Hepatitis: The silent epidemic

Published 10:56 am Tuesday, September 6, 2022

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Through this column, I share health-related information on issues to raise awareness in Polk County. At St. Luke’s Hospital, we’re always looking for ways to keep you healthier. Hepatitis is the focus of today’s article.


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  • 67% of persons with hepatitis B infection do not know they have the virus.
  • 51% of persons with hepatitis C infection do not know they have the virus.
  • In the four states most affected by the opioid epidemic (Kentucky, Tennessee, Virginia, and West Virginia), acute hepatitis C infections increased 364% from 2006 to 2012.
  • Hepatitis A incidence increased by 1,325% from 2015 through 2019. 
  • North Carolina is one of the thirty-seven states with reported hepatitis A outbreaks. 


Hepatitis is liver inflammation caused by viruses, drugs, alcohol, toxins, genetic disorders, or an overactive immune system. Hepatitis can flare up suddenly (acute) and then goes away, or a long-term condition (chronic) produces subtle symptoms and progressive liver damage. The world health organization (WHO) estimates more than 350 million people have chronic hepatitis globally, and more than 1.5 million die each year. In addition, cases of hepatitis are on the rise worldwide at alarming rates.


There are five viral classifications (A, B, C, D, and E), each caused by a different virus.


Hepatitis A is an acute disease resulting from an infection with the hepatitis A virus (HAV) and has the highest rate of infection globally. Transmission occurs when people eat food or drink water contaminated with hepatitis A. Sexual contact is another leading method of spreading this disease.


Hepatitis B is a chronic condition caused by the hepatitis B virus (HBV). The Centers for Disease Control CDC estimates that more than 826,000 people in the US live with this disease. Twenty-five percent of adults chronically infected as a child later die from liver cancer or cirrhosis. In the US, HBV is transmitted by young, sexually active adults or through dirty needles shared by drug users. 


Hepatitis C is a chronic condition from the hepatitis C virus (HCV), one of the most common bloodborne viral infections in America. According to the CDC, more than 2.4 million people in the US have hepatitis C.


Hepatitis D only occurs in patients with hepatitis B and is very rare. Like other variants of hepatitis, hepatitis D virus (HDV) causes liver inflammation, but a person cannot contract HDV without an existing hepatitis B infection. Five percent of the people who have hepatitis B will develop hepatitis D.


Hepatitis E is an acute disease most often found in areas with poor sanitation. Hepatitis E virus (HEV) comes from ingesting water contaminated with fecal matter. It is infrequent in the United States.


While the symptoms vary by the type of hepatitis, general symptoms include:


  • nausea
  • malaise
  • fatigue
  • jaundice
  • dark urine
  • light-colored stools
  • ascites (fluid in the abdomen)
  • tenderness in the upper right abdomen




  • Blood tests checking for elevated liver enzymes and the presence of any of the five hepatitis viruses 
  • Ultrasound to detect any changes in the liver
  • Liver biopsy when other tests are inconclusive and to determine the exact degree of liver damage




There is no cure for hepatitis A and B. The first line of treatment for hepatitis is vaccinations against hepatitis A and hepatitis B. Unfortunately, there are no vaccines against hepatitis types C, D, and E. Treatment for infected people concentrates on preventing additional damage to the liver and, if possible, reversing existing damage. Most acute hepatitis cases will resolve over time. For autoimmune hepatitis, some medications can help keep an overactive immune system in check.


If you have any of these symptoms, contact your primary care provider. If you do not have a provider, contact one of our providers at Foothills Medical Associates at (828) 894-7627 or Saluda Family Medicine at (828) 749-0149.


If you have a healthcare topic of interest or a question, send me a note at Michelle.Fortune@slhnc.org.