Gastroenterology & Nutrition

Viral Hepatitis

Infection and inflammation of the liver caused by hepatitis A, B, C, D or E, ranging from self-limiting acute illness to chronic infection with cirrhosis, liver failure and hepatocellular carcinoma.

Definition

Viral hepatitis is inflammation of the liver caused by hepatitis A, B, C, D or E. It ranges from a self-limiting acute illness to chronic infection with progressive fibrosis, cirrhosis, liver failure and hepatocellular carcinoma.

First principles

Transmission predicts chronicity and prevention

Hepatitis A and E are mainly enterically transmitted and usually cause acute infection. Hepatitis B, C and D are blood-borne viruses that can also spread sexually or vertically; B and C may persist, while D requires hepatitis B to replicate. The route therefore predicts the key prevention strategy: hygiene and vaccination for A, vaccination and exposure prevention for B, harm reduction and testing for C, and prevention of hepatitis B for D.

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