Viral hepatitis is inflammation of the liver caused by a viral infection. The most common types of viral hepatitis in the United States are hepatitis A, B and C. Less common causes of viral hepatitis include hepatitis D and E.

Overview and Symptoms
Hepatitis A and E viruses are contracted by ingesting contaminated food or water. Outbreaks of both hepatitis A and E have occurred in countries primarily without modern sanitation, but there have also been outbreak of hepatitis A in the United States.

Both viruses cause an infection that can last several weeks. While most patients recover with no lasting liver damage, there are rare cases of severe infection that can result in liver failure or death. Liver transplantation can be used to treat patients with liver failure.

Hepatitis B virus is spread through blood, semen and other bodily fluids.  It can be transmitted from mother to baby during childbirth, through sexual intercourse with an infected individual, or through the use of shared equipment such as razors, toothbrushes or needles and syringes for injecting medication or illicit drugs.

Hepatitis B can cause symptoms similar to hepatitis A or E, but can cause chronic liver disease resulting in liver damage, scarring of the liver and eventual cirrhosis. It is also a leading cause of liver cancer.

Hepatitis C virus is also spread through contact with blood from an infected person though sharing of equipment such as needles or syringes or by receiving a blood transfusion or organ transplant prior to 1992. The Centers for Disease Control and Prevention (CDC) estimate that 3.5 million people in the United States have chronic hepatitis C virus infection, and about half of these people are unaware of it. Most of those infected were born between the years 1945-1965 (“baby boomers”), before universal precautions and infection control procedures were adopted.

Infection with hepatitis C often occurs without any symptoms and can lead to chronic infection that can result in liver damage or cirrhosis, and is a major risk factor for liver cancer.  It is the leading cause of liver transplantation in the United States.

Hepatitis D virus infections only occur in patients with hepatitis B virus infection. The presence of hepatitis D with hepatitis B virus infection can cause more severe liver disease. These infections can occur at the same time (co-infection) or hepatitis D virus infection can occur after hepatitis B infection (super infection). All patients with hepatitis B infection should be tested for hepatitis D infection.

Treatment at BIDMC

Hepatitis A and Hepatitis E
Safe water supply, food safety, improved sanitation, hand washing are the most effective ways to combat this disease. There is an effective vaccine for hepatitis A that is recommended for all children over the age of one, travelers to countries where hepatitis A is widespread, for family and caregivers of children adopted from countries where it is widespread, men who have sex with men, users of recreational drugs and those with a diagnosis of chronic liver disease. 

Hepatitis B
There is a vaccine for hepatitis B that is offered to all children at birth. The vaccine is also available and recommended for unvaccinated adults with diabetes, uninfected household members and sexual partners with hepatitis B, people with multiple sexual partners, persons seeking evaluation or treatment for a sexually transmitted disease, men who have sex with men, people who inject drugs, and people with chronic liver disease or HIV infection.

There are medications that can be used to treat patients with chronic hepatitis B infection, which are highly effective in controlling the infection and improving liver function.

Hepatitis C
Anyone born between 1945-1965 should speak to their doctor about being tested for hepatitis C virus infection. There is no vaccine for hepatitis C virus, but many medications are now available that can treat and cure the infection.

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The Liver Center at BIDMC brings together an exceptional team of multidisciplinary providers to offer personalized care and the most advanced treatment options to patients with a variety of liver conditions.

Liver Center