Symptoms of Hepatitis and its Screening

Hepatitis is commonly caused by a viral infection and may be temporary (acute) or long term (chronic) depending on the duration it lasts.

Updated: August 18, 2020

Hepatitis is commonly caused by a viral infection and may be temporary (acute) or long term (chronic) depending on the duration it lasts.

Symptoms of Hepatitis:

The acute form of hepatitis is caused by a viral infection and the signs and symptoms appear quickly. They include:

fatigue
dark urine
pale stool
flu symptoms
loss of appetite
abdominal pain
unexplained weight loss
signs of jaundice such as yellow skin and eyes

The infectious forms of hepatitis that are chronic, like hepatitis B and C, will not have symptoms in the beginning. Symptoms may not occur until the damage affects liver function. Chronic hepatitis develops slowly, so these signs and symptoms are detected only by liver laboratory studies for screening purposes.

As the inflammation progresses, symptoms developed are similar to acute hepatitis, including fatigue, nausea, vomiting, poor appetite, and joint pain. Jaundice can also occur which is a sign of advanced disease. Chronic hepatitis interferes with hormonal functions of the liver which can result in acne, abnormal hair growth, and lack of menstrual period in women. Over time, extensive damage and scarring of the liver can develop cirrhosis which can lead to other life-threatening complications such as hepatic encephalopathy and liver cancer.

Screening for Hepatitis:

Identifying infection and type of virus for hepatitis as early as possible is the main purpose of screening so that early treatment can be done to can prevent disease progression, and decreases transmission to others.

Hepatitis A:

Screening is done to assess immunity in a person who is at high risk of contracting the virus as hepatitis A causes an acute illness that does not progress to chronic liver disease. The screen is also done for the person with known liver disease for whom hepatitis A infection could lead to liver failure.

Persons who are at high risk and in need of screening include:

close contact with someone who has hepatitis A, either living with or having sexual contact
having poor sanitary habits such as not washing hands after using the restroom or changing diapers
not using clean water
having liver disease
traveling to an area with endemic hepatitis A
adoptive family members of a child from an area with endemic hepatitis A
Illicit drug users

These people who are not already immune can receive the hepatitis A vaccine.

The presence of anti-hepatitis A IgG in the blood indicates past infection with the virus or prior vaccination.

Hepatitis B:

Hepatitis B screening is recommended for certain high-risk populations which include the person who is:

HIV positive
intravenous drug users
in close contact with people known to have hepatitis B, i.e. live or have sex with
found to have elevated liver enzymes without a known cause
Pregnant
Blood, organ, or tissue donors
beginning immunosuppressive or cytotoxic therapy
on hemodialysis
Incarcerated
born in countries where the prevalence of hepatitis B is high, despite vaccination

Screening is done by a blood test that detects the hepatitis B surface antigen (HBsAg). To differentiate between acute and chronic infections another test is done on the same blood sample that detects the antibody for the hepatitis B core antigen (anti-HBcAg). These persons can take the hepatitis B vaccine to prevent future infection.

Hepatitis C:

Hepatitis C screening is recommended for certain high-risk populations which include the person who is:

HIV positive
Intravenous drug users
In close contact with people known to have hepatitis B, i.e. live or have sex with
Found to have elevated liver enzymes without a known cause
Pregnant
Blood, organ, or tissue donors
Adults in the United States born between 1945 to 1965
Recipients of blood products or organs prior to 1992 in the United States
On hemodialysis
Born to HCV-positive mothers
Sex workers
Incarcerated
men who have sex with men

Screening is done by a blood test that detects the anti-hepatitis C virus antibody. If anti-hepatitis C virus antibody is present, a confirmatory test can be done to detect HCV RNA which indicates chronic disease. Screening should be done in periodic intervals, maybe once a year to prevent the disease.