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Viral Hepatitis: Symptoms and Risk Factors

Hepatitis is a disease of the liver that results in widespread destruction of liver cells. It can be acute or chronic (lasting longer than six months) and may progress to liver failure, cirrhosis, and/or liver cancer. The most common causes of hepatitis in the United States are alcohol abuse and viral infection.

Viral hepatitis can be caused by dozens of different viruses. The most common are called hepatitis viruses: hepatitis A, hepatitis B, and hepatitis C.

  • Hepatitis A is a common cause of acute hepatitis, but does not result in chronic disease. It is usually spread by poor hygienic practices and inadequate sanitation, especially in third–world countries. The disease is usually mild, and patients may be asymptomatic.
  • Hepatitis B generally does not cause severe acute disease, but can result in chronic hepatitis, which can be fatal. It is spread by blood and body fluids (e.g., unprotected sex, intravenous drug use, blood transfusions, and tattoo and body piercing). Sexual contact is the most common mode of transmission in the United States.
  • Hepatitis C is the most common cause of chronic hepatitis in the United States and is the most common reason for liver transplantation. Patients with chronic hepatitis C usually do well for 20 to 25 years before developing cirrhosis. The most common cause of hepatitis C in the United States is intravenous drug use. Although transmission rarely occurs via blood products, this is much less common since universal blood screening for hepatitis began in 1990.


Many cases are asymptomatic. However, the condition may cause these symptoms:

  • Fever
  • Nausea and vomiting
  • Fatigue
  • Jaundice (yellow discoloration of the skin)
  • Right–sided abdominal pain
  • Dark urine with pale stools

Risk Factors

  • Exposure to blood or body fluids (e.g., intravenous drug use, unprotected sexual intercourse, tattoos, body piercing, blood transfusion, and occupational needlestick exposure). Transmission via blood transfusion is now rare due to universal blood screening.
  • Contact with an infected person (hepatitis A)
  • Poor hygiene and inadequate sanitation (hepatitis A)
  • Underlying liver disease. Patients with underlying liver disease (e.g., autoimmune hepatitis, hemochromatosis, Wilson’s disease, and alpha–1 antitrypsin deficiency) are at increased risk of developing symptomatic hepatitis.
  • Alcohol use, smoking, HIV infection, and fatty liver. Each of these is a risk factor for progression of hepatitis to a chronic state.


Viral Hepatitis: Diagnosis and Treatment >>