Acute Hepatitis: Symptoms, Causes & Treatment

Acute hepatitis is inflammation of the liver that lasts less than 6 months and can cause symptoms such as fatigue, nausea, loss of appetite, and yellowing of the skin and eyes. This condition can develop suddenly and may be linked to infections, medications, alcohol use, or immune system changes.

In most cases, acute hepatitis improves within a few weeks or months, but some cases can become severe. When this happens, liver function may be affected and complications like acute liver failure can occur, which is a serious and potentially life-threatening condition.

Acute hepatitis that lasts longer than 6 months is considered chronic hepatitis. Diagnosis is based on symptoms, medical history, and lab tests, and treatment depends on the cause but may include rest, fluids, stopping certain medications, and hospital care in more severe cases.

Acute hepatitis symptoms

The main symptoms of acute hepatitis are:

• Tiredness or fatigue

• Loss of appetite

• Fever

• Joint and muscle pain

• General discomfort

• Headache

• Nausea or vomiting

A few days after symptoms begin, some people may develop jaundice, which is yellowing of the skin and eyes. According to the CDC, symptoms of acute hepatitis B can also include fatigue, fever, loss of appetite, nausea or vomiting, joint pain, dark urine, and clay-colored stools.

After this phase, most people go through a recovery period, during which signs and symptoms gradually improve. In many cases, acute hepatitis clears up completely, but in some people the liver inflammation lasts more than 6 months and develops into chronic hepatitis.

Confirming a diagnosis

Acute hepatitis is diagnosed by a primary care provider, hepatologist (liver specialist), or gastroenterologist based on symptoms, health history, medication use, and alcohol consumption.

To confirm the diagnosis, the provider may order tests that can detect liver tissue damage or changes in liver and bile duct function. These may include alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase, bilirubin, albumin, and coagulation tests.

Imaging tests, such as an ultrasound or CT scan, may also be ordered to look at the liver. If the diagnosis is still unclear, a liver biopsy may be needed.

Can acute hepatitis be serious?

Although it is not common, some cases of acute hepatitis can become severe, especially when the condition is not detected early or treatment is not started promptly.

Severe hepatitis can impair liver function. This can increase the risk of bleeding, interfere with protein production, affect immune function, and impact how other organs work.

In rare cases, acute hepatitis can lead to acute liver failure. According to the American Association for the Study of Liver Diseases, acute liver failure requires prompt evaluation and management, and liver transplantation may be needed in some cases.

Possible causes

The main causes of acute hepatitis include:

• Infection with the hepatitis A, B, C, D, or E virus

• Viral infections, such as adenovirus, cytomegalovirus, parvovirus, Epstein-Barr virus, herpes, dengue, yellow fever, or COVID-19

• Alcohol use disorder or the use of illicit drugs, such as cocaine or methamphetamine

• Drug-induced hepatitis, such as from high doses of acetaminophen, other medications, or herbal products

• Immune-related or inflammatory conditions, such as autoimmune hepatitis or bile duct obstruction and inflammation

• Metabolic or inherited conditions, such as nonalcoholic fatty liver disease, hemochromatosis, or Wilson’s disease

• Pregnancy-related conditions, such as preeclampsia, eclampsia, HELLP syndrome, or acute fatty liver of pregnancy

• Ischemic or vascular conditions, such as cardiogenic shock, heat stroke, or sinusoidal obstruction syndrome

• Worsening of chronic hepatitis or cancer

There is also a condition known as transinfectious hepatitis, which is caused by infections that do not occur directly in the liver but happen along with severe generalized infections, such as sepsis.

Treatment options

Treatment for acute hepatitis is guided by a hepatologist or gastroenterologist and varies depending on the cause. For acute viral hepatitis, the doctor may recommend supportive treatment in the hospital, with IV fluids and medications to relieve nausea or vomiting.

In all cases of acute hepatitis, rest, increased fluid intake, avoiding alcohol, and eating a light, balanced, low-fat diet are recommended.

If acute hepatitis is caused by medication, the doctor may recommend stopping the medication responsible for the liver inflammation. However, if it is caused by acetaminophen, treatment with N-acetylcysteine may be recommended.

When can acute hepatitis turn into acute liver failure?

Acute liver failure happens only in rare cases of hepatitis that progress very quickly and severely disrupt the body’s metabolism.

Acute liver failure, sometimes called fulminant hepatitis, is one of the most serious liver conditions and can be life-threatening. The risk of complications depends on the cause, the person’s age, how severe the condition is, and how quickly treatment begins.

Early symptoms are similar to those of typical hepatitis, but other signs may also appear, such as dark urine, yellowing of the eyes, sleep problems, slurred speech, mental confusion, and slow thinking.

There is also a risk of serious complications, such as organ failure, which can be life-threatening. It is important to seek medical care right away if symptoms suggest this condition.