Hepatitis adalah peradangan hati karena berbagai sebab.

Hepatitis yang berlangsung kurang dari 6 bulan disebut "hepatitis akut",

hepatitis yang berlangsung lebih dari 6 bulan disebut "hepatitis kronis".
Virus hepatitis A terutama menyebar melalui tinja. Penyebaran ini terjadi akibat
buruknya tingkat kebersihan. Di negara-negara berkembang sering terjadi wabah y
ang penyebarannya terjadi melalui air dan makanan.
Waktu terekspos sampai kena penyakit kira-kira 2 sampai 6 minggu. anda akan meng
alami gejala gejala seperti demam, lemah, letih, dan lesu, pada beberapa kasus,
seringkali terjadi muntah muntah yang terus menerus sehingga menyebabkan seluruh
badan terasa lemas. Demam yang terjadi adalah demam yang terus menerus, tidak s
eperti demam yang lainnya yaitu pada demam berdarah, tbc, thypus, dll.
Selama 2 minggu setelah gejala pertama atau 1 minggu setelah penyakit kuning mun
cul. jangan terlalu banyak aktivitas.
Mencuci tangan dengan teliti, orang yang dekat mungkin harus menerima injeksi im
unoglobulin; imunisasi dianjurkan bagi beberapa orang.
Akan tetapi, kini tak perlu khawatir karena obat-obatan yang tersedia di pasaran
sudah bisa menyembuhkan Hepatitis B, asalkan hati belum telanjur rusak seluruhn
ya.
Ada beberapa obat Hepatitis B kronis yang telah disetujui di Indonesia, yakni en
tecavir (baraclude). Ini adalah obat terbaru yang dapat menekan replikasi (perke
mbangbiakan) virus. Obat antiviral ini merupakan obat oral yang dikemas dalam be
ntuk tablet. Ada juga lamivudine dan adefovir dipivoxil dalam bentuk tablet dan
pegylated interferon yang diberikan melalui suntikan.
Pelaksanaan vaksinasi hepatitis B dilaksanakan dalam tiga tahap. Pertama, diberi
kan segera setelah bayi dilahirkan. Kedua, setelah bayi berusia satu bulan. Tera
khir, ketika berusia 5 - 6 bulan. Efek samping vaksin ini relatif ringan yakni b
erupa sedikit demam.
Selain bayi, vaksinasi ini juga diperlukan bagi semua orang beresiko tinggi tert
ular seperti pekerja medis, orang yang sering cuci darah, sering berkontak denga
n bahan darah, ada anggota keluarga positif virus Hepatitis B, pasien penyakit d
arah, orang yang sering transfusi darah, dan seharusnya juga untuk para remaja.
Biasanya, untuk orang dewasa terlebih dahulu diperiksa darahnya. Hal ini untuk m
enilai status darahnya sehubungan dengan Hepatitis B-nya. Untuk itu diperiksa ni
lai darah seperti HBsAg, Anti-HBc, dan Anti-HBs. Melihat hasil ketiga nilai itu,
dokter akan menentukan apakah seseorang masih memerlukan vaksinasi.
Jika dari hasil pemeriksaan ternyata tubuh sudah memiliki kekebalan cukup terhad
ap Hepatitis B, vaksinasi tidak perlu lagi diberikan. Hanya pada tubuh yang belu
m kebal, atau kekebalannya masih di bawah standar, vaksinasi perlu dilakukan. Se
telah serangkaian vaksinasi diberikan (setelah sekitar 6 bulan), untuk mengetahu
i apakah vaksinasi memberikan hasil, pemeriksaan darah perlu diulang. Hal ini un
tuk melihat apakah tubuh merespon pembentukan zat kekebalan dengan melihat kadar
Anti-HBs dalam darah. Jika ternyata zat kekebalan terhadap Hepatitis B-nya masi
h negatif atau kadarnya di bawah standar, vaksinasi perlu diulang sampai zat kek
ebalan mencapai kadar sekurang-kurangnya sama dengan nilai standar. (Dari berbag
ai sumber)
Dalam masyarakat kita, penyakit hepatitis biasa dikenal sebagai penyakit kuning.
Sebenarnya hepatitis adalah peradangan organ hati (liver) yang disebabkan ole
h berbagai faktor. Faktor penyebab penyakit hepatitis atau sakit kuning ini anta
ra lain adalah infeksi virus, gangguan metabolisme, konsumsi alkohol, penyaki
t autoimun, hasil komplikasi dari penyakit lain, efek samping dari konsumsi ob
at-obatan maupun kehadiran parasit dalam organ hati (liver).
Lalu mengapa masyarakat kita menyebutnya sebagai penyakit kuning? Begini penjela
sannya. Salah satu gejala penyakit hepatitis (hepatitis symptoms) adalah timbuln
ya warna kuning pada kulit, kuku dan bagian putih bola mata.
Peradangan pada sel hati dapat menyebabkan kerusakan sel-sel, jaringan, bahkan s
emua bagian dari organ hati (liver). Jika semua bagian organ hati (liver) telah
mengalami kerusakan maka akan terjadi gagal hati (liver) yang menyebabkan kemati
an

Pencegahan hepatitis A
Pencegahan dapat dilakukan dengan tepat jika kita mengetahui cara-cara penularan
berbagai penyakit hepatitis. Hepatitis A menular melalui makanan dan minuman ya
ng tercemar feses penderita hepatitis A. Kebiasaan jajan makanan dan minuman di
sembarang tempat meningkatkan resiko tertular penyakit hepatitis A. Makanan ment
ah maupun setengah matang berpotensi terkontaminasi virus ini.
Beberapa cara pencegahan terhadap penyakit hepatitis A:
1. Imunisasi
Imunisasi sangat efektif mencegah infeksi suatu penyakit. Setelah imunisasi tubu
h akan menghasilkan antibodi yang merupakan zat kekebalan tubuh terhadap penyaki
t tersebut. Imunisasi hepatitis A diberikan pada anak-anak usia antara 2 hingga
18 tahun sebanyak satu kali. Orang dewasa membutuhkan imunisasi ulang (booster)
setelah 6 hingga 12 bulan imunisasi pertama. Kekebalan yang didapat dari imunisa
si ini dapat bertahan selama 15 hingga 20 tahun. Namun seseorang yang telah diim
unisasi dapat terkena hepatitis A jika ia terinfeksi VBA antara waktu 2 hingga 4
minggu setelah imunisasi, karena pada saat itu tubuh belum menghasilkan antibod
i dalam jumlah cukup.
Mereka yang sebaiknya mendapatkan imunisasi ini adalah:
Pekerja restoran atau yang biasa menangani makanan
Remaja yang tinggal di asrama pelajar yang mengalami kontak erat dengan t
eman-temannya.
Pekerja dan anak-anak pada tempat penitipan anak.
Orang yang menderita penyakit hati menahun
Pekerja laboratorium
2. Imunitas sementara
Mereka yang sering bepergian ke daerah lain sebaiknya mendapatkan kekebalan seme
ntara untuk mencegah infeksi VHA terutama jika daerah tujuannya adalah daerah en
demik hepatitis A atau daerah yang sanitasinya buruk. Imunitas sementara dapat d
iperoleh dengan pemberian immunoglobulin (Ig). Ig untuk pencegahan hepatitis A b
erisi antivirus hepatitis A yang sangat efektif setelah 2 minggu pemberian. Untu
k mereka yang harus menetap di daerah endemic, Ig anti VHA sebaiknya diulang set
iap 3 hingga 5 bulan.
3. Menjaga kebersihan
Mencuci tangan dengan menggunakan sabun setiap kali selesai buang air besar dan
kecil sangat dianjurkan untuk menghambat penularan VHA. Hal yang sama perlu dil
akukan pula pada saat sebelum makan, mengolah dan menyiapkan makanan. Awasi dan
berikan pngertian pada anak-anak agar tidak memasukkan benda-benda ke dalam mulu
tnya.

Pencegahan hepatitis B
Pencegahan terhadap hepatitis B dapat dilakukan dengan beberapa sebagai cara ber
ikut:
1. Imunisasi
Imunisasi lengkap hepatitis B dapat mencegah infeksi VHB selama 15 tahun. Imunis
asai hepatitis B diberikan sebanyak 3 kali. Imunisasi pertama dan kedua diberika
n dalam jarak 1 bulan. Sedangkan imunisasi ketiga diberikan 5 bulan setelah imun
isasi kedua. Pemberian imunisasi hepatitis B sebaiknya sedini mungkin yaitu saat
bayi hendak pulang dari rumah bersalin.
Bagi orang dewasa sebelum diimunisasi, sebaiknya dilakukan terlebih dahulu pemer
iksaan untuk melihat kadar anti HBS. Anti HBS adalah antibodi terhadap antigen p
ermukaan VHB (HBs-Ag). Dengan begitu dapat dinilai apakah tubuh telah memiliki k
ekebalan terhadap hepatitis B atau tidak. Jika tubuh telah memiliki cukup kekeba
lan terhadap hepatitis B maka imunisasi hepatitis B tidak diperliukan lagi. Namu
n pada kenyataannya pemeriksaan kadar anti-HBs lebih mahal daripada harga vaksin
hepatitis B. Dengan begitu bagi mereka yang beresiko tinggi tertular VHB imunis
asi bisa langsung diberikan.
Imunisasi hepatitis B sangat dianjurkan untuk kelompok orang berikut:
* Bayi baru lahir
* Anak dan remaja yang belum mendapat imunisasi hepatitis B
* Keluarga yang salah satu anggota keluarganya terinfeksi virus hepati
tis B
* Pekerja medis
* Pekerja laboratorium
* Penderita gangguan penyakit yang sering cuci darah atau mendapat tra
nsfusi darah.
* Pekerja seks
* Pengguna narkoba
* Pecinta tato
2. Tidak menggunakan barang orang lain
Barang-barang yang dapat menyebabakan luka dapat menjadi media penularan virus h
epatitis B. Barang-barang tersebuat antara lain pisau cukur, gunting kuku, sikat
gigi, dan lain-lain.
3. Melakukan hubungan seks sehat dan aman
Melakukan hubungan seks dengan bergonta ganti pasangan beresiko tinggi tertular
hepatitis B. Jika suami atau istri terinfeksi hepatitis B maka sang suami wajib
menggunakan kondom saat berhubungan seksual.
4. Jika terinfeksi hepatitis B jangan mendonorkan darah
Palang merah Indonesia akan melakukan serangkaian pemeriksaan pada darah yang di
donorkan. Jika ternyata sejumlah darah pada bank darah terinfeksi virus hepatit
is B maka darah tersebut akan dimusnahkan.
5. Bersihkan ceceran darah
Jika ada ceceran darah meski sedikit harus segera dibersihkan. Penggunaan laruta
n pemutih pakaian diyakini dapat membunuh virus.

Pencegahan hepatitis C
Hingga saat ini belum ditemukan vaksin yang dapat digunakan untuk mencegah hepat
itis C. Sedangkan pencegahan lainnya dapat dilakukan dengan cara yang sama seper
ti pada pencegahan infeksi virus hepatitis B yaitu:
1. Tidak menggunakan barang orang lain
Barang-barang yang dapat menyebabkan luka dapat menjadi media penularan virus he
patitis C. Barang-barang tersebuat antara lain pisau cukur, gunting kuku, sikat
gigi, dan lain-lain.
2. Melakukan hubungan seks sehat dan aman
Hubungan seks dengan bergonta ganti pasangan beresiko tinggi dalam penularan hep
atitis C. Jika suami atau istri terinfeksi hepatitis C maka sang suami wajib men
ggunakan kondom saat berhubungan seksual.
3. Jika terinfeksi hepatitis C jangan mendonorkan darah
Palang merah Indonesia akan melakukan serangkaian pemeriksaan pada darah yang di
donorkan. Jika ternyata sejumlah darah pada bank darah terinfeksi virus hepatit
is C maka darah tersebut akan dimusnahkan.
4. Bersihkan ceceran darah
Jika ada ceceran darah meski sedikit harus segera dibersihkan. Penggunaan laruta
n pemutih pakaian diyakini dapat membunuh virus.

Agar tujuan kesembuhan tercapai, pengobatan hepatitis harus dilakukan sesuai den
gan diagnosis yang tepat. Dokter menentukan diagnosis berdasarkan anamnesis, pem
eriksaan fisik, pemeriksaan laboratorium dan pemeriksaan penunjang lainnya seper
ti USG, sinar X, CT scan, atau MRI.
Anamnesis adalah wawancara yang dilakukan dokter kepada pasien untuk memperoleh
informasi tentang keluhan dan gejala penyakit yang dirasakan pasien. Selain itu
dokter juga dapat mengetahui informasi tentang semua hal yang diperkirakan sebag
ai penyebab penyakit hepatitis serta proses pengobatan yang pernah dilakukan ole
h pasien.
Pemeriksaan fisik dilakukan untuk melihat adanya tanda-tanda kelainan atau gangg
uan pada tubuh pasien. Pemeriksaan laboratorium berguna untuk memastikan diagnos
is jenis penyakit hepatitis. Sedangkan pemeriksaan penunjang berguna untuk menen
tukan letak kelainan ataupun menilai parah tidaknya penyakit tersebut.

Hepatitis yang disebabkan oleh infeksi virus menyebabkan sel-sel hati mengalami
kerusakan sehingga tidak dapat berfungsi sebagaimana mestinya. Pada umumnya, sel
-sel hati dapat tumbuh kembali dengan sisa sedikit kerusakan, tetapi penyembuhan
nya memerlukan waktu berbulan-bulan dengan diet dan istirahat yang baik.
Hepatitis B akut umumnya sembuh, hanya 10% menjadi Hepatitis B kronik (menahun)
dan dapat berlanjut menjadi sirosis hati atau kanker hati. Saat ini ada beberapa
perawatan yang dapat dilakukan untuk Hepatitis B kronis yang dapat meningkatkan
 kesempatan bagi seorang penderita penyakit ini. Perawatannya tersedia dalam ben
tuk antiviral seperti lamivudine dan adefovir dan modulator sistem kebal seperti
Interferon Alfa ( Uniferon)
Selain itu, ada juga pengobatan tradisional yang dapat dilakukan. Tumbuhan obat
atau herbal yang dapat digunakan untuk mencegah dan membantu pengobatan Hepatiti
s diantaranya mempunyai efek sebagai hepatoprotektor, yaitu melindungi hati dari
pengaruh zat toksik yang dapat merusak sel hati, juga bersifat anti radang, kol
agogum dan khloretik, yaitu meningkatkan produksi empedu oleh hati. Beberapa jen
is tumbuhan obat yang dapat digunakan untuk pengobatan Hepatitis, antara lain ya
itu temulawak (Curcuma xanthorrhiza), kunyit (Curcuma longa), sambiloto (Androgr
aphis paniculata), meniran (Phyllanthus urinaria), daun serut/mirten, jamur kayu
/lingzhi (Ganoderma lucidum), akar alang-alang (Imperata cyllindrica), rumput mu
tiara (Hedyotis corymbosa), pegagan (Centella asiatica), buah kacapiring (Garden
ia augusta), buah mengkudu (Morinda citrifolia), jombang (Taraxacum officinale).

Hepatitis yang disebabkan oleh infeksi virus menyebabkan sel-sel hati mengalami
kerusakan sehingga tidak dapat berfungsi sebagaimana mestinya. Pada umumnya, sel
-sel hati dapat tumbuh kembali dengan sisa sedikit kerusakan, tetapi penyembuhan
nya memerlukan waktu berbulan-bulan dengan diet dan istirahat yang baik.<ref nam
e="infocathuslib">Templat:Cite web</ref>
Hepatitis B akut umumnya sembuh, hanya 10% menjadi Hepatitis B kronik (menahun)
dan dapat berlanjut menjadi sirosis hati atau kanker hati.<ref name="IDI">Templa
t:Cite web</ref> Saat ini ada beberapa perawatan yang dapat dilakukan untuk Hepa
titis B kronis yang dapat meningkatkan kesempatan bagi seorang penderita penyaki
t ini. Perawatannya tersedia dalam bentuk antiviral seperti lamivudine dan adefo
vir dan modulator sistem kebal seperti Interferon Alfa ( Uniferon).<ref>Templat:
Cite journal</ref>
Selain itu, ada juga pengobatan tradisional yang dapat dilakukan. Tumbuhan obat
atau herbal yang dapat digunakan untuk mencegah dan membantu pengobatan Hepatiti
s diantaranya mempunyai efek sebagai hepatoprotektor, yaitu melindungi hati dari
pengaruh zat toksik yang dapat merusak sel hati, juga bersifat anti radang, kol
agogum dan khloretik, yaitu meningkatkan produksi empedu oleh hati. Beberapa jen
is tumbuhan obat yang dapat digunakan untuk pengobatan Hepatitis, antara lain ya
itu temulawak (Curcuma xanthorrhiza), kunyit (Curcuma longa), sambiloto (Androgr
aphis paniculata), meniran (Phyllanthus urinaria), daun serut/mirten, jamur kayu
/lingzhi (Ganoderma lucidum), akar alang-alang (Imperata cyllindrica), rumput mu
tiara (Hedyotis corymbosa), pegagan (Centella asiatica), buah kacapiring (Garden
ia augusta), buah mengkudu (Morinda citrifolia), jombang (Taraxacum officinale).
<ref name="infocathuslib">Templat:Cite web</ref>

Hepatitis B
Also known as: anti-HBs; HBsAg; HBeAg; anti-HBc; anti-HBc,IgM; anti-HBe; HBV DNA
Related tests: Hepatitis A; Hepatitis C
* At a Glance
* Test Sample
* The Test
* Common Questions
* Ask Us
* Links
The Test
1. How is it used?
2. When is it ordered?
 3. What does the test result mean?
4. Is there anything else I should know?
How is it used?
There are several tests used to detect the presence of hepatitis B antibodies. A
ntibodies are produced by the body to offer protection from antigens (foreign pr
oteins). There are also several tests that detect the presence of viral antigens
.
The hepatitis B surface antibody (anti-HBs) is the most common test. Its presenc
e indicates previous exposure to HBV, but the virus is no longer present and the
person cannot pass on the virus to others. The antibody also protects the body
from future HBV infection. In addition to exposure to HBV, the antibodies can al
so be acquired from successful vaccination. This test is done to determine the n
eed for vaccination (if anti-HBs is absent), or following the completion of vacc
ination against the disease, or following an active infection.
Hepatitis B surface antigen (HBsAg) is a protein antigen produced by HBV. This a
ntigen is the earliest indicator of acute hepatitis B and frequently identifies
infected people before symptoms appear. HBsAg disappears from the blood during t
he recovery period. In some people (particularly those infected as children or t
hose with a weak immune system, such as those with AIDS), chronic infection with
HBV may occur and HBsAg remains positive.
Sometimes, HBV goes into hiding in the liver and other cells and does not produce
new viruses that can infect others, or produces them in such low amounts that th
ey cannot be found in the blood. People who have this form are said to be carrie
rs. In other cases, the body continues to make viruses that can further infect t
he liver and can be spread to other people. In both these cases, HBsAg will be p
ositive. The next test is helpful for distinguishing these two states.
Hepatitis B e-antigen (HBeAg) is a viral protein associated with HBV infections.
Unlike the surface antigen, the e-antigen is found in the blood only when there
are viruses also present. When the virus goes into hiding, the e-antigen will no
longer be present in the blood. HBeAg is often used as a marker of ability to sp
read the virus to other people (infectivity). Measurement of e-antigen may also
be used to monitor the effectiveness of HBV treatment; successful treatment will
usually eliminate HBeAg from the blood and lead to development of antibodies ag
ainst e-antigen (anti-HBe). There are some types (strains) of HBV that do not ma
ke e-antigen; these are especially common in the Middle East and Asia. In areas
where these strains of HBV are common, testing for HBeAg is not very useful.
Anti-HBe is an antibody produced in response to the Hepatitis B e antigen. In th
ose who have recovered from acute hepatitis B infection, anti-HBe will be presen
t along with anti-HBc and anti-HBs. In those with chronic hepatitis B, usually a
nti-HBe becomes positive when the virus goes into hiding or is eliminated from t
he body. In strains that do not make HBe antigen, anti-HBe is also positive.
Anti-hepatitis B core antigen (anti-HBc) is an antibody to the hepatitis B core
antigen. The core antigen is found on virus particles but disappears early in th
e course of infection. This antibody is produced during and after an acute HBV i
nfection and is usually found in chronic HBV carriers as well as those who have
cleared the virus, and usually persists for life. Anti-HBc testing is either spe
cific for the IgM antibody, anti-HBc, IgM, which indicates acute infection, or m
easures total antibody, anti-HBC, which indicates past infection, either acute o
r chronic.
HBV DNA is a more sensitive test than HBeAg for detecting viruses in the blood s
tream. It is usually used in conjunction with rather than instead of the regular
serologic tests. It may be used to monitor antiviral therapy in patients with c
hronic HBV infections.
^ Back to top
When is it ordered?
These tests are used to determine whether the vaccine has produced the desired l
evel of immunity as well as to diagnose and follow the course of an infection.
In a patient with acute hepatitis, anti-HBc IgM and HBsAg are usually ordered to
gether to detect recent infection by HBV. In persons with chronic hepatitis, or
with elevated ALT or AST, HBsAg and anti-HBc are usually done to see if the live
r damage is due to HBV. If so, HBsAg and HBeAg are usually measured on a regular
basis (every 6 months to a year), since in some people HBeAg (and, less commonl
y, HBsAg) will go away on their own. Recent evidence suggests that many of those
who have anti-HBc but no HBsAg may have very low levels of HBV DNA in their blo
od and/or in their liver. The significance of this is still being debated. In th
ose who are being treated for chronic HBV, HBeAg and HBV DNA can be used to dete
rmine whether the treatment is successful (in which case, both will become undet
ectable). If a person is given the HBV vaccine, anti-HBs is used to see if it su
ccessful; if levels of the antibody are over 10 IU/mL, the person is probably pr
otected for life from infection by HBV, unless they have or develop problems wit
h their immune system (such as HIV infection, renal failure, or treatment with d
rugs that suppress the immune system).
All donated blood is tested for the presence of the HBsAg before being distribut
ed.
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What does the test result mean?
* Hepatitis B surface antibody (anti-HBs): a positive result indicates immun
ity to hepatitis B from the vaccination or recovery from an infection.
* Hepatitis B surface antigen (HBsAg): A negative result indicates that a pe
rson has never been exposed to the virus or has recovered from acute hepatitis a
nd has rid themselves of the virus (or has, at most, an occult infection). A pos
itive (or reactive) result indicates an active infection but does not indicate w
hether the virus can be passed to others.
* Hepatitis B e-antigen (HBeAg): A positive (or reactive) result indicates t
he presence of virus that can be passed to others. A negative result usually mea
ns the virus cannot be spread to others, except in parts of the world where infe
ction with strains that cannot make this protein are common.
* Anti-hepatitis B core antigen (anti-HBc): If it is present with a positive
anti-HBs, it usually indicates recovery from an infection and the person is not
a carrier or chronically infected. In acute infection, the first type of antibo
dy to HBc to appear is an IgM antibody. Testing for this type of antibody can pr
ove whether a person has recently been infected by HBV (where anti-HBc, IgM woul
d be positive) or for some time (where anti-HBc, IgM would be negative).
* HBV DNA: A positive (or reactive) result indicates the presence of virus t
hat can be passed to others. A negative result usually means the virus cannot be
spread to others, especially if tests that can pick up as few as 200 viruses (c
opies) in one mL of blood are used.
^ Back to top
Is there anything else I should know?
While the tests described above are specific for HBV, other liver function tests
such as AST, ALT, and gamma-glutamyl transferase (GGT) may be used to monitor t
he progress of the disease. In some cases, a liver biopsy may be performed for c
onfirmation.
What is it?
Hepatitis is an inflammation of the liver that can be caused by viruses, chemica
ls, drugs, alcohol, inherited diseases, or the patient s own immune system. This i
nflammation can be acute, flaring up and then resolving within a few weeks to mo
nths, or chronic, enduring over many years. Chronic hepatitis may simmer for 20
years or more before causing significant symptoms related to progressive liver d
amage such as cirrhosis (scarring and loss of function), liver cancer, or death.
The liver is a vital organ located in the upper right-hand side of the abdomen.
It performs many functions in the body, including processing the body s nutrients,
manufacturing bile to help digest fats, synthesizing many important proteins, r
egulating blood clotting, and breaking down potentially toxic substances into ha
rmless ones that the body can use or excrete. Inflammation may (in severe cases)
interfere with these processes and allow potentially toxic substances to accumu
late.
The symptoms of hepatitis are the same, regardless of the cause, but vary from p
erson to person and may vary over time. With acute hepatitis, many people have f
ew or mild symptoms that may be mistaken for the flu. These may include fatigue,
nausea, loss of appetite, fever, and abdominal pain. Others may experience jaun
dice, itching, dark colored urine, and light colored stools. A physical examinat
ion may reveal a liver that is tender and enlarged. Chronic hepatitis usually ca
uses no symptoms or may be noticeable as only a loss of energy and tiredness. In
some people, chronic hepatitis can gradually damage the liver and, after many y
ears, cause liver failure. The chronic form typically lasts for many years and o
nly rarely goes away without treatment.
Viral Hepatitis
The most common cause of hepatitis is an infection with a virus. The viruses pri
marily associated with hepatitis are named in the order of their discovery: A, B
, C, D, and E (see Viral Hepatitis Table).
* Hepatitis A is spread through infected water and food that have been conta
minated with fecal material. The Centers for Disease Control and Prevention (CDC
) estimates that as many as one third of the U.S. population becomes infected wi
th hepatitis A at some point in their life. Symptoms may be flu-like and are fre
quently not identified as being due to hepatitis. Most patients recover fully wi
thin about six months.
* Hepatitis B is the most common cause of acute viral hepatitis. It can be s
pread by exposure to blood, infected needles, through sexual relations, and from
mother to baby. The number of new cases in the U.S. each year is approximately
73,000, a decline from the 1980s when the average was 260,000. Most people will
get better without any intervention, but about 1-3% become carriers - chronicall
y infected and able to continue to infect others. Newborns are especially vulner
able to chronic infection, with up to 90% of those exposed becoming carriers. Wi
th the advent of screening pregnant women for hepatitis B and the vaccination of
newborns, the number of infected babies has fallen. Most chronic hepatitis B in
fections are now seen in people born in parts of the world (particularly souther
n and eastern Asia, southern Europe, and Africa) where infection among newborns
still remains common.
* Hepatitis C is spread by exposure to contaminated blood. Some mechanisms o
f exposure include the sharing of needles or other 'works' used in consuming dru
gs such as cocaine or heroin; use of contaminated equipment for activities such
as body piercing and tattooing; occupational exposure of healthcare workers to u
sed needles or other sharp objects; through sexual activity that results in tiss
ue tears; from mother to baby during childbirth; or from cuts sustained during a
thletic or other activity. It is less common than hepatitis B as a cause of acut
e hepatitis but is the most common cause of chronic hepatitis. According to the
CDC, about 55% to 85% of those exposed to the virus develop chronic hepatitis.
* Hepatitis D and E are rare in the U.S. Hepatitis D only causes an infectio
n when hepatitis B is present and can make that infection more severe. It is usu
ally spread by exposure to blood or infected needles. Hepatitis E is spread in a
 similar fashion to hepatitis A and is found primarily in Asia, Africa, and Sout
h America.
Chemically-Induced Hepatitis
The liver is responsible for the metabolism of alcohol, drugs, and environmental
toxins. It breaks them down into substances that can be used and then excreted
by the body. Some drugs or chemicals cause liver damage whenever a person is exp
osed to high levels of them. Acetaminophen, which is found in many over-the-coun
ter and prescription medications, is an example of this. In therapeutic doses, i
t is a useful pain reliever, but in very high dosages or in combination with alc
ohol, it has the potential to cause life-threatening acute liver failure. Excess
ive consumption of alcohol, by itself, is also toxic to the liver and is one of
the most common causes of chemical hepatitis.
Many drugs have the potential to cause hepatitis in a few people, in a seemingly
random fashion. Their effect cannot be foreseen and appears to be related to an
allergic reaction to the medication. Drugs that have had this affect in some pe
ople include anesthetics, antibiotics, anabolic steroids, and seizure medication
s.
Inherited Forms of Hepatitis
Several inherited diseases can become apparent primarily by causing acute or chr
onic hepatitis. The most common of these is hemochromatosis, an inherited diseas
e associated with accumulation of too much iron in the body. The liver is one of
the principal organs damaged, and chronic hepatitis may be due to hemochromatos
is. Deficiency of alpha-1-antitrypsin is also a relatively common inherited dise
ase, and in children who have this deficiency state, both acute and chronic hepa
titis are common. In adults, the liver involvement is often hard to detect, but
cirrhosis and liver cancer are both more common in those with alpha-1-antitrypsi
n deficiency. A more rare inherited disorder, Wilson s disease, is associated with
an accumulation of excess copper in the liver, brain, and in other tissues. Thi
s disease may cause both acute and chronic hepatitis. Unless Wilson's disease is
treated, it becomes progressively worse and is eventually fatal.
Non-Alcoholic Fatty Liver Disease (NAFLD) and Chronic Hepatitis
One of the most common causes of chronic hepatitis is accumulation of excess fat
in the liver. This is most commonly seen in people with the metabolic syndrome,
a combination of problems such as obesity (especially too much fat in the belly
), hypertension, high triglyceride levels, low HDL cholesterol, and insulin resi
stance or type 2 diabetes. The more severe form of hepatitis is sometimes also t
ermed non-alcoholic steatohepatitis (NASH). There are no laboratory tests that c
an make the diagnosis of NAFLD or NASH other than a liver biopsy.
Autoimmune Hepatitis
Autoimmune hepatitis is usually a chronic form of hepatitis that frequently lead
s to progressive damage of the liver; in about 25% of cases, it may present like
acute hepatitis. It is more common in women than men; in fact, according to the
American Liver Foundation, 70% of those affected are female. For reasons that a
re not fully understood, the body s immune system targets and attacks the liver. A
utoimmune hepatitis may be found in association with other autoimmune disorders,
such as type 1 diabetes, ulcerative colitis, and Sjogren s syndrome.