Hepatitis is an inflammation of the liver, usually caused by a viral infection or by excessive alcohol consumption.
There are five different types of viral hepatitis (A, B, C, D and E), as well as alcohol and autoimmune hepatitis. Some types will pass without any serious problems, while others can be long-lasting and cause scarring of the liver (cirrhosis), loss of liver function and, in some cases, liver cancer.
There are currently safe and effective vaccines for most types of hepatitis, with antiviral medication and/or corticosteroids used to treat symptoms. There is no vaccine at present for hepatitis C.
Good hygiene, including hand washing, and a healthy lifestyle are some simple ways to may help prevent becoming infected, but see your GP if you have any persistent or troublesome symptoms that you think could be caused by hepatitis.
While hepatitis can be asymptomatic, when symptoms occur they can include:
- muscle and joint pain,
- loss of appetite,
- stomach pain,
- dark urine,
- pale, grey-coloured poo,
- itchy skin,
- yellowing of the eyes and skin, i.e. jaundice.
Short-term (acute) hepatitis is hepatitis that resolves within six months, and which often has no noticeable symptoms.
Long-term (chronic) hepatitis lasts longer than six months and can also not have any obvious symptoms until the liver stops working properly (liver failure). It is sometimes only picked up during blood tests.
- Hepatitis A Virus (HAV)
Most often transmitted through faeces, contaminated water or food or through sex. While overall, HAV infections are mild, with most people making a full recovery and becoming immune, HAV can be severe and even life threatening.
- Hepatitis B Virus (HBV)
Transmitted through infected blood, semen and other bodily fluids. HBV can be passed from infected mothers to infants at the time of birth, or from family members to infants in early childhood. Transfusions of infected blood and blood products during medical procedures or through infected needles are additional routes, with healthcare workers at risk of accidental needle stick injuries while caring for infected patients.
HBV is uncommon in the UK, with most cases occurring in southeast Asia and sub-Saharan Africa. Most adults can fight off the virus and fully recover within a couple of months. However, those infected as children often develop chronic HBV, which can lead to cirrhosis and liver cancer.
In the UK, vaccination against HBV is recommended for people in high-risk groups, such as:
- healthcare workers,
- people who inject drugs,
- men who have sex with men,
- children born to mothers with HBV,
- people travelling to countries where the infection is more common.
- Hepatitis C Virus (HCV)
Transmitted mainly through infected blood via transfusions of HCV-contaminated blood and blood products and through infected needles. Sexual transmission is also possible but is much less common. In the UK, it’s most commonly spread through sharing needles used to inject drugs.
HCV often causes only mild or no noticeable 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’ll stay in the body for many years, and can cause cirrhosis and liver failure. Chronic HCV can be treated with very effective antiviral medications, but there’s currently no vaccine available.
- Hepatitis D Virus (HDV)
Occurs only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and outcome. HBV vaccines provide protection from HDV infection.
- Hepatitis E Virus (HEV)
Mostly transmitted through faeces or contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.
- Alcoholic Hepatitis
Caused by drinking excessive amounts of alcohol over many years. Though often without symptoms, the disease can result in sudden jaundice and liver failure. The condition is common in the UK, but many people do not realise they have it.
Cutting out alcohol will usually allow the liver to recover, but if the person does not stop drinking to excess, there’s a risk of developing cirrhosis, liver failure or even liver cancer. You can reduce your risk of developing alcoholic hepatitis by limiting your alcohol intake to no more than 14 units a week. (One unit of alcohol = 10ml of pure alcohol which varies from drink to drink, so do check drinkaware.co.uk or with your GP for specific advice.)
- Autoimmune Hepatitis
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 the disease, and it’s not known whether anything can be done to prevent it.