What do drugs, alcohol, unprotected sex, tattoos, and body piercings have in common? They're all things your parents might lecture you about avoiding, but there's another connection: They can all lead to a liver condition called hepatitis.

What Is Hepatitis?

The liver is one of the body's powerhouses. It helps process nutrients and metabolizes medication. The liver also helps clear the body of toxic waste products.

The word hepatitis means an inflammation of the liver. It can be caused by one of many things — including a bacterial infection, liver injury caused by a toxin (poison), and even an attack on the liver by the body's own immune system. However, the condition is usually caused by a virus. The three most common hepatitis viruses are hepatitis A, hepatitis B, or hepatitis C. Two other types of hepatitis virus, D and E, are rare in the United States.

Some hepatitis viruses can mutate. That can make them hard for for the body to fight because they change over time. In some cases, hepatitis B or C can destroy the liver. The patient then will need a liver transplant to survive, which is not always available or successful.

Hepatitis A

The hepatitis A virus (HAV) is transmitted through the feces (poop) of infected individuals. People usually get hepatitis A by eating food or drinking water that's been contaminated with feces. As disgusting as that sounds though, hepatitis A is actually considered less destructive than some other hepatitis viruses.

Unlike some other hepatitis viruses, hepatitis A rarely leads to permanent liver damage. Within a few weeks, the symptoms will have gone away on their own and the virus will no longer be in your system. Once someone has recovered from a hepatitis A infection, that person has immunity to the virus, meaning he or she will probably never get it again. People are also protected against hepatitis A if they've been vaccinated for it.

Hepatitis B

Hepatitis B is a more serious infection. It may lead to a condition called cirrhosis (permanent scarring of the liver) or liver cancer, both of which cause severe illness and even death. Hepatitis B virus (HBV) is transmitted from person to person through blood or other body fluids.

In the United States, the most common way people get infected with HBV is through unprotected sex with a person who has the disease. People who share needles also are at risk of becoming infected because it's likely that the needles they use will not have been sterilized.

As yet, there's no effective cure for hepatitis B. In most cases, teens who get hepatitis B will recover from the disease and may develop a natural immunity to future hepatitis B infections. But some people will have the condition forever. Medications can help some people with hepatitis B get rid of the virus.

Hepatitis C

The hepatitis C virus (HCV) is  transmitted from person to person through blood or other body fluids. Like hepatitis B, hepatitis C can lead to cirrhosis or liver cancer.

Hepatitis C is the most serious type of hepatitis. It's now one of the most common reasons for liver transplants in adults. Every year, thousands of people in the United States die from HCV. And there's no cure and no vaccine.

An estimated 4.1 million Americans are currently infected with the virus. The most common way people become infected is through sharing drug paraphernalia such as needles and straws. People also get hepatitis C after having unprotected sex with an infected partner. Before 1990, many people got it through blood transfusions, but better blood screening and handling procedures now mean that this rarely happens.

The medications currently used to treat hepatitis C are effective in controlling the disease in some people. However, hepatitis C treatments are not very easy to take, especially because some require frequent injections.

What Are the Signs and Symptoms?

Hepatitis infection causes inflammation of the liver, which means that the liver becomes swollen and damaged and begins losing its ability to function. People with hepatitis often get symptoms similar to those caused by other virus infections, such as weakness, tiredness, and nausea. Because the symptoms of hepatitis are similar to other conditions, it's easy for someone who has it to confuse it with another illness.

In addition, people with hepatitis A may not show any symptoms, so the infection can go undiagnosed. People with hepatitis B or C infection also may not show symptoms right away, but can develop health problems from the infection many years later. Even when infected people don't have any symptoms, they can still pass the disease on to others.

Symptoms of hepatitis include:

  • yellowing of the skin and eyes, known as jaundice
  • fever
  • nausea, vomiting, and lack of appetite
  • abdominal pain (on the upper right side)
  • light-colored bowel movements
  • dark-colored urine

The incubation period (how long it takes between the time someone becomes infected and symptoms first appear) for hepatitis varies depending on the type a person has. Somebody may not feel any different than before, or may notice these symptoms anywhere from 15 days to 4 months after getting the disease, depending on the type of hepatitis.

How Is Hepatitis Diagnosed and Treated?

A blood test is usually needed to determine if a person has hepatitis.

Doctors don't prescribe medications to treat hepatitis A; they usually recommend resting until any fever and jaundice are gone and the person's appetite has returned to normal. It is also important to stay well hydrated by drinking lots of fluids.

Hepatitis B and C can sometimes be treated with medications, although some forms of medication used to treat hepatitis C are only approved for use in adults. Although treatments for hepatitis B and C are becoming more effective, a cure cannot be guaranteed.

Protecting Yourself

Vaccines can protect people against hepatitis A and hepatitis B. Today, all kids in the United States are routinely vaccinated against hepatitis B at birth and against hepatitis A between the ages of 1 and 2 years.

Doctors recommend that the hepatitis A vaccine be given to anyone who wants to be immunized against the condition. However, people who travel to parts of the world where sanitation isn't very good should be immunized.

If a person has been recently exposed to hepatitis A or B, a doctor may recommend a shot of immune globulin containing antibodies against the virus. This can help prevent the person from coming down with the disease.

In addition to receiving vaccinations against hepatitis A and B, here's how to protect yourself against hepatitis virus infection:

  • Don't have unprotected sex.
  • Avoid intravenous drug use and sharing of drug paraphernalia.
  • Wash your hands before handling food and after using the bathroom.
  • Be sure tattoo or piercing shops sterilize needles and other equipment properly.
  • Don't share toothbrushes or razors. Hepatitis can be transmitted through sores or cuts.
  • Avoid eating raw shellfish (such as clams or oysters). You could put yourself at risk for hepatitis A if the shellfish was harvested from contaminated water.

Hepatitis infection can be serious, but knowing what puts you at risk can help protect you.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: February 2010

Related Sites

Centers for Disease Control and Prevention (CDC)
Immunization Action Coalition
CDC Immunization: Pre-teens and Adolescents
CDC Travelers' Health

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