Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Chronic hepatitis occurs when there is persistent injury and inflammation to the liver cells that lasts for longer than 6 months. This condition can be divided into two classifications: chronic persistent and chronic active hepatitis. There are several causes: viruses, metabolic conditions, immunologic abnormalities, and medications. The most common causes are hepatitis B and C. Jointly these two viruses are the cause of more than 75% of the cases of chronic hepatitis. If you have chronic hepatitis B or C, you can be infectious to others. About 20% of the time autoimmune chronic hepatitis is the cause. In this condition, the body’s immune system reacts to itself, causing damage to the liver. There are also some inherited disorders that can cause chronic hepatitis. These include Wilson’s disease and alpha- 1-antitrypsin deficiency. Long-term use of some medications can also cause a small number of cases of chronic hepatitis. These drugs include phenytoin, nitrofurantoin, and isoniazid. Chronic hepatitis occurs in about 2 in 1,000 individuals. The condition is detected by a liver biopsy. Evaluation of infectious hepatitis blood markers are of use if the cause is infectious. The prognosis is generally good with chronic persistent hepatitis. About 40% to 50% of patients with chronic active hepatitis die within 5 years of the onset of symptoms. The cause of death is usually from liver failure and complications of portal hypertension (increased pressure in the liver veins).

Living With Your Diagnosis
The most common symptom of chronic hepatitis is fatigue. Other symptoms include mild upper abdominal discomfort, decreased appetite, and achy joints. Some patients may have signs of liver failure and cirrhosis. Signs of liver failure are jaundice (a yellow color to the skin or whites of the eyes), ascites (abdominal swelling caused by fluid), and coma. Depending on the cause, other organ systems can be affected. Those organs include the thyroid, intestines, eyes, joints, spleen, kidneys, and skin. Because of the chronic scarring of the liver, hepatocellular cancer can develop in some patients with chronic hepatitis.

The treatment of chronic hepatitis depends on the cause. Prednisone or other corticosteroids help to reduce the inflammation. Azathioprine or mercaptopurine are drugs used to treat chronic hepatitis caused by immune disorders. Interferon is a drug used to treat chronic hepatitis caused by hepatitis B and C. However interferon is not effective in all cases. Relapses can occur in about half of those treated. In severe cases of liver failure, a liver transplantation is an option.

The DOs
• Modify physical activity according to the symptoms. A good fitness program may help with the fatigue.
• A well-balanced diet is necessary.
• Make sure you properly wash your hands if you have chronic hepatitis or are caring for someone with the disease. This is particularly important after contact with blood or other body fluid. It will help with prevention and transmission of the disease.
• An individual with chronic hepatitis B or C should use separate or disposable eating and drinking utensils.
• Use latex condoms. It may prevent transmission of the hepatitis B and C.
• If exposed to blood and body fluids on the job, use proper protective equipment such as gloves and eye protection to lessen the chance of accidental exposure.
• If you are in a high-risk group, you should receive hepatitis B vaccine. High-risk groups are health workers, homosexual men, and household contacts of carriers.
• All newborns and children should be immunized with Hepatitis B vaccine.

The DON’Ts
• Avoid alcohol
• Avoid medications that can be harmful to the liver such as acetaminophen, sedatives, and tranquilizers.
• Avoid salt in the diet.
• Avoid sexual contact with an individual infected with hepatitis B.
• Avoid contact with blood or blood products.
• If you have had chronic hepatitis B or C, you should not donate blood.
• Women who have chronic hepatitis B or C should not breast-feed their babies.
• If you are an intravenous drug addict, do not share needles and other equipment because of possible contamination.

When to Call Your Doctor
• If symptoms of chronic active hepatitis develop.
• If symptoms worsen or do not improve with treatment.
• If new symptoms develop, particularly worsening jaundice or abdominal pain.