Health - VIRAL INFECTIONS - Hepatitis

Introduction 

Hepatitis is the term used to describe inflammation of the liver. It's usually the result of a viral infection or liver damage caused by drinking alcohol.

There are several different types of hepatitis, most of which are outlined below.

Some types will pass without any serious problems, while others can be long-lasting (chronic) and cause scarring of the liver (cirrhosis), loss of liver function and, in some cases, liver cancer.

This page covers:

Symptoms of hepatitis

Short-term (acute) hepatitis often has no noticeable symptoms, so you may not realise you have it.

If symptoms do develop, they can include:

• muscle and joint pain
• a high temperature (fever) of 38C (100.4F) or above
• feeling and being sick
• feeling unusually tired all the time
• a general sense of feeling unwell
• loss of appetite
• abdominal (tummy) pain
• dark urine
• pale, grey-coloured poo
• itchy skin
• yellowing of the eyes and skin (jaundice)

See your GP if you have any persistent or troublesome symptoms that you think could be caused by hepatitis.

Long-term (chronic) hepatitis also may not have any obvious symptoms until the liver stops working properly (liver failure) and may only be picked up during blood tests.

In the later stages it can cause jaundice, swelling in the legs, ankles and feet, confusion, and blood in your stools or vomit.

Hepatitis A

Hepatitis A is caused by the hepatitis A virus. It's usually caught by consuming food and drink contaminated with the poo of an infected person and is most common in countries where sanitation is poor.

Hepatitis A usually passes within a few months, although it can occasionally be severe and even life-threatening. There's no specific treatment for it, other than to relieve symptoms such as pain, nausea and itching.

Vaccination against hepatitis A is recommended if you're travelling to an area where the virus is common, such as the Indian subcontinent, Africa, Central and South America, the Far East and Eastern Europe.

Read more about hepatitis A.

Hepatitis B

Hepatitis B is caused by the hepatitis B virus, which is spread in the blood of an infected person.

It's a common infection worldwide and is usually spread from infected pregnant women to their babies, or from child-to-child contact. In rare cases, it can be spread through unprotected sex and injecting drugs.

Hepatitis B is uncommon in the UK and most cases affect people who became infected while growing up in part of the world where the infection is more common, such as Southeast Asia and sub-Saharan Africa.

Most adults infected with hepatitis B are able to fight off the virus and fully recover from the infection within a couple of months.

However, most people infected as children develop a long-term infection. This is known as chronic hepatitis B and it can lead to cirrhosis and liver cancer. Antiviral medication can be used to treat it.

In the UK, vaccination against hepatitis B is recommended for people in high-risk groups, such as healthcare workers, people who inject drugs, men who have sex with men, and people travelling to parts of the world where the infection is more common.

Read more about hepatitis B.

Hepatitis C

Hepatitis C is caused by the hepatitis C virus and is the most common type of viral hepatitis in the UK. It's usually spread through blood-to-blood contact with an infected person.

In the UK, it's most commonly spread through sharing needles used to inject drugs. Poor healthcare practices and unsafe medical injections are the main way it’s spread outside the UK.

Hepatitis C often causes no noticeable symptoms, or only flu-like symptoms, so many people are unaware they're infected.

Around one in four people will fight off the infection and be free of the virus. In the remaining cases, it will stay in the body for many years. This is known as chronic hepatitis C and can cause cirrhosis and liver failure.

Chronic hepatitis C can be treated with very effective antiviral medications, but there's currently no vaccine available.

Read more about hepatitis C.

Hepatitis D

Hepatitis D is caused by the hepatitis D virus. It only affects people who are already infected with hepatitis B, as it needs the hepatitis B virus to be able to survive in the body.

Hepatitis D is usually spread through blood-to-blood contact or sexual contact. It's uncommon in the UK, but is more widespread in other parts of Europe, the Middle East, Africa and South America.

Long-term infection with hepatitis D and hepatitis B can increase your risk of developing serious problems, such as cirrhosis and liver cancer.

There's no vaccine specifically for hepatitis D, but the hepatitis B vaccine (see above) can help protect you from it.

Hepatitis E

Hepatitis E is caused by the hepatitis E virus. It's usually caught by consuming food and drink contaminated with the poo of an infected person. It's now the most common cause of short-term (acute) hepatitis in the UK.

Hepatitis E is generally a mild and short-term infection that doesn't require any treatment, but it can be serious in a small number of people. It can become chronic in people who have a suppressed immune system, such as those who have had an organ transplant. 

There's no vaccine for hepatitis E, but you can reduce your risk by practising good food and water hygiene measures, particularly when travelling to parts of the world with poor sanitation.

The British Liver Trust has more information about hepatitis E.

Alcoholic hepatitis

Alcoholic hepatitis is a type of hepatitis caused by drinking excessive amounts of alcohol over many years.

The condition is common in the UK and many people don't realise they have it because it doesn't usually cause any symptoms, although it can cause sudden jaundice and liver failure in some people.

Stopping drinking will usually allow your liver to recover, but if you continue to drink alcohol excessively, there's a risk you could eventually develop cirrhosis, liver failure or liver cancer.

You can reduce your risk of developing alcoholic hepatitis by controlling how much you drink. It's recommended that you don't regularly drink more than 14 units of alcohol a week.

Read more about alcohol-related liver disease and the health risks associated with alcohol.

Autoimmune hepatitis

Autoimmune hepatitis is a rare cause of long-term hepatitis in which the immune system attacks and damages the liver.

Eventually, the liver can become so damaged that it stops working properly.

Treatment for autoimmune hepatitis involves very effective medicines that suppress the immune system and reduce inflammation.

It's not clear what causes autoimmune hepatitis and it's not known whether anything can be done to prevent it.

The British Liver Trust has more information about autoimmune hepatitis.