Updated: Apr 2
By Alma Barranco-Mendoza Ph.D.
Hepatitis is an inflammatory condition of the liver. It is most commonly caused by a viral infection, but there are other possible causes of hepatitis, such as an autoimmune condition and as a secondary result of medications, drugs, toxins, and alcohol.
According to Asrani et al. (2019) "Liver disease accounts for approximately 2 million deaths per year worldwide, 1 million due to complications of cirrhosis and 1 million due to viral hepatitis and hepatocellular carcinoma. Cirrhosis is currently the 11th most common cause of death globally [...] Cirrhosis is within the top 20 causes of disability-adjusted life years and years of life lost, accounting for 1.6% and 2.1% of the worldwide burden. About 2 billion people consume alcohol worldwide and upwards of 75 million are diagnosed with alcohol-use disorders and are at risk of alcohol-associated liver disease. [...] The global prevalence of viral hepatitis remains high, while drug-induced liver injury continues to increase as a major cause of acute hepatitis. Liver transplantation is the second most common solid organ transplantation, yet less than 10% of global transplantation needs are met at current rates. Though these numbers are sobering, they highlight an important opportunity to improve public health given that most causes of liver diseases are preventable."
Worldwide, 500 million people are estimated to be infected with hepatitis B or C. These viruses kill 1.5 million people a year; 1 in every 3 people has been exposed to either or both viruses and most infected people do not know about it due to dormant symptoms.
There are 5 types of viral hepatitis, identified as A, B, C, D, and E, each caused by a different virus. Hepatitis A is a short-term disease, with acute symptoms. It is most commonly transmitted by consuming food or water contaminated by feces from an infected person. Since it is short-term, it usually doesn't get treatment beyond bed rest and diet and hydration in case of vomiting and diarrhea.
Hepatitis B, Hepatitis C, and Hepatitis D are most likely to become ongoing and chronic. Chronic hepatitis B&C can be treated with antiviral medication. Hepatitis D can be prevented by getting the vaccination for hepatitis B, as infection with hepatitis B is necessary for hepatitis D to develop.
Hepatitis E is usually acute but can be particularly dangerous in pregnant women.
Autoimmune hepatitis can occur in children and adults of all ages. It is a generally progressive, chronic hepatitis of unknown cause, which may have a fluctuating course, with periods of increased or decreased activity. The way it is diagnosed is based on abnormal levels of serum globulins, including autoantibodies, histologic abnormalities, and characteristic clinical and biochemical findings.
There are other toxic causes of hepatitis. The most common is excessive alcohol consumption, which can cause liver damage and inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol directly injures the cells of your liver. Over time, it can cause permanent damage and lead to liver failure and cirrhosis, a thickening and scarring of the liver.
Overuse or overdose of medications and exposure to poisons can also lead to toxic hepatitis.
Depending on the type of hepatitis, it is treatable by antiviral and other medications and by preventative methods such as vaccines (Hepatitis A&B), hygiene, not sharing needles, toothbrushes, etc., practicing safe sex by using condoms and dental dams, and by the regular ingestion of fatty acid supplements rich on omega-3.
There are scientific research studies that show an inflammation dampening effect with increased omega-3 fatty acid supplementation in several inflammatory diseases, including hepatitis.
Asrani, Sumeet K., et al. "Burden of liver diseases in the world." Journal of hepatology 70.1 (2019): 151-171. https://www.sciencedirect.com/science/article/abs/pii/S0168827818323882
Cuthbert, Jennifer A. "Hepatitis A: old and new." Clinical microbiology reviews 14.1 (2001): 38-58. https://cmr.asm.org/content/14/1/38.short
Hoofnagle, Jay H., Kenrad E. Nelson, and Robert H. Purcell. "Hepatitis E." New England Journal of Medicine 367.13 (2012): 1237-1244. https://www.nejm.org/doi/full/10.1056/NEJMra1204512
Krawitt, Edward L. "Autoimmune hepatitis." New England Journal of Medicine 354.1 (2006): 54-66. https://www.nejm.org/doi/full/10.1056/nejmra050408
Lai, Ching Lung, et al. "Viral hepatitis B." The Lancet 362.9401 (2003): 2089-2094. https://www.sciencedirect.com/science/article/abs/pii/S0140673603151082
Lucey, Michael R., Philippe Mathurin, and Timothy R. Morgan. "Alcoholic hepatitis." New England Journal of Medicine 360.26 (2009): 2758-2769. https://www.nejm.org/doi/full/10.1056/nejmra0805786
Poynard, Thierry, et al. "Viral hepatitis C." The Lancet 362.9401 (2003): 2095-2100. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)15109-4/fulltext
Rizzetto, Mario. "Hepatitis D: thirty years after." Journal of hepatology 50.5 (2009): 1043-1050. https://www.sciencedirect.com/science/article/pii/S0168827809000592
Schmöcker, Christoph, et al. "Omega‐3 fatty acids alleviate chemically induced acute hepatitis by suppression of cytokines." Hepatology 45.4 (2007): 864-869. doi:10.1002/hep.21626 https://pubmed.ncbi.nlm.nih.gov/17393517/
World Health Organization. Regional Office for Europe. Data and Statistics. (2020) https://www.euro.who.int/en/health-topics/communicable-diseases/hepatitis/data-and-statistics