As with so many diseases, we’ve come a long way in understanding hepatitis, notably two chronic and serious forms: hepatitis B and hepatitis C. Several drugs are now on the market to manage hepatitis B, and hepatitis C is now curable. At the same time, we’re continually learning how to use approved medications much more easily and effectively.
But first, here are some basics.
The liver is the largest organ inside the human body. About the size of a football, it is located in the upper right part of the abdomen. We can’t live without a functioning liver. It’s the body’s filter, power plant and warehouse. Almost all cells and tissues in the body depend on the liver. When something goes wrong with the liver, it can have a serious effect on almost every other organ in the body.
A little more than 1.5 quarts of blood pump through the liver every minute, allowing the liver to quickly and effectively remove toxins and waste products from the bloodstream. At the same time, the liver stores important nutrients such as vitamins, minerals and iron. The liver also plays a role in managing levels of certain substances in the body, such as cholesterol, hormones and sugars, which are all necessary for survival and are potentially harmful when out of balance. The liver also has a key role in digesting food because it produces bile. In addition, the liver controls blood-clotting factors, which prevent excessive bleeding.
Hepatitis is a general term that means inflammation of the liver. The ancient Greek word hepa refers to the liver, and the Latin word itis means inflammation (as in arthritis, dermatitis and pancreatitis).
Inflammation of the liver—hepatitis—has several possible causes, including:
- Toxins and chemicals such as excessive amounts of alcohol.
- Autoimmune diseases that cause the immune system to attack healthy tissues in the body.
- Microorganisms, including viruses.
- Excess fat in the liver.
Hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infect liver cells—called hepatocytes—that provide the best conditions for these viruses to reproduce. In response to the infection, the body’s immune system targets the liver, causing inflammation (hepatitis). If the hepatitis is severe (which can happen with HAV and HBV) or goes on for a long period of time (which can happen with HBV and HCV), hardened tissue can develop in the liver, a condition called fibrosis.
HBV and HCV can lead to chronic liver disease, liver cancer and cirrhosis. Cirrhosis occurs when, over time, hardened scar tissue replaces more and more normal liver tissue. This can obstruct the normal flow of blood through the liver and seriously affect its structure and ability to function properly.
If the liver is severely damaged, blood can back up into the spleen and the small blood vessels in the digestive tract, which can result in high pressure in these areas. This condition is called portal hypertension. Too much pressure on the blood vessels can cause the veins to become enlarged. These are known as varices. If the varices ;burst, it is known as varicesal bleeding. Significant liver damage can also reduce the production of bile needed for proper digestion, and it can decrease the liver’s ability to store and process nutrients needed for survival. If the liver is unable to manage protein, fluid can accumulate in the abdominal region, a condition known as ascites. Other effects of a damaged liver include the inability to remove toxins from the bloodstream, which can eventually lead to mental confusion and even coma (encephalopathy).
Hepatitis B can be managed, and hepatitis C can be cured. The only way to know you’re infected with these viruses—and to get medical care if you are—is to get tested.
- Blacks are 1.7 times as likely as whites to die from viral hepatitis. They are also more likely to be chronically infected with either HBV or HCV—or both.
- As many as 2.2 million people have chronic hepatitis B in the United States, and roughly 1,700 people die of complications from the disease every year.
- Rates of HBV infection are declining in the United States, from 43,000 in 2007 to nearly 21,000 reported in 2016.
- Roughly 3.5 million Americans are living with chronic HCV.
- The number of new HCV infections occurring every year is rising, largely due to the opioid epidemic. There were an estimated 41,200 new HCV cases in 2016 in the United States.
- There are 18,000 deaths due to HCV-related liver disease every year in the United States, although many experts believe this number is substantially higher.
- There are vaccines to prevent HBV, and several drugs are approved to treat the infection. st HCV, the infection can be prevented. The disease can also be cured using a combination of approved medications.
For more information and support for people living with, and at risk for, viral hepatitis, with a specific focus on chronic HBV and HCV infection please visit our sister site Hep.
Last Reviewed: February 22, 2019