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Liver Disorders

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Viral Hepatitis

Hepatitis in an inflammation of the liver, marked by jaundice, anorexia, abnormal liver function and abdominal pain. Severe hepatitis can result in liver disease. Viral hepatitis is caused by one of these hepatitis viruses: A, B, C or D (delta). Hepatitis A (HAV) is an acute infection typically spread by fecal-oral contact. Common among people with poor hygiene, or in areas of poor sanitation, it is highly contagious, particularly during the two weeks before sudden symptom onset, which include jaundice, fever, diarrhea, clay-colored stools, dark urine, and an enlarged spleen and liver. HAV can be asymptomatic in children under the age of two. Though rare, acute liver failure can occur. Immunization against HAV is recommended.

Hepatitis B (HBV) occurs with the exchange of body fluids or through parenteral transmission. It can be transmitted through blood products, infected needles, sex with an infected partner or perinatally, even when the mother is without symptoms. Early phase flu-like symptoms include rash, fever and nausea, progressing to jaundice and liver pain. Children five or younger may have a rash on arms and legs. HBV is a chronic infection, warranting ongoing monitoring of kidney and liver function. It is the largest identifiable cause of fulminant liver failure. Immunization against HBV is recommended by the American Academy of Pediatrics and Center for Disease Control, Immunization Practices Advisory Committee.

Generally asymptomatic, Hepatitis C is one of the most common forms of viral hepatitis. It is spread by sexual contact, infected blood products and by perinatal transmission; the cause remains unknown. Symptoms include malaise, fever, nausea and abdominal pain. Serum transaminases are often high, but can fluctuate even when the condition is active. A diagnosis is made by detection of its antibody and by polymerase chain reaction testing. HCV is a chronic infection, warranting ongoing monitoring of kidney and liver function. There is no immunization against HCV.

Hepatitis D, or delta virus, is characterized as a "parasite" of Hepatitis B, in that it is only symptomatic or infectious when HBV is present. The epidemiology and acute presentation of HDV mirror HBV, but bring mortality rates up to 20 times higher. Chronic HDV progresses to cirrhosis.

Treatment for acute and chronic forms of viral hepatitis includes interferon-alpha, which helps to improve liver function, diet modifications and general self-care. Liver transplant is an option long-term.