause liver damage
Depending on the toxins involved, symptoms of toxic hepatitis can appear within a few hours of exposure. The condition may reverse itself after exposure to the toxin is ceased, but toxic hepatitis may also permanently damage the liver, leading to cirrhosis or liver failure.
Autoimmune Hepatitis
Autoimmune hepatitis occurs when the body’s own immune system attacks the cells of the liver. The exact cause of this condition is unclear, but it is believed that both genetic and environmental factors interact in some way over time to trigger the disease.
Treatment For and Living With Hepatitis
Treatment for hepatitis varies with the cause. Chronic hepatitis treatment focuses on limiting symptoms and long term damage over “curing” the disease.
Hepatitis A Treatment
Hepatitis A may not require treatment other than bed rest and hydration, but more severe cases of hepatitis A may require medication or even hospitalisation.
A vaccine is available for hepatitis A and is recommended when travelling to areas in which the virus is common.
Hepatitis B Treatment
Treatment for hepatitis B is intended to help maintain prolonged good health but is not a cure for the disease. Antiviral medications are the most common treatment prescribed for hepatitis B. Interferon may also be prescribed. These medicines are used long term and either stop the virus from multiplying or may reduce the progression to cirrhosis.
While not a cure, slowing the spread of the virus may limit the amount of liver damage, significantly lowering the chances of severe complications.
An effective hepatitis B vaccine is available and is part of the standard immunisation schedule in Australia.
Hepatitis C Treatment
Medications referred to as direct-acting antivirals (DAAs) can be used very effectively to cure hepatitis C. These treatments are known to be more than 90% effective in curing the disease with few side effects, and are readily affordable for any Australian with a Medicare card.
The specific DAA prescribed depends on the length of time a person has had hepatitis C and the amount of liver damage the virus has caused.
There is no vaccination available for hepatitis C, but avoiding sharing needles and protecting yourself during sex is the best way to limit chances of infection.
Hepatitis D Treatment
No antiviral medications exist to combat hepatitis D as yet. A drug known as alpha interferon has shown some efficacy in treating hepatitis D, but it only shows improvement in around 25% of cases.
While there is no vaccine for hepatitis D, an immunisation against hepatitis B makes infection impossible as HDV only thrives in the presence of HBV.
Hepatitis E Treatment
As of this time there is no specific treatment for hepatitis E, but in most cases the infection is acute and can be treated with bed rest and proper hydration. Pregnant women with hepatitis E should seek medical care and monitoring.
Alcohol Related Hepatitis Treatment
If the hepatitis is due to binge drinking, any changes to the liver may be reversed or alleviated by refraining from the use of alcohol. If heavy drinking continues, this may lead to cirrhosis.
Toxic Hepatitis Treatment
The symptoms of toxic hepatitis may recede once contact with the toxin is ceased, but damage to the liver may be permanent. Specific treatments depend on the toxins involved.
Autoimmune Hepatitis
Like many other autoimmune diseases, autoimmune hepatitis is typically treated using immunosuppressive medications that lower the responsiveness of the immune system. In some cases in which immunosuppressive therapies are ineffective, a liver transplant may be necessary.
As it is a lifelong condition, early diagnosis of autoimmune hepatitis is key to effective treatment.
If you require treatment for already diagnosed hepatitis, or believe you may have been infected, the fastest and most convenient way to schedule an appointment with a doctor is to search and book online with MyHealth1st.