COVID-19 & Infectious Disease

Your Liver and Hepatitis: a Battle You Want to Avoid

May is hepatitis awareness month, a good time to focus on liver health, that Darth Vader helmet-shaped organ that shares the upper abdominal neighborhood with the stomach. It’s a good assumption that people don’t think much about the liver unless something makes it sick, like hepatitis. Then the liver is hard to ignore.

What is the Liver’s Function?

The liver is obsessed with keeping the body clean. It processes nutrients from food, but it also filters alcohol, drugs and chemicals from the blood, and fights infections.1 It filters unwanted substances so that the body can flush them out through the urine or stomach bile.2

The liver can come under siege from outside forces. Sometimes, as the organ perks along and does its job, toxins form and inflame or damage the organ, causing non-viral hepatitis.

Non-viral Hepatitis

There are three types of non-viral hepatitis:3

  1. Alcoholic hepatitis—caused by drinking too much alcohol. Over time, excessive alcohol can injure the liver’s cells, causing the organ to fail. Alcohol can also cause cirrhosis, which thickens and scars the liver.4
  2. Autoimmune hepatitis—caused by the immune system attacking the liver, causing inflammation, scarring, cancer and liver failure
  3. Toxic hepatitis—caused by drugs (prescription and over-the-counter), chemicals and nutritional supplements

The liver breaks down chemicals and drugs, but if there is too much of these substances in the blood, the organ can become damaged, leading to toxic hepatitis.5 Using too much of the following medicines may cause this condition:

  • Pain and fever medicines that have acetaminophen
  • Aspirin and over-the-counter pain and fever medicines (nonsteroidal anti-inflammatory medicines)
  • Anabolic steroids
  • Some antibiotics
  • Birth control pills
  • Statins, used to lower cholesterol
  • Sulfa drugs, a type of antibiotic
  • Anti-epileptic medicines
  • Herbal substances, such as ephedra, germander, pennyroyal, etc.

Viral Hepatitis

Additionally, five types of viruses can invade the liver and cause different forms of hepatitis: A, B, C, D and E.6 While these viruses can cause similar symptoms, they are spread in different ways with varying impacts on the liver:7

Hepatitis A

  • Causes about 6,700 new infections in the U.S. annually
  • Usually a short-term infection; can last a few weeks to several months
  • Most people recover with no lasting liver damage
  • Usually occurs among drug-users and people who are homeless
  • More common in countries that do not have modern sanitation
  • Can be prevented with a vaccine

Hepatitis B

  • Causes about 22,100 new infections in the U.S. annually
  • 1.5 million people in the U.S. have the illness
  • 95% of adults recover and are not chronically infected
  • Can range from a mild illness to a lifelong, chronic condition
  • Spreads by blood, semen and other body fluids, and sharing needles, syringes and personal items such as toothbrushes and razors; can be spread by poor infection control in healthcare facilities; can be transmitted to a newborn from an infected mother
  • Is a leading cause of cirrhosis, liver failure, liver cancer and the need for a liver transplant
  • Can be prevented with a vaccine

Hepatitis C

  • About 44,000 new infections each year
  • 2.4 million people may be living with the illness; 50% may not know they are infected
  • Spreads by blood, contaminated needles and syringes, and poor infection control in healthcare facilities; can be transmitted to a newborn from an infected mother
  • Ranges from a mild illness to a lifelong, chronic condition; most infected people develop chronic hepatitis C
  • Is a leading cause of cirrhosis, liver failure or liver cancer
  • Cannot be cured by a liver transplant alone—antiviral medication is also required
  • No vaccine is available

Hepatitis D

  • Uncommon in the U.S.; reported in South America, West Africa, Russia, the Pacific islands, Central Asia and the Mediterranean8
  • Affects from 15-20 million people worldwide9
  • Only occurs with an existing hepatitis B infection
  • Spreads by contact with bodily fluids and childbirth
  • Causes liver swelling, which can impair the organ’s function and lead to long-term problems, including liver scarring and cancer
  • May resolve on its own, but may last for six months or longer
  • No cure or vaccine available

Hepatitis E

  • Uncommon in the U.S.; reported in the Middle East, Asia, Central America and Africa10; affects about 20 million people worldwide11
  • Shed in the stools of infected persons; transmitted mainly through contaminated drinking water
  • Usually the infection is self-limiting and resolves within two to six weeks.
  • Occasionally becomes a serious disease, known as fulminant hepatitis (acute liver failure), which can be fatal

Many people with hepatitis may not have symptoms so they don’t know they are infected.

If symptoms occur with an acute infection, they can appear two weeks to six months after exposure. Symptoms of chronic viral hepatitis can take decades to develop. The best-known symptom of viral hepatitis is jaundice, which causes the skin or the whites of the eyes to turn yellow. Not everyone with hepatitis gets jaundice, however.12 Other symptoms may include:

  • Fever
  • Fatigue
  • Dark urine
  • Clay-colored bowel movements
  • Abdominal pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain

Hepatitis Prevention and Treatment

There are several ways to prevent hepatitis; see our infographic, The Care and Feeding of a Healthy Liver.

If you have symptoms, ask your doctor if a blood test to check for viral antibodies is right for you. And let your doctor know if you frequently use pain relievers, herbal supplements, have come into contact with chemicals or toxins, or have other risk factors.

Hepatitis A usually requires minimal treatment and the liver usually heals within a few months.  Severe hepatitis may require treatment by a hepatologist or gastroenterologist, who are specialists in liver diseases.  Doctors sometimes use antiviral drugs for people with hepatitis B and C.13 These drugs can be expensive, so check your health insurance plan to see what’s covered.

Bottom line: you need your liver. Treat it like a friend.
1CDC, “What is Viral Hepatitis?”
2WebMD, “What Is Toxic Liver Disease, or Hepatotoxicity?”
3Aurora Health Center, “Non-viral Hepatitis”
4Healthline, “Hepatitis”
5Johns Hopkins Medicine, “Drug-induced Hepatitis”
6Healthline, “What is What is Hepatitis?”, “Hepatitis A, B, and C: Learn the Differences”
8Healthline, “What is Hepatitis D?”
9World Health Organization, “Hepatitis D Key Facts”
10CDC, “Hepatitis E Questions and Answers”
11World Health Organization, “Hepatitis E Key Facts”
12WebMD, “How Do I Know If I Have Hepatitis?”
13WebMD, “Understanding Hepatitis: Diagnosis and Treatment”

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MORE RESOURCES, “Hepatitis A, B, and C: Learn the Differences”
Healthline, “What Are the Newest Treatments for Hepatitis C?”

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