Even if you've been vaccinated against it, you may have a lot of unanswered questions about hepatitis. The condition, which is characterized by inflamed liver tissue, can be caused by a variety of factors, including viruses, an overactive immune system, and alcohol abuse. Hepatitis symptoms also vary widely, from a flu-like feeling that clears up in a few weeks to liver failure. Here are some facts worth knowing about every type of hepatitis—including the most common types, hepatitis B and hepatitis C.
1. There are five types of viral hepatitis.
Every case of hepatitis is characterized by inflammation of the liver tissue. When looking at viral hepatitis specifically, the treatments, modes of transmission, and duration of symptoms vary from according to which virus strain is causing it. Hepatitis A is an acute illness that often goes away on its own over time. It spreads primarily via the oral-fecal route, usually when someone ingests food or water contaminated with the hepatitis A virus. The second type, hepatitis B, can be either acute or chronic, and it spreads through bodily fluids like blood and semen. Hepatitis C mainly spreads through blood and is most likely to develop into a chronic condition.
The fourth and fifth types of viral hepatitis are hepatitis D and E, though they aren’t talked about much in the U.S. Like hepatitis A, hepatitis E is mostly spread through oral-fecal contamination. Hepatitis D can only be contracted if the patient has already had hepatitis B. Both types are less common in the U.S. compared to countries that lack access to clean drinking water.
2. Non-viral hepatitis can be caused by alcohol and other factors.
Catching a virus isn’t the only way to contract hepatitis. Even if you’re up-to-date on your shots and practice good hygiene, you can get it from exposure to toxic chemicals, taking prescriptions or over-the-counter-drugs, or abusing alcohol. All of these conditions are known as toxic hepatitis. There’s also autoimmune hepatitis, which occurs when the body’s immune system attacks the liver and treats it like a hostile invader. Doctors aren’t entirely sure why this happens, but it’s more common in people with a history of infections or other immune diseases.
3. Chronic hepatitis may not show any symptoms.
Chronic hepatitis is diagnosed when the condition lasts longer than six months. Sometimes it develops following a bout of acute hepatitis, but more often it’s asymptomatic. Vague signs of this form of hepatitis may include malaise, fatigue, and nonspecific upper abdominal discomfort. It’s under-diagnosed, but if patients suspect they have hepatitis symptoms, they can get a liver function test, a viral serologic test, or other blood work done to confirm it’s there.
4. Yellow eyes and skin are common symptoms of acute hepatitis.
Unlike chronic hepatitis, acute hepatitis quickly presents clear signs. These include pale stool, dark urine, fatigue, loss of appetite, and flu-like symptoms. One of the tell-tale symptoms of hepatitis is jaundice, which is characterized by yellowish skin or eyes. This occurs when bilirubin, an orange-colored waste material produced by the normal breakdown of red blood cells, builds up in the blood because the liver isn’t functioning properly.
5. Some types of hepatitis can be prevented with vaccines.
Hepatitis types A and B can both be protected against with vaccines. The hepatitis A vaccine is administered in two doses six to 18 months apart and the hepatitis vaccine is doled out in three shots over six months. Cases of hepatitis B in the U.S. have dropped by as much as 73 percent since the vaccine was first introduced in the 1980s and hepatitis A cases have declined by 95 percent in the same time period.
6. There's no vaccine for Hepatitis C—but doctors are working on it.
Hepatitis C is the most common form of viral hepatitis, but there's still no vaccine for it. Scientists have identified at least six genetically distinct types of the virus, and about 50 different subtypes. This makes it difficult to develop a one-size-fits-all vaccine for hepatitis C, but medical experts have been working on one since the disease was first detected 25 years ago.
7. Some types of hepatitis can be cured.
There’s no specific therapy for hepatitis A once you contract it, but treating it is simple: With plenty of bed rest and hydration, the symptoms should clear up on their own within a few weeks or months. Hepatitis B, on the other hand, has a cure. Pegylated interferon-alphaA, a weekly shot administered over six months, eradicates hepatitis B in 25 percent of people. When it doesn’t work, patients can take oral medications, like amivudine and adefovir, that suppress symptoms. People with hepatitis C can take a combination of pegylated interferon and ribavirin tablets to recover from the condition, but this treatment doesn’t always work and can cause harsh side effects that are hard for some patients to tolerate.
In people with non-viral hepatitis, avoiding the cause—whether it’s drugs, alcohol, or toxic chemicals in their environment—is the first and most important step toward protecting their liver. Patients with autoimmune hepatitis may need to take drugs like Prednisone that lower their immune activity. If chronic hepatitis has gone untreated for a long time and the liver is severely damaged, a liver transplant may be the only option.
8. Long-term effects of hepatitis can be deadly.
If left untreated for too long, chronic hepatitis can have severe health effects. Even when symptoms aren’t immediately apparent, hepatitis takes its toll on the liver. One of the more dire outcomes of this condition is cirrhosis, a deadly liver disease that occurs when scar tissue starts to overtake healthy tissue inside the liver. This stops the liver from functioning properly and can lead to gallstones, swelling of the legs and feet, increased blood pressure, chronic bruising and bleeding, and poisoning of the brain. Liver cancer is another potential long-term side effect of chronic hepatitis.
9. Baby boomers are more likely than other age groups to have hepatitis C.
Baby boomers, a.k.a. people born between 1945 and 1965, are five times more likely to have hepatitis C than the rest of the population [PDF]. Transmission of hepatitis C reached its peak in the 1960s through the 1980s, before regular screenings for the virus became common, which is when most Boomers living with the disease today likely contracted it. Health experts recommend that everyone in this age group be tested for hepatitis C even if they don’t exhibit symptoms.
10. Viral hepatitis kills more people than malaria.
There are more than 325 million people around the world living with viral hepatitis today—that’s roughly equivalent to 4 percent of Earth's population. Every year, the disease leads to 1.34 million fatalities, which makes it deadlier than HIV, tuberculosis, and malaria. While the death rates associated with those diseases are on the decline, deaths caused by viral hepatitis increased 22 percent between 2000 and 2015. In 2017, Charles Gore, then president of the World Hepatitis Alliance, said the spike can be blamed on a lack of funding and prioritization of hepatitis compared to other global health threats. Lack of awareness is also a problem: Just 5 percent of people with viral hepatitis realize they have it.