Chronic Viral Hepatitis (Hepatitis B and C)

Chronic viral hepatitis is a long-term liver infection caused by either hepatitis B or hepatitis C viruses. When these viruses persist in your body for more than 6 months, the infection becomes chronic. Unlike acute hepatitis that resolves on its own, chronic hepatitis continues to damage your liver over years or decades.

Hepatitis B and C viruses attack liver cells, causing ongoing inflammation and injury. This persistent damage can lead to scarring called fibrosis. Over time, severe scarring can progress to cirrhosis, where healthy liver tissue is replaced by scar tissue. Some people with chronic hepatitis may also develop liver cancer.

Your liver performs over 500 vital functions, including filtering toxins, producing proteins, and storing energy. Chronic viral hepatitis disrupts these processes gradually. Many people live with chronic hepatitis for years without knowing it because symptoms develop slowly. Early detection through blood testing allows you to monitor liver health and start treatment before serious damage occurs.

Many people with chronic viral hepatitis have no symptoms for years or even decades. This makes regular blood testing essential for detection. When symptoms do appear, they may include:

• Persistent fatigue that does not improve with rest
• Loss of appetite and unintended weight loss
• Nausea or vomiting
• Abdominal pain or discomfort in the upper right side
• Dark colored urine
• Pale or clay colored stools
• Jaundice, which is yellowing of the skin and eyes
• Joint pain
• Itchy skin
• Easy bruising or bleeding

Some people remain asymptomatic until the disease has progressed to advanced liver damage. This silent progression makes proactive testing crucial, especially if you have risk factors for hepatitis B or C.

Hepatitis B spreads through contact with infected blood, semen, or other body fluids. This can happen through sharing needles, unprotected sex, childbirth from mother to baby, or sharing personal items like razors or toothbrushes. Healthcare workers face exposure risk through needlestick injuries. Hepatitis C spreads primarily through blood-to-blood contact, most commonly from sharing needles or drug equipment. Less commonly, it can spread through unscreened blood transfusions before 1992, improperly sterilized medical equipment, or from mother to baby during birth.

Risk factors for chronic viral hepatitis include injection drug use, having multiple sexual partners, receiving blood products before screening programs began, being born to a mother with hepatitis, getting tattoos or piercings with unsterilized equipment, and working in healthcare settings. People born between 1945 and 1965 have higher hepatitis C rates and should get tested at least once. Living with HIV also increases hepatitis risk. Unlike hepatitis A, hepatitis B and C do not spread through food, water, or casual contact like hugging or sharing meals.

Chronic viral hepatitis is diagnosed through blood tests that detect viral antibodies, viral genetic material, and liver enzyme levels. Initial screening tests look for hepatitis B surface antigen and hepatitis C antibodies. If these are positive, additional tests measure viral load and identify the specific virus strain. Blood tests also check liver function through enzymes like alanine aminotransferase or ALT.

ALT levels typically rise when liver cells are damaged or inflamed. In chronic hepatitis, ALT often stays elevated at 2 to 10 times the normal range. These levels may fluctuate over time, which is characteristic of chronic infection. Regular ALT monitoring helps doctors assess disease activity, guide treatment decisions, and track how well antiviral medications are working. Rite Aid offers comprehensive blood testing that includes ALT measurement at over 2,000 Quest Diagnostics locations nationwide. Your doctor may also order imaging tests like ultrasound or FibroScan to evaluate liver scarring, or in some cases, a liver biopsy.

Treatment for chronic viral hepatitis focuses on stopping viral replication, preventing liver damage, and supporting overall liver health. Approaches include:

• Antiviral medications that specifically target hepatitis B or C viruses and can suppress or cure the infection
• Regular monitoring of liver enzyme levels and viral load through blood tests every 3 to 6 months
• Avoiding alcohol completely, as it accelerates liver damage
• Maintaining a healthy weight through balanced nutrition and regular physical activity
• Avoiding medications and supplements that stress the liver without doctor approval
• Getting vaccinated against hepatitis A to prevent additional liver infection
• Eating a nutrient-dense diet rich in vegetables, fruits, lean proteins, and whole grains
• Staying hydrated with plenty of water throughout the day
• Getting adequate sleep to support immune function
• Managing stress through mindfulness, yoga, or other relaxation techniques

Modern antiviral treatments can cure hepatitis C in over 95% of cases with 8 to 12 weeks of medication. Hepatitis B typically requires long-term suppressive therapy. Work closely with a hepatologist or gastroenterologist who specializes in liver disease. Regular blood testing helps track treatment response and catch any progression toward cirrhosis or liver cancer early.