(This information is not intended to be a substitute for the advice of a doctor or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor for your specific condition.)


The liver is an important organ of the body. It is located in the upper right part of the abdomen. The liver regulates the body’s nutrition system. After we eat food, it is digested and absorbed, then taken through large blood vessels to the liver. The liver processes absorbed substances such as fat, sugar, protein, and vitamins so the rest of the body can use them.

The liver gets rid of harmful substances called toxins before they have a chance to poison the body. The liver also makes bile; a yellowish liquid that helps absorb the food we eat. Bile is made out of a substance called bilirubin, a yellowish chemical. Bile is secreted directly into the first part of the intestines through the common bile duct. It can also be stored in the gallbladder before being secreted into the intestines. Bile is what makes our stools a brownish green color. The liver also makes special chemicals that cause our blood to clot when we are injured.

Hepatitis is an inflammation of the liver. Inflammation causes soreness and swelling. Hepatitis can be caused by many things. Hepatitis is most commonly caused by one of the hepatitis viruses (A, B, C)

Hepatitis A

Hepatitis A causes inflammation of the liver, which leads to soreness and swelling. Hepatitis A is different from other types of hepatitis because it isn't typically as serious and doesn't develop into chronic hepatitis or cirrhosis like hepatitis B and C can.

The hepatitis A virus is usually in your system for 1 month before symptoms appear. When symptoms do appear, they can appear suddenly and include:
• Nausea
• Vomiting
• Jaundice (the yellowing of the skin and the whites of the eyes)
• Low-grade fever (fever up to 102°F)
• Fatigue
• Pain in your abdomen, especially on your right side
• Dark-colored urine
• Loss of appetite
• Muscle pain
• Itching

You are most contagious soon after you are infected and before symptoms appear. Adults who are otherwise healthy are no longer contagious 2 weeks after the illness begins. People who have weak immune systems may be contagious for up to 6 months.

Hepatitis A is typically spread through contact with infected feces. You can get infected through close contact with an infected person (for example, changing a diaper or having sexual contact), even if that person does not have any symptoms. In fact, hepatitis A is most contagious before symptoms appear. You can also get infected by eating contaminated food or drinking contaminated water. The virus can live on hands, in water and in soil.
• Ask your doctor about the hepatitis A vaccine. The shot is safe for anyone over 1 year of age and can provide protection for up to 20 years.
• Wash your hands with soap and warm water before and after cooking, after using the bathroom and after changing diapers.
• Wash fruits and vegetables thoroughly before eating and avoid raw or undercooked meat and fish.

There is no specific medicine to treat or cure hepatitis A. If you have the virus, you should get plenty of rest, eat a balanced diet and avoid alcohol and acetaminophen (paracetamol). Both alcohol and medicines like acetaminophen are broken down by the liver and may increase the speed of liver damage in people who have hepatitis.

(Source: Hepatitis A by SC Brundage M.D., M.P.H. and AN Fitzpatrick, M.P.H. - American Family Physician. June 15, 2006)

Hepatitis B

Hepatitis B is the most common serious liver infection. It is caused by the hepatitis B virus that attacks the liver. It cannot be spread through sneezing, coughing, hugging or eating food prepared by someone who is infected.The virus is transmitted through blood and infected bodily fluids. This can occur through
• direct blood-to-blood contact
• unprotected sex
• use of un-sterile needles
• from an infected woman to her newborn during the delivery process.

An adult usually fights off the virus but if the body cannot fight it, chronic hepatitis B develops. Chronic hepatitis B can lead to cirrhosis or liver cancer, which can stop the liver from working properly. A person will die if his or her liver does not function.

When a person is first infected with the hepatitis B virus, this is called an "acute infection.” Fortunately, 90% of healthy adults will recover and develop antibodies against the hepatitis B virus. They become “immune” to the hepatitis B virus. For those who do not get rid of the virus after 6 months of infection, a person is then diagnosed as having a “chronic hepatitis B", this means the virus may stay in the liver and blood for a lifetime.

In the liver, a chronic hepatitis B infection can lead to cirrhosis. Cirrhosis is a condition where the cells of the liver are scarred by tissue fibers. This causes the liver to become less effective. With severe cirrhosis, the liver stops working. This is known as liver failure. A chronic hepatitis B infection can also lead to liver cancer over time. Regular evaluation by a physician (for example, a liver specialist), seeking treatment if appropriate, and maintaining a healthy lifestyle can help slow down possible liver damage from the hepatitis B virus. Most people do not have symptoms during the acute hepatitis B infection stage. Any common symptoms that might show up are usually flu-like. Some have flu-like symptoms including fever, fatigue, muscle or joint pain, loss of appetite, mild nausea and vomiting.

Only 1% of infected people have severe symptoms while their body is trying to fight off the virus. Severe symptoms include nausea and vomiting, yellow eyes and skin called “jaundice”, and a bloated or swollen stomach. This condition, which can develop suddenly, is life threatening and requires immediate medical attention. Hepatitis B is often called the “silent infection” because most people do not know they have been infected. People with chronic hepatitis B can live for decades without having any symptoms. Even though they have no symptoms, the hepatitis B virus can be silently damaging the liver for years. This is why it is important for all people to know if they have been infected with hepatitis B.

A simple blood test can easily diagnose a hepatitis B infection. The test looks for antigens and antibodies in your blood. If you think you were recently infected, it will be 4 to 6 weeks before the virus can be found in your blood.

There is no special diet for people with chronic hepatitis B. It is best to eat a healthy, well-balanced diet that is low in fat and includes plenty of vegetables. You should avoid eating raw shellfish since they can contain bacteria that are harmful to your liver. Raw oysters may carry the bacteria Vibrio vulnificus which can cause a serious blood infection in individuals with liver disease. Approximately 40% of these cases are fatal.

For an acute hepatitis B infection, there is generally no treatment besides rest and managing any symptoms – the body will fight off the virus on its own. There are treatments that help slow the progression of liver disease by slowing down the virus, although not all people with chronic hepatitis B need treatment. The following are some of the FDA approved drugs: Entecavir (Baraclude®), peginterferon alfa-2a (Pegasys®), Interferon alfa-2b (Intron A®), Lamivudine (Epivir-HBV®) and Adefovir dipivoxil (Hepsera®). These drugs slow down the hepatitis B virus and reduce potential liver damage. In rare cases, they may even get rid of the virus completely.

Hepatitis B is 100 times more contagious than the AIDS virus, yet it can be prevented with a safe and effective vaccine. With 3 separate shots, a person becomes immune to hepatitis B.

(Source:  U. S. National Library of Medicine - National Institute of Health)

Hepatitis C

A virus called Hepatitis C can invade the human body through contaminated blood.  Hepatitis C can lead to serious complications that affect the health of the liver and may even lead to death.

When a person becomes infected with the Hepatitis C virus, he or she may not notice any symptoms at first. Symptoms of Hepatitis C are usually flu-like, including:  fever, chills, stomach pain, nausea and fatigue. Sometimes Hepatitis C symptoms may be severe right away, causing liver dysfunction. If this is the case, bilirubin may not be excreted in the bile, leading to high levels of bilirubin in the blood. With high levels of bilirubin in the blood, the skin and the whites of the eyes become yellow, causing a condition called jaundice. High bilirubin levels in the blood can also cause severe itching. High levels of bilirubin in the blood also cause urine to look dark yellow. Stools are chalk white because they are not colored by the bile. Over 20 years or so, Hepatitis C may lead to the destruction of the liver, a condition called cirrhosis. With cirrhosis, the liver cannot clean the blood or meet the body’s nutritional needs. This could lead to coma or death.

When people with Hepatitis C drink alcohol, their chances of getting cirrhosis become much greater. Patients with Hepatitis C have a higher risk of developing liver cancer. Of every 100 persons infected with Hepatitis C about:
• 55-85 of persons might develop long-term infection
• 70 persons might develop chronic liver disease affecting to some extent the function of the liver.
• 5-20 persons might develop cirrhosis over a period of 20 to 30 years which severely impairs liver function and may necessitate a liver transplant
• 1-5 of persons might die from the consequences of long term infection (liver cancer or cirrhosis)

Currently there are only 2 types of medications used to treat Hepatitis C: Interferons and Ribavirin. Interferons are chemicals that boost the immune system and fight off the Hepatitis C virus. Ribavirin works directly against the Hepatitis C virus. Combination therapy with a weekly injection of interferon and daily oral ribavirin is the treatment of choice resulting in sustained response rates of 40%-80%.

Since treatment for Hepatitis C is not always effective, it is best to PREVENT it rather than to have to TREAT it! Four of the BEST ways to prevent Hepatitis C are:
1. Practice safe sex by using condoms, and knowing your partner.
2. Do not share needles or other objects that may have come in contact with another person’s blood, such as razors or toothbrushes.
3. Use gloves if you expect to be in contact with blood or other body fluids.
4. If you decide to get a tattoo or a body piercing, make sure that the instruments used are sterile.

(Source: U. S. National Library of Medicine - National Institute of Health)