Is a viral infection that causes inflammation and damage to the tissues of the liver.

Other causes besides viral can be seen
   -  Alcohol
   -  Toxic Chemicals
   -  Bacterial
   -  Parasites
   -  Certain Drugs
   -  Wilson’s disease
   -  Alpha 1-antitrypsin deficiency

Viral hepatitis is common and a list of virus are as follows:

Hepatitis A

  -   HAV – a 27-nm RNA hepatovirus. HAV vaccine introduce in 1995
   -  called infectious hepatitis
   -  Transmitted by fecal-oral routes.
   -  Typically seen in over crowded areas and poor sanitation.
   -  Passed in contaminated waters or foods.
   -  Mortality rate is low
   -  Fulminate hepatitis A is uncommon alone.
   -  More prevalent with patients already having Hepatitis C.
   -  Can persist for years and 30% of the population in the US have serologic evidence of previous infection.

Hepatitis B

   -   HBC – a 42 nm hepadnavirus –
   -  8 different genotypes (A-H) may determine infection and ability for response of antiviral medication.
   -  Transmitted through blood or blood products – through sexual contact and is present in saliva, semen, and vaginal secretions.
   -  Mothers with Hep B can pass it to their child during delivery.
   -  Incubation time is 6 weeks to 6 months.
   -  Risk of fulminate Hepatitis B is 1% of which have a mortality rate of 60%

Hepatitis C 

   -  HCV – single stranded RNA virus – 6 major genotypes
   -  50% of individuals infected from IV drug use.
   -  Other risk factors are intranasal cocaine use, body piercings, tattoos, multiple sexual partners, and hemodialysis.
   -  Transmission via breast-feeding has not been documented.
   -  Incubation is 6 weeks on average.
   -  Second most common cause agent of cirrhosis – (after alcohol induced liver disease)

Hepatitis D

   -  HDV – defective RNA virus – only seen with hepatitis B.
   -  Occurance is seen simultaneously with B.
   -  If infections occurs at the same time as B outcome is usually similar to B.
   -  If infections occurs in individual with chronic B than short term outcome may be worse.
   -  Including fulminant or progression to cirrhosis.
   -  Seen in IV drug users.
   -  Overall uncommon infection.
   -  Individuals having HDV has a 3x risk of hepatocullular carcinoma.

Hepatitis E

   -  HEV – a 29-32 nm RNA virus.
   -  Rare in US – typically seen in an endemic area.
   -  Waterborne transmission.
   -  Mortality rate of 10% – 20% in pregnant women

Hepatits G

   -  HGV – flavivirus and is percutaneously transmitted.
   -  Does not typically cause liver disease.
   -  Typically does not affect those individuals with chronic B or C

Symptoms:

   -  Prodromal phase
   -  Icteric phase
   -  Covbalescent phase, and complications
   -  Hepatomegaly is seen in over 40% of cases.
   -  Liver tenderness can be seen as can lymph tenderness.
   -  Enlarged Spleen can be seen in 10–15 %.
   -  Neural imparement can be seen in chronic C
   -  Jaundice
   -  Fever
   -  Abdominal pain
   -  Nausea
   -  Weakness
   -  Cirrhosis