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Viruses are the most common cause of hepatitis. Although the symptoms of liver inflammation caused by diverse viruses are the same, the form of the disease, the way that they spread, and the outcome are different for each virus.

Many different factors can cause hepatitis. Chronic exposure to toxins, alcohol, or some drugs can cause the inflammation of the liver. Sometimes even our own immune system can attack the liver tissue and damage it, causing autoimmune hepatitis. Bacteria and parasites cause hepatitis too. But viruses are the most frequent cause of hepatitis. Generally speaking, there are five hepatitis viruses, plus a few more that can cause liver inflammation.

Regardless of the cause, most of the time, the symptoms of hepatitis are the same. Depending on the severity of the disease, the symptoms may include: 

  • Abdominal pain in the upper right quadrant
  • Jaundice
  • Diarrhea
  • Bruising easily
  • Fatigue
  • Fever
  • Dark urine

Hepatitis A

Hepatitis A is a viral disease of the liver. The route of infection is fecal-oral, which means that a healthy person can get the disease if they ingest parts of feces from an infected person. This can happen when food or water are contaminated with fecal matter. This disease often strikes if unsanitary conditions or poor personal hygiene are present. Hepatitis A causes acute liver disease, starting two to four weeks after ingesting contaminated food or water. 

There is no therapy for hepatitis A, nor is it needed, unless cute liver failure occurs. However, there are ways of preventing the disease.

There is a vaccine against this disease and certain countries include this vaccine in their vaccination schedule. If you aren't vaccinated, you should consider it if you plan on travel to the part of the world where hepatitis A is more common, or if that country doesn't have adequate sanitation. Other ways one can get infected is by using recreational drugs, or having anal sex. It is important to always use safe water supply for drinking and washing your food. Also, you should use safe water to wash your hands. 

Hepatitis B

Unlike hepatitis A, hepatitis B can cause both acute and chronic infections. While the acute infection often passes unnoticed, chronic infection may lead to serious complications, such as cirrhosis, liver cancer, and even death. This disease is transmitted via blood and other bodily fluids. This virus is very resistant, and can survive outside of the body for seven days. On average, the incubation period is 75 days. Hepatitis B is a worldwide health problem, and it is estimated that there are 257 million people around the world living with this disease. Other than direct contact with infected blood, sharing syringes or getting a tattoo are also important ways of transmission. Sexual transmission is possible as well. It is important to note that this disease is an occupational risk for people who work in health institutions.

There is no therapy for acute hepatitis B, but if the chronic form develops, antiviral drugs are available. These drugs can help slow down the deterioration of the liver and improve long term survival. There is a vaccine.

Since one of the ways of transmission from mother to a newborn during child birth, it is highly recommended for children to be vaccinated during the first 24 hours after birth. Vaccines for adults are also available, and are recommended to people who come in contact with blood or other bodily fluids often, people with multiple sexual partners, people who plan on getting a tattoo or a piercing, and IV drug users.

Hepatitis C

Hepatitis C is also a blood borne infection. Although not as widespread as hepatitis B, it leads to serious complications more often. In the acute form of the disease, there are rarely any symptoms, and sometimes the organism clears the virus within six months. But, up to 80 percent of people infected develop a chronic infection. The main risk groups include IV users who share the needle, and people who are professionally exposed to infected blood. Less commonly, this disease can be spread sexually, or during childbirth, from an infected mother to her child.

There is no vaccine for this type of hepatitis, at least not yet. Therapy is available, and some modern drugs have a cure rate of up to 95 percent.

Unfortunately, access to these medicines is low. We should focus on prevention, but since there is no vaccine, other means of prevention should be practiced. Hand washing and using new needles and syringes decrease the risk of getting infected, as well as practicing safe sex. If you are in a risk group, or have come in contact with other people's blood, you should get tested. 

Hepatitis D

Like hepatitis B, hepatitis D is also transmitted through contact with infected blood and other bodily fluids. This infectious sub-viral particle is different from other hepatitis viruses, since it actually isn't a virus, but something much smaller and more simple. Hepatitis D needs an existing hepatitis B infection to be able to enter the cell and cause infection. This may seem like long shot, but if we take the number of people infected with hepatitis B into consideration, plus the same transmission route, the odds of catching this infection are larger than they seem, and a least twenty million people are infected worldwide.

The combination of hepatitis B and hepatitis D is considered to be the deadliest combination of all hepatitis infections, since the progression towards liver cancer is rapid. Even though there is no vaccine for hepatitis D, since it needs hepatitis B virus to cause the infection, the vaccine for hepatitis B protects against hepatitis D as well. 

Hepatitis E

Like hepatitis A, hepatitis E is also spread by contaminated food and water. There are four types of this virus, and two of them also infect animals, so, besides fecal-oral transmission, an infection from an animal carrying a disease is also possible, by eating undercooked meat. Even though this virus is present worldwide, most cases are reported in South and East Asia. The disease usually resolves itself, and the organism clears the virus in six weeks. Rarely, some complications occur. 

There is a vaccine for hepatitis E, but only in China. The other things that you can do to avoid infection include using clean water for drinking and washing hands and food, and if you eat meat, be sure that it's well cooked.


In most cases, viral hepatitis is caused by one of these five viruses, but, rarely, some other viruses can cause the inflammation of the liver too. These viruses, such as herpesvirus influenza or coronavirus, don't primarily attack the liver tissue, but can cause hepatitis in certain situations. Also, an existence of two more hepatitis viruses (F and G) has been hypothesized, but their connection to the disease is yet to be proven.

  • Photo courtesy of SteadyHealth

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