Hepatitis means inflammation (swelling and pain) of the liver. The liver is important for a range of functions in the body. These include regulating metabolism, making proteins, storing vitamins and iron, removing toxins and producing bile.
If the liver doesn’t work properly, it can cause serious illness or sometimes even death. Hepatitis may be caused by infection, viruses, chemicals, alcohol, drug use and other factors. ‘Chronic hepatitis’ means ongoing inflammation of the liver, irrespective of the underlying cause.
The various forms of viral hepatitis are named after different letters of the alphabet. These include hepatitis A, B, C, D and E. They are also sometimes called ‘hep A’, ‘hep B’, ‘hep C’ and so on. While all these viruses affect the liver, they are spread in different ways and have different treatments. The most common types of viral hepatitis in Australia are A, B and C.
Other viruses may also cause hepatitis, such as the yellow fever virus and the virus that causes glandular fever.
Symptoms of hepatitis
Not everyone with hepatitis has symptoms. Generally speaking, when symptoms occur, they may include:
- abdominal discomfort
- dark urine
- lethargy (tiredness)
- painful joints
- oedema (swelling)
- easy bruising
- jaundice (yellow skin and eyes).
Anyone can be infected if they come in direct contact with the hepatitis A virus through food, drinks or objects contaminated by the faeces (poo) of an infected person. Symptoms may last several weeks but the person usually recovers completely. Infection with hepatitis A will give lifelong immunity. However, this doesn’t offer immunity against the other types of hepatitis. A vaccine is available to protect against hepatitis A.
Hepatitis B virus is found in the blood and, to a lesser degree, in body fluids such as semen and vaginal secretions. You can get hepatitis B through unsafe sex, sharing contaminated injecting drug equipment and other activities where the blood of an infected person enters your bloodstream.
Mothers who have long-term or chronic hepatitis B sometimes pass the virus to their children, either through the womb (rarely), at the time of birth or (more commonly) shortly after birth.
People who become infected with the hepatitis B virus may develop a long-term hepatitis B infection, which occurs when the virus stays in their body for their entire life. Babies and children who become infected are more likely than adults to develop long-term hepatitis B.
A vaccine is available to prevent hepatitis B infection. It is included in the standard immunisation schedule, beginning in infancy. Screening the mother before birth can prevent infection of newborn infants. If a mother tests positive, hepatitis B immunoglobulin is given to the baby when they are born, as well as hepatitis B vaccination.
Hepatitis C is a blood-borne virus that is spread when blood from an infected person enters another person’s bloodstream. In Australia, the most common way it is transmitted is through sharing unsterile injecting drug equipment. Around 20 to 30 per cent of people who have been infected with hepatitis C may clear the virus from their blood with no treatment. These people no longer have hepatitis C and are not infectious.
Around 70 to 80 per cent of people infected with hepatitis C, if untreated, may continue to have the virus in their blood and are likely to have chronic hepatitis C. Of these, about 10 to 20 per cent will develop cirrhosis, which is scarring of the liver. This can take 20 years or more to develop. A small number of people with cirrhosis may develop liver cancer.
Combination treatment with the medicines pegylated interferon and ribavirin has greatly improved the outcomes for people with hepatitis C. These treatments can help decrease inflammation in the liver and can clear the virus in 30 to 65 per cent of people, but there are some side effects. There is no vaccine available to prevent hepatitis C infection.
Hepatitis D infection is uncommon in Australia and is prevalent in countries that have a high incidence of hepatitis B. Hepatitis D virus can be acquired either as a co-infection (occurs at the same time) with hepatitis B virus or as a ‘super-infection’ in people who are already infected with hepatitis B virus.
You can get hepatitis D through unsafe sex, sharing unsterile injecting drug equipment and other activities where the blood of an infected person enters your bloodstream.
Hepatitis E is most common in developing countries. There is no chronic (long-term) infection associated with this virus. Hepatitis E is more severe among pregnant women, especially in the third trimester. The hepatitis E virus is found in the faeces of infected people and animals and is spread by eating or drinking contaminated food or water. Transmission from person to person occurs less commonly than with hepatitis A virus.
Pregnant women from Australia are strongly advised not to travel to areas where there is a lot of hepatitis E, especially during the last three months of pregnancy.
Diagnosis of hepatitis
Tests used to diagnose hepatitis may include blood tests and a liver biopsy (a small piece of liver tissue is taken for laboratory examination).
Treatment for hepatitis
Treatment depends on the type of hepatitis. Please consult your doctor for specific information about treatment. Chronic viral hepatitis – whether due to hepatitis B or C – can, after many years, lead to cirrhosis and primary cancer of the liver.
Where to get help
This page has been produced in consultation with and approved by:
Department of Health and Human Services - RHP&R - Health Protection - Communicable Disease Prevention and Control Unit
Page content currently being reviewed.
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