What are the causes of hepatitis?

Hepatitis is a widespread infection across the globe, yet it’s often surrounded by misinformation and myths.

Many people mistakenly believe that hepatitis can be transmitted through everyday interactions such as sharing utensils, hugging, or kissing – or that it’s an inherited condition.

We spoke with Dr Yiannis Kallis, consultant hepatologist and gastroenterologist at Nuffield Health St Bartholomew’s Hospital, to clear up these misconceptions and to shed light on the various types of hepatitis, including their causes, treatments, and how they differ from one another.

What is hepatitis?

“Viral hepatitis is an infection of the liver with a virus,” explains Kallis. “There are five different types of viral hepatitis: hepatitis A through to E. Some cause an acute but transient infection; others may cause a chronic, persistent infection over many years and may lead to cirrhosis, liver failure, or liver cancer.”

What causes them?

“Hepatitis A and hepatitis E are spread via the oral route,” explains Kallis. “This means that they can be caught by drinking contaminated water or by eating infected food, much like a type of food poisoning or gastroenteritis.

“These viruses are more prevalent in the developing world, but they can also, rarely, be acquired in the UK.”

However, hepatitis B, C and D (called ‘delta’) are acquired through contact with contaminated blood.

“For example, through blood transfusion, sharing needles, the use of poorly sterilised medical/dental equipment, or at childbirth,” says Kallis. “These are termed the blood-borne viruses. Hepatitis B and delta may also be spread through sexual contact.”

What are some of the biggest misconceptions about hepatitis?

“The blood-borne viruses (hepatitis B, C and delta) are very unlikely to be caught by holding hands, kissing, sharing cutlery etc,” clarifies Kallis. “This is a misconception. It is also uncommon for hepatitis C to be caught through sex.”

What are some signs of hepatitis?

“Most people who catch a chronic viral hepatitis have no symptoms when they first acquire the virus and are unaware that they have it,” says Kallis. “This is especially the case if it is transmitted at childbirth or in childhood, which is the commonest time to catch chronic hepatitis B or C.”

Some forms of viral hepatitis, if acquired as an adult, will cause jaundice and other general symptoms of feeling unwell, he adds.

“Jaundice is a yellow discolouration of the eyes and skin and is usually accompanied by very dark-coloured urine,” says Kallis. “If anyone becomes jaundiced, they should seek medical attention.”

The other sign of having a chronic viral hepatitis ( B or C) may be a persistent abnormality of some of the liver blood tests.

“This is sometimes found by chance or during a general health check-up,” says Kallis. “If someone has persistently abnormal liver blood tests, they should see their GP or a liver specialist to ensure that this is properly investigated.”

Can hepatitis lead to serious complications if left untreated?

“Hepatitis A and hepatitis E generally only cause a transient illness from which the liver function fully recovers, and the virus is cleared,” says Kallis.

But, there are a few rare exceptions to this.

“Chronic hepatitis B, C or delta can lead to the development of cirrhosis, liver cancer or liver failure over many years,” notes Kallis. “Hepatitis delta can only occur in people who also have hepatitis B infection. Chronic viral hepatitis is a leading cause of death due to liver disease globally and in some countries is a leading cause of cancer.”

Can hepatitis be prevented?

“Careful food hygiene and only drinking clean water are ways to reduce the risk of hepatitis A or E infection, particularly whilst travelling within the developing world,” says Kallis.

There are also vaccines available for certain types of hepatitis.

“There are effective vaccines against hepatitis A and B infection, but there is no specific vaccines for hepatitis C, D or E,” says Kallis. “But the transmission of blood-borne viruses can be prevented by not sharing needles among people who inject recreational drugs and sexual transmission risk can be minimised by the use of barrier methods such as condoms.”

Can hepatitis is treated?

“Hepatitis A and E are normally transient, self-limiting viruses that the body can clear with a full recovery,” says Kallis. “There is highly effective and very well-tolerated treatment to cure chronic hepatitis C infection, which involves taking a course of tablet medications for a few weeks. Cure rates are greater than 90%.”

Unfortunately, there are currently no treatments that can cure hepatitis B.

“However, there are very safe and effective medications that can treat hepatitis B, control the infection, and reduce the risk of developing cirrhosis, liver failure or liver cancer,” says Kallis. “These medications are only available through specialist liver clinics and need to be taken long-term.”