Hepatitis A

Hepatitis A is a highly contagious liver infection most commonly contracted through contaminated food or water. You can also get the virus through contact with a contaminated person or object. Hepatitis A symptoms usually appear within a few weeks, with mild cases not requiring specialized treatment and most people recovering fully with no complications. Vaccines to protect against hepatitis A are recommended for children and are given in two doses, six months apart.
  • Symptoms of hepatitis A include:

    • Fatigue
    • Sudden nausea and vomiting
    • Abdominal pain or discomfort
    • Having clay-colored bowel movements
    • Loss of appetite
    • Low-grade fever
    • Dark urine
    • Joint pain
    • Jaundice (yellowing of the skin and whites of the eyes)
    • Itching
    To diagnose an individual with Hepatitis A, a blood test is usually taken.
  • Most patients with acute hepatitis A and jaundice improve on their own without treatment over weeks. There are rare cases of worsening liver function that needs close monitoring by your liver doctor. There is no specific treatment for Hepatitis A. General measures are advised for supportive care, such as:
    • Resting 
    • Managing nausea by eating smaller, calorically dense foods and replenishing fluids lost through vomiting
    • Avoiding alcohol and taking medications carefully as the liver may have difficulties processing these substances
    • Washing your hands and avoiding food preparation (avoiding food preparation?) as the infection can be passed on to other individuals.
    • Seeking urgent medical attention if symptoms worsen or if the patient becomes confused

Hepatitis B

Hepatitis B is a serious liver infection if undetected and not properly followed. Hepatitis B infections can become chronic, lasting more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis (advanced scarring of the liver). Once the infection is acquired, adults usually recover, however, infants and children are more likely to develop a chronic case of the condition. The virus is usually spread through sexual contact, sharing needles and razers, contaminated tattoo needles and can be passed from mother to child during childbirth. People who live in certain parts of the world, namely Asia, the Pacific Islands, Africa and Eastern Europe, are more likely to acquire the infection.

Although there is a vaccine that prevents hepatitis B, there exists no cure if you already have the condition. If you are infected, taking certain precautions can prevent the virus from spreading to others.
  • Most patients with hepatitis B exhibit no symptoms. Signs and symptoms of hepatitis B in some patients can range from mild to severe and usually appear one to four months after the infection.

    Possible symptoms of Hepatitis B include:

    • Dark urine
    • Abdominal pain
    • Fever
    • Joint pain
    • Loss of appetite 
    • Nausea and vomiting
    • Weakness and fatigue
    • Jaundice

    Hepatitis B is diagnosed by obtaining blood tests. These tests help us to know if the infection is acute or chronic and if the infection is active or dormant. We can also assess the effect of the virus on the liver by testing liver enzymes and function tests. If the virus is active, the body responds to it by causing inflammation in the liver (hepatitis), which will be reflected in the blood tests as high liver enzymes.

    Abdominal ultrasound is often required to rule out advanced scarring of the liver (cirrhosis) and liver tumors. A specialized non-invasive test similar to the ultrasound called Fibroscan is also used to rule out liver scarring. In some cases, taking a sample from the liver (biopsy) may be required to guide treatment decisions.

    Screenings for hepatitis B are also recommended for healthy adults as the virus can cause liver damage without showing any symptoms.
  • Chronic active hepatitis B infection requires long-term treatment. Treatment prevents you from passing on the virus and reduces the risk of developing liver disease, including liver cancer; treatment is in the form of a pill taken once daily; Treatment options include Tenofovir and Entecavir. ​​

    Your doctor may recommend holding treatment if the virus infection is not causing liver damage. Regular follow-ups – however- are important to observe the virus and start treatment when it shows signs of activity. Patients with hepatitis B who don’t do liver tests every 6 months put themselves at risk of developing liver cirrhosis or cancer over the years. ​​

    Liver transplant: This is necessary if your liver has been severely damaged and cannot function properly. Testing and evaluation are required before being approved for a transplant, which involves removing the damaged liver and replacing it with a healthy one.

Hepatitis C

Hepatitis C is a viral infection that, if left untreated, can cause serious liver damage. The virus can cause inflammation of the liver, leading to the development of cirrhosis (scarring of the liver) and potential liver failure.
  • Hepatitis C often causes no symptoms. In some patients symptoms of hepatitis C may include:

    • Poor appetite
    • Jaundice
    • Confusion
    • Fatigue
    • Dark urine
    • Bruising or bleeding easily
    • Having fluid buildup in your abdomen (ascites)


    Hepatitis C infection can be transmitted in a similar manner to Hepatitis B. Up to 85% of patients who acquire hepatitis C virus will develop long-term (chronic) infection.

    A blood test is ordered if hepatitis C is suspected. If this test is positive, another confirmatory test is requested to detect the virus in the blood. Other blood tests are done to look for signs of liver damage. Ultrasound of the liver may be requested to look for signs of advanced liver scarring (cirrhosis).

    Magnetic resonance elastography (MRE): This non-invasive method creates a visual map of the liver, indicating areas of stiffness and can determine the extent to which the liver has been damaged.
  • Your doctor will recommend lifestyle changes to mitigate the symptoms and spread of hepatitis C. These include:

    • Stopping the consumption of alcohol
    • Reviewing medications and dietary supplements with your doctor
    • Take precautions to avoid spreading the infection to others, including informing health care workers of your condition and avoiding sharing needles and personal hygiene tools


    There is no vaccine for hepatitis C, so treatment is aimed at removing the virus from the body and preventing liver damage and cancer. Unlike Hepatitis B infection, hepatitis C infection is curable. Treatment is in the form of highly effective pills that can be taken for 2 to 3 months with minimal side effects. Repeat blood tests are done 3 months after the end of treatment, and if negative, will confirm that the patient is cured of hepatitis C.

Hepatitis D

Hepatitis D is a viral infection that causes inflammation of the liver, leading to potential complications such as scarring of the liver (cirrhosis) or liver cancer. Hepatitis D cannot be contracted on its own; only individuals with hepatitis B can develop the infection.
  • The symptoms of hepatitis D are similar to that of hepatitis B, however, some individuals with hepatitis D may not have symptoms.

    Symptoms of hepatitis D include:
    • Abdominal pain
    • Jaundice
    • Poor appetite
    • Dark urine
    • Fatigue
    • Joint pain
    • Having light-colored stool
    To diagnose hepatitis D, your doctor will perform a blood test to detect the presence of anti-hepatitis D antibodies, this means your body has been exposed to the virus. A liver function test will also be required to evaluate your liver and determine if the liver is inflamed.
  • Hepatitis D is not curable; however it can sometimes respond to treatments that can limit its activity. The treatment for hepatitis D includes interferon injections medications which may help control the virus replication and slow down liver damage. Other treatment options are studied in clinical trials with fewer side effects and are expected to become available for patients soon. A liver transplant may be considered if the patient developed significant liver damage.

Hepatitis E

Hepatitis E is a viral infection that causes inflammation of the liver, most commonly contracted through ingesting the undercooked meat of infected animals or contaminated water. Infection can also be caused through contact with fecal matter and is more common in parts of the world with poor sanitation. In most cases, hepatitis E is mild and individuals can recover without specialized treatment and in most cases without symptoms.
  • Most individuals are asymptomatic, however, some patients may develop symptoms including:
    • Fatigue
    • Poor appetite
    • Dark urine
    • Jaundice (yellowing of the skin and whites of the eyes)
    • Having light-colored stool
    • Abdominal pain
    When diagnosing hepatitis E, your doctor will review your medical history and physical symptoms. Inform your doctor of any recent travel and if you were potentially exposed to contaminated food or water. Further tests may involve a blood or stool test.
  • Hepatitis E usually does not require specialized treatment and most individuals will recover without treatment. Hepatitis E may cause a more severe form of liver injury in pregnant and immunocompromised patients.
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