Diagnosis
Your healthcare professional may give you a physical exam and look for symptoms of liver damage such as yellowing skin and stomach pain. Different blood tests can detect all five types of hepatitis viruses. A sample of blood is taken, usually from a vein in your arm. The sample is sent to a laboratory for testing.
Hepatitis A
Blood test results can tell your healthcare professional if the infection is current or if you had a hepatitis A infection in the past.
Hepatitis B
Blood test results can tell your healthcare professional if the infection is acute or chronic.
Tests that check for liver damage or complications caused by hepatitis B include:
- Transient elastography. This imaging test is a type of ultrasound that sends vibrations into the liver. The test measures how fast the vibrations go through liver tissue. It shows places where the liver is stiff.
- Magnetic resonance elastography (MRE). This test combines magnetic resonance imaging (MRI) with low-frequency vibrations to create a visual map that shows areas of liver stiffness.
- Liver biopsy. A small sample of liver tissue is removed using a thin needle and sent to a lab to check for damage. This is called a liver biopsy.
Hepatitis C
Blood test results can tell your healthcare professional if the infection is current or if you had a hepatitis C infection in the past. Blood tests also can:
- Measure the quantity of the hepatitis C virus in your blood, called the viral load.
- Identify the genotype and subtype of the virus to help guide treatment.
- Evaluate the health of your liver.
Tests that check for liver damage or complications caused by hepatitis C are similar to those used for hepatitis B. These may include transient elastography, magnetic resonance elastography (MRE) or liver biopsy.
Hepatitis D
Blood test results can tell your healthcare professional if the infection is current or you had a hepatitis D infection in the past.
Hepatitis E
Blood test results can tell your healthcare professional if the infection is current, near the end of recovery or if an infection occurred in the past. Stool tests also can detect the hepatitis E virus.
More Information
Treatment
Hepatitis A
No specific treatment exists for hepatitis A. The body clears the hepatitis A virus on its own. In most cases, the liver heals within six months with no lasting damage.
Getting the hepatitis A vaccine or an injection of an antibody called immunoglobulin within two weeks of exposure to the hepatitis A virus may protect you from infection.
Hepatitis B
Acute hepatitis B infection treatment typically isn't needed. The infection often goes away on its own.
Chronic hepatitis B infection treatment typically focuses on lowering the risk of liver damage such as cirrhosis and liver cancer, and improving long-term survival. Chronic hepatitis B can't be cured.
Most people with chronic hepatitis B virus infection need treatment for the rest of their lives. The decision to start treatment depends on many factors, including how much damage your liver has from fibrosis or cirrhosis and if you have other infections such as HIV.
Treatment for chronic hepatitis B may include:
- Antiviral medicines. Many antiviral medicines can help fight the virus and slow its ability to damage your liver. Entecavir (Baraclude) and tenofovir (Viread) are the two most common medicines prescribed. Your healthcare professional may prescribe lamivudine (Epivir) or adefovir (Hepsera). You take antiviral medicines by mouth, most often for the long term. Antiviral medicines are safe for people who are pregnant.
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Interferon shots. Interferon is a lab-made version of a substance that the body makes to fight infection. This type of medicine includes peginterferon alfa-2a (Pegasys). One upside of interferon shots is that they're taken for a much shorter time than are antiviral medicines. But interferon has a high rate of side effects, such as upset stomach, vomiting, trouble breathing and depression.
Interferon mainly is used for young people with hepatitis B who wish to not need long-term treatment. It's also used for people who might want to get pregnant within a few years. Do not take interferon during pregnancy. Interferon also may be unsafe for people with cirrhosis or acute liver failure.
- Liver transplant. If your liver has been badly damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. The new liver may come from a donor who has died or from a living person who donates part of the liver.
Getting the hepatitis B vaccine, an injection of an antibody called immunoglobulin, or both after exposure to the hepatitis B virus may protect you from infection.
Hepatitis C
Blood tests can't tell the difference between an acute or chronic hepatitis C infection. Acute infections can go away on their own but most often hepatitis C infections are chronic.
Hepatitis C infection treatment focuses on clearing the virus from the body and lowering the risk of chronic liver disease. Treatment is typically given whether the infection is acute or chronic. Hepatitis C can be cured.
Treatment for hepatitis C may include:
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Antiviral medicines. Antiviral medicines focus on clearing the virus from the body for at least 12 weeks after treatment ends. Some newer antiviral medicines, called direct-acting, have better outcomes, fewer side effects and shorter treatment times. Treatment can be as short as eight weeks.
The choice of medicines and length of treatment depend on the hepatitis C genotype, whether the liver is damaged, other medical conditions and earlier treatments. Throughout treatment, the care team watches the treatment for response to the medicines and side effects. Treatment with direct-acting antiviral medicines usually lasts 12 weeks.
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Liver transplant. A liver transplant might be an option for serious liver damage from chronic hepatitis C infection. During a liver transplant, a surgeon removes the damaged liver and replaces it with a healthy liver. Most transplanted livers come from dead donors. A small number come from living donors who donate a part of their livers.
In most cases, a liver transplant alone doesn't cure hepatitis C. The infection is likely to return. This means more treatment with antiviral medicines to prevent damage to the new liver. Studies have shown that newer antiviral medicines cure hepatitis C after a transplant.
Hepatitis D
Acute hepatitis D infection treatment typically isn't needed. The infection is short lived and most often it goes away on its own.
Chronic hepatitis D infection treatment typically focuses on lowering the risk of liver damage such as cirrhosis and liver cancer, and improving long-term survival. People who have a superinfection with a chronic hepatitis B infection are sicker than people who have a coinfection with hepatitis B. Chronic hepatitis D can't be cured.
Treatment for hepatitis D may include:
- Interferon shots. Interferon is a lab-made version of a substance that the body makes to fight infection. This type of medicine includes peginterferon alfa-2a (Pegasys). Interferon has a high rate of side effects and relapses. Interferon shots are typically given for one year or longer. Do not take interferon during pregnancy. Interferon also may be unsafe for people with cirrhosis or acute liver failure.
- Liver transplant. If your liver has been badly damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. The new liver may come from a donor who has died or from a living person who donates part of the liver.
- New medicines. Researchers are working on new medicines to help treat chronic hepatitis D infections.
Hepatitis E
Acute hepatitis E infection treatment typically isn't needed. The infection often goes away on its own.
Chronic hepatitis E infection typically affects people who have weakened immune systems caused by solid organ transplants, some types of chemotherapy or illnesses such as HIV. Treatment focuses on reducing risks such as liver fibrosis and cirrhosis. Chronic hepatitis E may be able to be cured.
Treatment for hepatitis E may include:
- Reducing immunosuppressant medicines. A person who receives a solid organ transplant needs to take medicines to prevent organ rejection. Reducing the medicine helps the immune system fight the hepatitis E infection. Your healthcare team monitors your transplanted organ for signs of rejection.
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Antiviral medicine. Ribavirin (Virazone and Ribasphere) is an antiviral medicine used to help fight the virus and slow its ability to damage your liver. You take ribavirin by mouth, most often every day for three months. The most common side effect of ribavirin is anemia that may need blood transfusions or injections of erythropoietin, a lab-made version of a substance that helps the body make red blood cells. Do not take ribavirin during pregnancy.
Your healthcare professional may recommend a second treatment of ribavirin. Or you may take ribavirin with interferon to improve treatment response.
- Interferon shots. Interferon is a lab-made version of a substance that the body makes to fight infection. This type of medicine includes peginterferon alfa-2a (Pegasys). Interferon has a high rate of side effects and relapses. Interferon raises the risk of sudden organ rejection in people who have an organ transplant.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and home remedies
Help manage hepatitis symptoms with self-care measures:
- Rest. Many people with hepatitis feel tired and sick and have less energy.
- Eat well. Eat a balanced healthy diet. Nausea can make it difficult to eat. Try snacking throughout the day rather than eating full meals. To get enough calories, eat more high-calorie foods.
- Drink liquids to stay hydrated. It's important to prevent dehydration, especially if you have vomiting or diarrhea.
- Avoid alcohol. Don't drink alcohol. It can cause liver damage.
- Use medicines with care. Your liver may have a hard time processing some medicines. Talk with your healthcare professional about all the medicines you take, including medicines you can buy without a prescription.
Preparing for your appointment
If you have been exposed to hepatitis or have symptoms of hepatitis, make an appointment with your healthcare professional. Preparing and anticipating questions can help you make the most of your appointment.
What you can do
Because appointments can be brief and there's often a lot of information to cover, it's a good idea to be prepared.
- Be aware of pre-appointment restrictions. When you make the appointment, find out if there's anything you need to do in advance, such as change your diet.
- Make a list of your symptoms. Include those that seem unrelated to the reason for your appointment.
- Make a list of key personal information, including major stresses or recent life changes and recent travel or possible exposure to hepatitis.
- Make a list of all medicines, vitamins, herbs and other supplements you take. List how much you take of each one.
- Consider bringing a family member or friend. Someone who goes with you may remember something that you missed or forgot.
- Prepare a list of questions to ask your healthcare professional.
Basic questions to ask
Some basic questions to ask include the following.
Causes and diagnosis
- What is likely causing my symptoms or condition?
- What are other possible causes?
- What tests do I need? Should I be tested for other causes of liver disease?
- Is my condition likely short term or long term?
Treatment and overall health
- Do I need treatment for a hepatitis infection?
- What treatment choices do I have? What are the benefits and risks of each treatment choice?
- Are there any other treatment choices besides the one you suggest?
- Is there a generic version of the medicine you're prescribing?
- I have other health conditions. How can I best manage them together?
- Are there restrictions that I need to follow, including alcohol or medicines to avoid?
Protecting others and daily life
- Can I pass hepatitis to others? How can I protect people around me?
- Should my family be tested?
- Is there a vaccine for the type of hepatitis I have? If there is, should people close to me receive the hepatitis vaccine?
- If someone close to me is diagnosed with hepatitis, is there a vaccine to prevent infection?
- Can I continue to work or go to school?
- How will I know when I can no longer spread hepatitis?
- What symptoms could signal serious complications?
More information and care
- Should I see a specialist?
- Are there brochures or websites you recommend?
What to expect from your doctor
Your healthcare professional may ask you questions such as the following.
Possible exposure
- Have you recently traveled or been in an area with contaminated water or a hepatitis outbreak?
- Have you been exposed to someone with hepatitis?
- Have you been vaccinated for hepatitis A or B?
- Have you had hepatitis before?
Symptoms
- When did your symptoms begin?
- Are your symptoms constant or do they come and go?
- How bad are your symptoms?
- What, if anything, makes your symptoms better?
- What, if anything, makes your symptoms worse?
Symptoms and past diagnosis questions if hepatitis B or C is suspected include:
- Have you had jaundice, such as yellowing of the eyes or light-colored stool?
- Have you been diagnosed with hepatitis or another liver condition?
- Have you ever had a blood transfusion or organ transplant?
- Do you inject drugs?
- Have you had sex without a condom?
- How many sexual partners have you had?
- Does anyone in your family have hepatitis or liver disease?