What is viral hepatitis?

Viral hepatitis is an infection by a virus that mainly affects the liver. The liver is inflamed and becomes tender and swollen. The infection may destroy some parts of the liver.

The most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C. These types of hepatitis are based on the type of virus that is responsible for the infection. Another virus--the delta hepatitis virus--causes hepatitis only if you are already infected with hepatitis B. Other hepatitis viruses are hepatitis E and G.

How does it occur?

The viruses that cause hepatitis can be spread by:

• contamination from bowel movements

• blood

• inadequately cooked shellfish taken from polluted waters

• sexual contact

• contaminated needles

• saliva

• nasal mucus

• breast milk.

Some types of viral hepatitis can be transmitted by carriers who show no symptoms. These people are called asymptomatic carriers.

What are the symptoms?

You may not have any symptoms of hepatitis until 2 weeks to 6 months after you are infected with the virus. Or you may never have any obvious symptoms.

When symptoms first occur, they may be the following flulike symptoms:

• loss of appetite

• fever

• general aches

• fatigue.

Other possible early symptoms are:

• itching hives

• painful joints

• loss of taste for cigarettes if you are a smoker.

After several days you may also have these symptoms:

• nausea and vomiting

• foul breath, bitter taste in the mouth

• darkened urine

• yellowish skin and eyes (jaundice)

• pain just below the ribs on your right side, especially if you press on that part of your abdomen

• bowel movements that are whitish or light yellow and may be looser than normal.

How is it diagnosed?

Your doctor will review your symptoms and examine you. He or she will press on your abdomen to see if the liver is enlarged and tender.

The doctor may order the following lab tests:

• urine tests

• tests of a stool sample

• blood tests, including tests to determine what type of hepatitis you have.

How is it treated?

Antibiotics are not useful in treating hepatitis. The usual treatment is bed rest, a balanced diet, and total abstinence from alcohol. Hospitalization is required only in more serious cases (for instance, if you become severely dehydrated).

You should avoid taking certain drugs that are metabolized in the liver. Ask your doctor which drugs these are.

How long do the effects last?

It usually takes 1 to 3 months to recover from an acute case of hepatitis.

Relapse can occur after some types of hepatitis. It can be triggered by drinking excessive amounts of alcohol or overexertion before you are fully recovered. It may be caused by a second infection. Relapses are generally milder than the initial infection.

Chronic hepatitis is an inflammation of the liver that lasts longer than 6 months. It can last for several years and may develop if you have hepatitis B or C.

Hepatitis can lead to cirrhosis, in which damage to the liver results in gradual changes to the liver structure. In severe, rare cases, some liver function may be lost.

How can I take care of myself?

• Rest in bed until your fever is gone, your urine returns to its normal color, and your jaundice lessens. Check with your doctor on how much bed rest you need.

• Do not drink any alcoholic beverages for at least 6 months.

• You should not take certain drugs that are metabolized in the liver. Ask your doctor which drugs these are.

• Follow a balanced diet, even when you feel nauseous. Especially in early stages of the disease, fatty foods may not appeal to you. Soda, juices, and hard candy may help you feel less nauseous.

• Take the medicines recommended by your doctor to relieve your symptoms.

• As your symptoms improve, you may gradually increase your level of activity. You should avoid too much exercise for 6 months.

What can be done to help prevent viral hepatitis?

Hepatitis A and B vaccinations can prevent these two types of hepatitis. In some cases another type of shot (gamma globulin) may be needed. If you have hepatitis, the doctor may advise that your close friends and family get shots to prevent getting hepatitis from you.

If someone in your household has hepatitis, take the following precautions:

• Flush bowel movements down the toilet and wash your hands immediately.

• Wear gloves if you must have contact with the sick person's bowel movements.

• Wash clothing and bed linens that are visibly soiled with a detergent that kills germs.

• Clean contaminated toilets and surfaces with a disinfectant.

Also:

• Avoid sharing toothbrushes and razorblades with someone who has hepatitis.

• Avoid sexual contact with someone who has hepatitis.