Chronic Hepatitis 

Chronic hepatitis causes the liver to become inflamed for at least six months.   Hepatitis is an inflammatory condition affecting the liver. When liver inflammation persists for at least six months, it’s referred to as chronic hepatitis. 

Causes of Chronic Hepatitis 

Chronic hepatitis is most commonly caused by: 

• The hepatitis C virus (HCV) 
• The hepatitis B virus (HBV) 
• Alcohol-related liver disease 
• Nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) 

Some of the less common causes of chronic hepatitis include: 

• The hepatitis D virus (HDV) 
• The hepatitis E virus (HEV) 
• Autoimmune hepatitis 
• Celiac disease 
• Primary biliary cholangitis 
• Alpha-1 antitrypsin deficiency 
• Hemochromatosis 
• Certain thyroid disorders 
• Certain drugs, such as amiodarone, isoniazid, methotrexate, methyldopa, nitrofurantoin, tamoxifen and in rare cases acetaminophen
• Wilson disease (in children and young adults) 

Notably, the hepatitis A virus (HAV) does not cause chronic hepatitis. 

Symptoms of Chronic Hepatitis 

Unlike with acute hepatitis, chronic hepatitis typically develops slowly and often doesn’t cause any noticeable symptoms until the liver becomes permanently scarred (cirrhosis). When early-stage symptoms do occur, they’re usually subtle and easily attributed to an unrelated condition.  

These symptoms may include: 

• Fatigue 
• Low-grade fever 
• Loss of appetite 
• Mild discomfort in the upper abdomen
• An overall feeling of being ill (malaise) 

Once chronic hepatitis has progressed and permanently scarred the liver, it can produce symptoms such as: 

• Spleen enlargement 
• A buildup of fluid in the abdomen (ascites) 
• Light-colored stools 
• Yellowing of the skin and the whites of the eyes (jaundice) 
• Small, spiderlike blood vessels that can be seen through the skin (spider angiomas) 
• Redness in the palms 
• A tendency to bleed easily (coagulopathy) 
• Itchiness 
• Impaired brain function (hepatic encephalopathy) 

Diagnosing Chronic Hepatitis 

If you think that you might have chronic hepatitis, it’s important to promptly consult with a physician, since ongoing liver inflammation can lead to serious complications such as liver cancer and liver failure. In addition to performing a physical examination, a doctor will likely order one or more of the following tests: 

• Blood tests 
• A liver biopsy 
• Imaging tests, such as elastography 

The results from these tests will confirm the diagnosis, identify the cause of the inflammation and determine the extent of liver damage. 

Treatment for Chronic Hepatitis 

Chronic hepatitis treatment will vary depending on what is causing the inflammation. For example, if a patient has a hepatitis B or C infection, a physician may prescribe antiviral drugs. Or, if a drug is causing a patient’s liver to become inflamed, then a doctor will likely take him or her off of that medication. 

Treatment also involves managing any complications arising from chronic hepatitis. And if this condition has caused someone to experience severe liver failure, liver transplantation may be necessary. The gastroenterologists and hepatologists at Tampa General Hospital will be able to recommend a course of treatment that’s right for your needs.