Last Updated on July 29, 2021 by Nancy Carteron, MD, FACR
STI Symptoms – Hepatitis
Hepatitis may start and get better quickly (acute hepatitis) or cause long-term disease (chronic hepatitis).
In some instances, it may lead to liver damage, liver failure, or even liver cancer.
How severe hepatitis is depends on many factors, including the cause of the liver damage and any illnesses you have. Hepatitis A, for example, is usually short-term and does not lead to chronic liver problems
Hepatitis A Symptoms:
Not all people who contract hepatitis A virus will have symptoms, but most adults who contract hepatitis A usually develop some symptoms.
Children under 6 years of age often have no symptoms, and, in general, children will have milder symptoms than adults (some will experience diarrhea).
Symptoms may occur 15 to 50 days from the time you first come in contact with the hepatitis A virus; the average is 28 days.
When you first contract the hepatitis A virus it is called an acute infection. Symptoms may include:
- Low-grade fever
- Malaise (feeling of ill-health)
- Fatigue (feeling tired all the time)
- Loss of appetite
- Abdominal discomfort
- Dark-colored urine
- Jaundice (yellowing of the skin and eyes)
The older you are when you get hepatitis A, the more likely that you will experience more severe symptoms.
Some people feel sick for 1 to 2 weeks, while in others the symptoms may last several months.
Hepatitis A rarely causes death.
However, persons with pre-existing chronic liver disease, including chronic hepatitis B and C, are at increased risk of serious complications from this infection.
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Hepatitis B Symptoms:
Many adults have few or no symptoms.
Because hepatitis B often has no symptoms, most people are not aware that they have the infection. About 1 out of 2 adults who have it never have hepatitis B symptoms.
When hepatitis B symptoms do occur, they usually appear between 6 weeks and 6 months after infection.
Symptoms may mimic the flu and can include:
- Loss of appetite
- Feeling ill
- Nausea and vomiting
- Dark urine
- Jaundice (yellowing of the skin and eyes)
- Rash, hives, or arthritis may occur prior to the onset of other symptoms (during the early acute stage)
- Extreme tiredness
- Tenderness or pain in the lower abdomen
- Pain in the joints
A few patients (1%) have a more severe course of illness and may experience sudden and severe liver failure within a short period of time after infection. These people may suddenly collapse with fatigue, have jaundice, and develop swelling in their abdomen. This can be fatal if not treated immediately.
What happens to you when you contract hepatitis B depends largely on the age at which you first become infected and how well your immune system copes with the virus. As an adult, you have a 95% chance of clearing the infection completely and developing lifelong protection against this virus. The acute infection rarely (in less than 1% of cases) leads to severe illness that requires a liver transplant.
Most babies and children exposed to this virus never have signs and symptoms. Unfortunately, they are more likely to become carriers of hepatitis B for life because their immune system is unable to fight and clear the virus from their body. In these cases, chronic infections are often not detected until much later in life when the person becomes seriously ill with liver disease.
People who are healthy with an inactive disease may still be at risk of virus reactivation, especially when their immune system is weakened by medicines such as chemotherapy or by other viral infections.
Hepatitis C Symptoms:
Most individuals with hepatitis C (70-80%) do not have signs or symptoms.
Liver disease progresses so slowly that a person can have hepatitis C for years without having symptoms.
Many individuals with chronic hepatitis C have mild to moderate liver damage but do not feel sick.
The possible symptoms for an acute infection (newly acquired or short-term) and a chronic (long-term or persistent) infection are different. If a person develops cirrhosis (scarring) of the liver, symptoms and signs may be more prominent.
In addition to fatigue, symptoms may include:
- Muscle weakness
- Poor appetite
- Weight loss
- Dark urine
- Fluid retention
- Abdominal swelling
Over time, the virus may disappear on its own, and you are no longer infected. This happens to approximately 25 out of 100 people with hepatitis C. If the virus does not disappear after months, your infection is chronic. This happens to approximately 75 out of 100 people with hepatitis C.
If your hepatitis C is chronic, in 3 out of 4 cases, you will have only very mild to moderate damage to your liver over time. However, in 1 out of 4 cases, chronic hepatitis C can lead to more serious problems including cirrhosis, liver failure and liver cancer over a period of 25 to 30 years.
Acute Hepatitis Symptoms:
Acute viral hepatitis can cause anything from a minor flu-like illness to fatal liver failure.
Sometimes there are no symptoms.
The severity of symptoms and speed of recovery vary considerably, depending on the particular virus and on the person’s response to the infection.
Hepatitis A and C often cause very mild symptoms or none at all and may be unnoticed. Hepatitis B and E are more likely to produce severe symptoms. Co-infection with hepatitis B and D may make the symptoms even more severe.
In about 2/3 of people, chronic hepatitis develops gradually without causing any obvious symptoms until cirrhosis occurs. In the remaining 1/3, it develops after a bout of acute viral hepatitis that persists or returns (often several weeks later).
Chronic Hepatitis Symptoms:
Symptoms often include a vague feeling of illness, poor appetite, and fatigue.
Sometimes, affected people also have a low-grade fever and some upper abdominal discomfort. Jaundice is rare.
Complications of chronic liver disease and cirrhosis may eventually develop. They can include an enlarged spleen, spiderlike blood vessels in the skin, redness of the palms, and accumulation of fluid in the abdominal cavity. Liver malfunction may lead to deterioration of brain function, particularly in people with cirrhosis due to hepatitis C.
Autoimmune hepatitis may cause other symptoms that can involve virtually any body system, especially in young people with vulvas/vaginas. Such symptoms include acne, cessation of menstrual periods, joint pain, lung scarring, inflammation of the thyroid gland and kidneys, and anemia.
In many people, chronic hepatitis does not progress for years. In others, it gradually worsens. The outlook depends partly on which virus is the cause:
- Chronic hepatitis C leads to cirrhosis, which develops over a period of years, in about 15 to 25% of people. The risk of liver cancer is increased but only if cirrhosis is present.
- Chronic hepatitis B tends to worsen, sometimes rapidly, and increases the risk of liver cancer.
- Chronic co-infection with hepatitis B and D causes cirrhosis in up to 70%.
- Autoimmune hepatitis can be effectively treated in most people, but some develop cirrhosis, with or without liver failure.
- Chronic hepatitis caused by a drug may completely resolve once the drug is stopped.
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