Viral hepatitis

Hepatitis (he-puh-TEYE-tuhs) means inflammation (swelling) of the liver. Hepatitis can be caused by:

• Toxins
• Certain drugs
• Some diseases
• Heavy alcohol use
• Bacterial and viral infections

Hepatitis is most often caused by one of several viruses, which is why it is often called viral hepatitis. The most common types of viral hepatitis in the United States are hepatitis A, hepatitis B, and hepatitis C.

This fact sheet focuses on viral hepatitis. You can learn more about other kinds of hepatitis from the National Library of Medicine.

Some people with viral hepatitis have no signs of the infection. Symptoms, if they do appear, can include:

• Jaundice (JOHN-duhs), which is when the skin and whites of the eyes turn yellow
• Low-grade fever
• Headache
• Muscle aches
• Tiredness
• Loss of appetite
• Nausea
• Vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain

You can get hepatitis A by eating food or drinking water contaminated with feces (stool) from a person infected with the virus or by anal-oral contact. Some ways you can get this type of hepatitis include:

• Eating food prepared by a person with the virus who didn't wash his or her hands after using the bathroom and then touched the food
• Contact with infected household members or sexual partners
• Touching diaper changing tables that aren't cleaned properly
• Eating raw shellfish that came from sewage-contaminated water

You can get hepatitis B if you come into contact with an infected person's:

• Blood
• Semen and other fluids from having sex
• Needles from drug use

The virus can also be passed from an infected mother to her baby during childbirth.

Hepatitis C is also spread through contact with the blood of an infected person. This usually happens when people use contaminated needles to inject drugs.

This depends on your risk factors. Ask your doctor about testing if:

• You have ever used injectable drugs, even once
• You have had a blood transfusion or organ transplant prior to 1992

You can live with hepatitis C for a long time without knowing it, so it is important to discuss your risk with your doctor.

If you think you might have viral hepatitis, see your doctor. To diagnose your illness, your doctor will:

• Ask you questions about your health history
• Do a physical exam
• Order blood tests

Hepatitis infections are diagnosed with blood tests that look for parts of the virus or antibodies your body makes in response to the virus.

Acute viral hepatitis is a short-term, viral infection. It happens when you first get infected with the virus and can be mild or severe. In some cases, acute infection leads to chronic infection. Chronic viral hepatitis is a long-lasting infection that can last a lifetime.

Hepatitis A only causes acute infection. Hepatitis viruses B and C can cause both acute and chronic infections. Chronic hepatitis B and C are serious health problems. They can lead to:

• Cirrhosis (suh-ROH-suhs)
• Liver failure
• Liver cancer

Viral hepatitis will often get better on its own after several weeks to several months. However, when hepatitis becomes a chronic or long-term illness, the infection may need to be treated with specific medications called antivirals.

If you think you have any type of viral hepatitis, talk to your doctor about what treatments may be right for you.

In the United States in 2007, there were an estimated:

• 25,000 new hepatitis A infections
• 43,000 new hepatitis B infections
• 17,000 new hepatitis C infections

An estimated 800,000 to 1.4 million people have chronic hepatitis B and 3.2 million people have chronic hepatitis C in the United States. Between 75 and 85 percent of people who get infected with the hepatitis C virus develop a chronic infection.

Below are the best methods for preventing the hepatitis viruses most commonly seen in the United States.

Hepatitis A prevention

• Get vaccinated. People with certain risk factors and health problems need this vaccine, so ask your doctor if the vaccine is right for you.
• Properly wash your hands following bathroom use and diaper changes, and before preparing or eating food.

Hepatitis B prevention

• Get vaccinated.
• As with other sexually transmitted infections, limit sexual partners and use latex condoms to help lower your risk.

Hepatitis C prevention

• Do not share needles or other equipment used to inject drugs, steroids, or cosmetic substances.
• Do not use personal items that may have come into contact with an infected person's blood, such as razors, nail clippers, toothbrushes, or glucose monitors.
• Do not get tattoos or body piercings from an unlicensed facility or in an informal setting.

If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharp objects.

If you are pregnant, your doctor will test your blood for hepatitis B. If you are an infected mother, your baby should be given hepatitis B immune globulin (H-BIG) and the hepatitis B vaccine within 12 hours after birth. If you have chronic hepatitis B, make sure your babies get all of their hepatitis B shots in the first six months of life.

The hepatitis A vaccine is given in two doses, six to 18 months apart. The vaccine is recommended for:

• Travelers to areas with high rates of hepatitis A
• Men who have sex with men
• Injection and non-injection drug users
• Persons with clotting factor disorders, like hemophilia (hee-muh-FIL-ee-uh)
• People with chronic liver disease
• All children at age 1

The hepatitis B vaccine is usually given in three doses over six months. The vaccine is recommended for:

• All children at birth
• A person that lives with or has sex with someone who has chronic hepatitis B
• Men who have sex with men
• Someone who has been recently diagnosed with a sexually transmitted infection (STI)
• People with multiple sex partners
• Someone who uses needles to inject drugs
• People whose jobs expose them to human blood

Only one series of the hepatitis A vaccine (two shots) and hepatitis B vaccine (three shots) is needed during a person's lifetime. Most people don't need a booster dose of either vaccine. But, if you have had hemodialysis (hee-moh-dy-AL-uh-suhs) (medical procedure to purify blood) or have a weakened immune system, your doctor might recommend a booster dose of the hepatitis B vaccine.

It is safe to visit someone with viral hepatitis. You cannot get hepatitis through casual contact. It is fine to shake hands with, hug, or kiss someone who is infected with any type of viral hepatitis.

During birth, blood from the mother gets inside the baby's body. If the mother has hepatitis B virus in her blood, her baby will likely become infected. But this can be prevented by having the baby receive all of the shots in the hepatitis B vaccine series. A very small number of babies get infected before birth.

Make sure your baby gets the hepatitis B vaccine and hepatitis B immune globulin (H-BIG) within 12 hours of birth. Your baby will need two or three more shots of vaccine over the next one to 15 months to help prevent hepatitis B. The timing and total number of shots will depend on the type of vaccine and baby's age and weight.

The vaccine is very important. More than 90 percent of babies who are exposed to the virus, but don't get the vaccine, develop chronic hepatitis B. Your baby should be tested after the last vaccine shot to make sure he or she is protected from the disease.

Yes, you can breastfeed your baby if you have hepatitis B. Make sure your baby gets the hepatitis B vaccine and hepatitis B immune globulin (H-BIG). Take good care of your nipples to prevent cracking and bleeding. If your nipples are cracking or bleeding, avoid nursing your baby on that breast until the sores heal. Until they heal, you can pump your milk to keep up your milk supply. But, you should throw away this pumped milk. Do not feed it to your baby.

For more information about viral hepatitis, call the OWH Helpline at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

• American Liver Foundation
  Phone: 212-668-1000
• American Social Health Association
  Phone: 919-361-8400; STI Resource Center Hotline: 919-361-8488
• Hepatitis Foundation International
  Phone: 301-622-4200; Toll-Free: 800-891-0707
• Immunization Action Coalition
  Phone: 651-647-9009
• National Digestive Diseases Information Clearinghouse (NIDDK), NIH, HHS
  Phone: 800-891-5389
• National Institute of Allergy and Infectious Diseases (NIAID), NIH, HHS
  Phone: 301-496-5717; Toll-Free: 866-284-4107