Chronic Hepatitis
Several types of hepatitis require clinical care by a physician or other health care professional. Listed in the directory below are some, for which we have provided a brief overview.
What is autoimmune hepatitis?
Autoimmune hepatitis is when your body’s infection-fighting system (immune system) attacks your liver cells. This causes redness and swelling (inflammation) and liver damage.
It is a long-term or chronic inflammatory liver disease.
There are 2 types of autoimmune hepatitis: type 1 (classic) or type 2.
Type 1 (classic)
Is the most common form of the disease
May occur at any age, but usually starts when you are a teen or young adult
Affects women more than men
Is often linked to other diseases where the body attacks itself (autoimmune disorders). These may include thyroiditis, Grave's disease, type 1 diabetes, and ulcerative colitis.
Type 2
Is less common
Most often affects girls between ages 2 and 14
.
What causes autoimmune hepatitis?
Experts don’t know what causes autoimmune hepatitis.
It is linked to a disorder called hypergammaglobulinemia. This disorder occurs when you have too many protein antibodies in your blood. It may be caused by a long-term (chronic) infection or certain blood diseases.
Type 1 autoimmune hepatitis is linked to other disorders where the body attacks itself (autoimmune disorders). These may include:
Thyroiditis
Grave's disease
Type 1 diabetes
Rheumatoid arthritis
Hemolytic anemia
Immune thrombocytopenia
Celiac disease
Ulcerative colitis
Medications
What are the symptoms of autoimmune hepatitis?
Each person’s symptoms may vary. Some people may have no symptoms or very mild ones, while others can have severe disease and symptoms. Some of the most common symptoms may include:
Extreme tiredness (fatigue)
Yellowing of the skin and eyes (jaundice)
Belly (abdominal) pain
Joint pain or swelling
Mild flu-like symptoms
Itching
Large abdomen due to large liver and spleen
Spiderlike blood vessels in the skin
Other autoimmune hepatitis symptoms may include:
Dark urine
Pale or gray-colored stools
Stop in menstrual periods in women
Loss of appetite
Fluid buildup in the belly (ascites)
Confusion
Rectal bleeding or vomiting blood
The symptoms of autoimmune hepatitis may look like other health problems. Always see your healthcare provider for a diagnosis.
How is autoimmune hepatitis diagnosed?
Your healthcare provider will look at your health history and give you a physical exam.
Some lab blood tests used to diagnose autoimmune hepatitis include:
Liver function tests. These check for any redness and swelling (inflammation) or damage to your liver.
Complete blood count or CBC. This test looks at the number and types of cells in your blood.
Coagulation panel. This test looks at how well the clotting proteins are working.
Electrolyte panel. This test checks to see if you have too many or too few minerals (electrolyte imbalance) in your blood.
Autoimmune antibodies. These are used to see if you have autoimmune hepatitis or another liver disease with similar symptoms.
Other liver tests. These are done to check for other possible types of liver disease.
Tests for other chemicals in your body.
You may also have imaging tests, such as:
CT scan. This test is more detailed than a standard X-ray. It can show detailed images of any part of the body, including the bones, muscles, fat, and organs. It uses both X-rays and computer technology to make horizontal images (often called slices) of the body.
MRI. This test makes detailed pictures of organs and structures inside your body. It uses a magnetic field and pulses of radio wave energy. A dye may be shot or injected into your vein. The dye helps the liver and other organs in the belly to be seen more clearly on the scan.
Ultrasound. This test uses high frequency sound waves to create a picture of the organs. It can also check blood flow in blood vessels.
Liver biopsy. Small tissue samples are taken from your liver with a needle. These samples are checked under a microscope to find out the type of liver disease you have.
How is autoimmune hepatitis treated?
Treatment works best when autoimmune hepatitis is found early. The goal of treatment is to control the disease and to reduce or get rid of any symptoms (be in remission).
To do this, medicines (corticosteroids and immune system suppressors) are used to help slow down or suppress your overactive immune system. They also stop your body from attacking your liver.
Once you have started treatment, it can take 6 months to a few years for the disease to go into remission. Some people can stop taking medicine, but often the disease comes back. You may need treatment now and then for the rest of your life. Some people need to remain on treatment if they have relapsed many times or if their disease is severe.
In some cases, autoimmune hepatitis may go away without taking any medicines. But for most people, autoimmune hepatitis is a chronic disease.
It can lead to scarring of the liver (cirrhosis). The liver can become so badly damaged that it no longer works. This is called liver failure.
If you have liver failure, a liver transplant may be needed.
Be sure to ask your healthcare provider about recommended vaccines. These include vaccines for viruses that can cause liver disease.
Key points about autoimmune hepatitis
Autoimmune hepatitis is when your body's infection-fighting system (immune system) attacks your liver cells.
It is a long-term chronic liver disease that causes redness and swelling (inflammation) and liver damage.
Experts don’t know what causes it.
It affects more women than men.
Medicines are often used to control the disease.
It can lead to scarring of the liver (cirrhosis) and liver failure.
Next steps
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your healthcare provider if you have questions.
What is hepatitis A?
Hepatitis A is a liver disease that is easily spread from person to person (highly contagious). It's caused by the hepatitis A virus.
Hepatitis is inflammation of the liver that sometimes causes lasting damage. Hepatitis A is a cause of hepatitis.
Hepatitis A causes immediate (acute) symptoms and does not cause a long-term (chronic) infection. But it can take some time to fully get well. You may be sick for a few weeks. But 15% of infected people take up to 6 months or longer to fully recover.
In rare cases, hepatitis A can cause severe liver damage, leading to death.
What causes hepatitis A?
Hepatitis A is spread when the virus is taken in by mouth. This happens when you have contact with objects, food, or drinks that are contaminated by the stool of an infected person.
This may happen through person-to-person contact, such as:
- When an infected person doesn’t wash their hands well after going to the bathroom and touches other objects or food.
- When a parent or caregiver doesn’t wash their hands well after changing diapers or cleaning up the stool of someone who is infected.
- When you have sex with someone who is infected.
This can also happen if you:
- Eat food made by someone who touched infected stool.
- Drink water that is contaminated by infected stool (a problem in developing countries).
In rare cases, the virus may also be spread by contamination from blood and other body fluids (blood-borne infection).
In most cases, normal contact in school or at work won’t spread the virus.
Who is at risk for hepatitis A?
You may be at high risk for hepatitis A if you travel to places where the virus is common. These places include:
- Africa.
- Asia (except Japan).
- The Mediterranean basin.
- Eastern Europe.
- The Middle East.
- Central and South America.
- Mexico.
- Parts of the Caribbean.
You may also be at high risk if you:
- Are living in or moving to a place in the U.S. or another country that has had large numbers of hepatitis A cases, or outbreaks, in the past 5 years.
- Are in the military.
- Have unsafe sex.
- Use illegal I.V. (intravenous) drugs.
- Have a blood disorder, such as hemophilia, and need to take blood treatments.
- Work at a day care center.
- Work in a nursing home, prison, or other type of care facility.
- Are a lab worker who handles live hepatitis A virus.
- Handle monkeys or apes (primates) that may have the hepatitis A virus.
- Are in close contact with a child recently adopted from a country with a medium to high rate of hepatitis A.
Hepatitis A is sometimes called a traveler's disease. It's a very common disease for travelers. But you can also get infected with hepatitis A in the U.S. In some cases, people in the U.S. have gotten the virus without having any risk factors.
What are the symptoms of hepatitis A?
Symptoms of hepatitis A often look like flu symptoms. Each person’s symptoms may vary. Symptoms come on suddenly and may include:
- A fever.
- Chills.
- Joint pain.
- Extreme tiredness (fatigue).
- An overall feeling of weakness.
- Loss of appetite.
- Upset stomach or nausea.
- Vomiting.
- Belly (abdominal) pain.
- Dark urine.
- Clay-colored stools.
- Yellowish skin and eyes (jaundice).
- Diarrhea.
- Rash.
Some adults have no symptoms. Most children have no symptoms, especially children younger than 6 years old.
Hepatitis A symptoms can look like other health problems. Always see your health care provider to be sure.
How is hepatitis A diagnosed?
Your health care provider will give you a physical exam and ask about your past health.
Hepatitis A is diagnosed with a blood test. This looks for infection-fighting cells (antibodies) against the hepatitis A virus. If these antibodies, called IgM anti-HAV antibodies, are in your blood, that means you have recently been infected.
How is hepatitis A treated?
Treatment will depend on your symptoms, age, and general health. It will also depend on how bad the condition is.
Most people with hepatitis A get better without any medical care. In some cases, bed rest and some medicines may be needed.
What are the complications of hepatitis A?
In rare cases, hepatitis A may cause liver failure, leading to death.
What can I do to prevent hepatitis A?
To help stop the spread of hepatitis A, it's important to have good personal health (hygiene) habits and avoid any risky behaviors.
Wash your hands often after using the bathroom or changing a diaper, and before making food.
To prevent hepatitis A, correct hand-washing is critical. Follow CDC guidelines, and teach family members to wash correctly too.
- Wet your hands with clean, running water (cold or warm is fine). Apply soap, and rub your hands together.
- Lather the backs of your hands, between your fingers, and under your nails.
- Scrub your hands for at least 20 seconds—the length of time it takes to hum the “Happy Birthday” song from beginning to end twice. Rinse thoroughly and dry.
And there are two shots (injections) that can help protect you from hepatitis A:
- Immune globulin shot. This shot is a mix of infection-fighting cells or antibodies. It's used along with the vaccine for people who are at very high risk of liver failure with hepatitis A. You can have the shot before you may be exposed to the virus, such as before you travel. It's also used in high-risk people after exposure to the virus.
- Hepatitis A vaccine. This is your first line of protection against hepatitis A. This vaccine is made from whole, killed hepatitis A virus. It doesn't have a live virus, so you can’t get hepatitis from it. The vaccine helps to get your body's natural infection-fighting system (immune system) working. After you have the shot, your body makes antibodies that protect you against the virus.
The hepatitis A vaccine is recommended for anyone who wants it. The vaccine is very important for people who are at risk for infection, such as:
- People traveling to or working in countries with medium to high rates of hepatitis A.
- All children, age 1 and older.
- Men who have sex with men.
- People who use illegal drugs.
- People whose jobs put them at risk for the disease.
- People with long-term (chronic) liver disease.
- People with bleeding disorders (clotting-factor disorders), such as hemophilia.
- People adopting children from a country with a medium to high rate of hepatitis A.
Living with hepatitis A
Symptoms of hepatitis A can last from a few weeks to a few months. Follow your health care provider’s advice on how to treat and manage hepatitis A.
When you have hepatitis A, it’s very important to:
- Have a healthy diet.
- Get plenty of rest.
- Take any medicines your health care provider recommends.
- Check with your provider before taking any over-the-counter pain or fever medicine, such as acetaminophen.
- Not drink alcohol.
- See your health care provider if symptoms return.
When should I get medical advice?
Contact your health care provider if your symptoms don’t go away as soon as expected. Also, call if your symptoms go away and then come back.
Key points about hepatitis A
- Hepatitis A is a liver disease that is easily spread from person to person (highly contagious). It's caused by the hepatitis A virus.
- In most cases, it doesn’t cause a long-term (chronic) infection. In some cases, it can cause severe liver damage, leading to death.
- It's often spread when you have contact with objects, foods, or drinks that are contaminated by the stool of an infected person.
- Symptoms can look like flu symptoms. Some adults have no symptoms. Most children have no symptoms.
- You may be at high risk if you travel to places where the virus is common.
- Other high-risk factors include using illegal drugs, having unsafe sex, traveling to places where the virus is common, and working in a day care center or nursing home.
- Prevention includes getting the hepatitis A vaccine, washing your hands, and practicing good hygiene.
Next steps
Here are some tips to help you get the most from a visit to your health care provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you don't take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your health care provider if you have questions, especially after office hours or on weekends.
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