Liver Disease Services Frequently Asked Questions

The liver is responsible for several functions. Primarily it converts food into energy, and it also filters various potential toxins from the body. The liver manufactures clotting factors and proteins and stores vitamins and minerals.

Hepatitis is the inflammation of the liver caused by a drug, virus, autoimmune process or alcohol. Hepatitis A and E viruses cause acute hepatitis and are spread by contaminated food or water, but they do not cause chronic infection. However, blood or body fluids transmit Hepatitis B and C. Hepatitis B and C cause chronic inflammation of the liver, and may lead to cirrhosis (chronic scarring of the liver) and liver cancer.

• Hepatitis A is transmitted via fecal-oral routes (i.e. by ingestion of contaminated food or water, etc.).
• Hepatitis B is transmitted via infected fluids (i.e. sexual contact, tattoos, body piercing tools and other contaminated needles, or from mother to newborn).
• Hepatitis C is spread in ways similar to Hepatitis B (i.e. through blood products, contaminated needles and other similar tools). Although it can be transmitted sexually or from mother to newborn, these rates of transmission are quite low.
• Hepatitis D can spread in ways similar to Hepatitis B, but usually it is spread by contact with blood, contaminated needles and sexual contact.
• Hepatitis E is like Hepatitis A in that it is transmitted by ingesting contaminated food or water. This type of hepatitis is rare in the U.S.

• Hepatitis A and E. Some may not have symptoms, while others may have yellow eyes, yellow skin, dark urine, light stool, fever, nausea, vomiting and abdominal pain. These are symptoms of acute hepatitis.
• Hepatitis B. Varies from no symptoms to mild flu-like symptoms, dark urine, light colored stools, jaundice, fatigue and possibly fever. Patients with chronic Hepatitis B usually have no symptoms.
• Hepatitis C. Most patients with chronic Hepatitis C are asymptomatic. Acute Hepatitis C is rarely symptomatic. If symptoms are present, they are similar to those listed under Hepatitis B.
• Hepatitis D. Typically only causes liver disease in patients already infected with the Hepatitis B virus.

Hepatitis A and E cause acute hepatitis and are managed by adequate rest, fluids, and avoidance of liver toxins. The virus leaves the blood stream once the illness is over and thus does not cause chronic infection. Hepatitis B and C may cause chronic liver disease and result in ongoing liver damage. Hepatitis B can be treated with pegylated-interferon or nucleoside or nucleotide analogues, while Hepatitis C is treated with pegylated interferon and ribavirin combination therapy. The duration of therapy depends on the patient's genotype.

Cirrhosis. Scarring of the liver (i.e. normal liver parenchyma is replaced by scar tissue) and is the consequence of chronic injury to the liver by any cause. Cirrhosis is caused by ongoing damage to the liver caused by chronic viral hepatitis, alcohol or other liver diseases. Scar tissue in the liver decreases the flow of blood through the liver, thus decreasing production of proteins and slowing processing of nutrients, drugs and toxins.

Non-Alcoholic Fatty Liver Disease (NAFLD). Collection of fat cells in the liver. NAFLD is very common and is usually seen in persons who are overweight or have diabetes. The subtype of NAFLD, called Non-Alcoholic Steatohepatitis (NASH), can progress to cirrhosis.

Hereditary Hemochromatosis. A genetic disorder with excessive absorption and storage of iron in the liver and other body organs. Diagnosis and treatment is necessary to prevent cirrhosis (scarring of the liver). Given its genetic nature, screening family members is crucial.

Liver Tumors. Non-cancerous liver cysts and hemangiomas are common. Malignant tumors can spread from other organs to the liver. Primary liver cancer can occur in chronic liver disease patients, especially those with cirrhosis. These tumors can be detected by radiologic imaging and may be associated with certain abnormal blood tests.

Primary Biliary Cirrhosis (PBC). A chronic liver disease causing slow but progressive destruction of the small bile ducts in the liver. PBC is more common among women than men and may not cause any symptoms other than abnormal liver blood test, fatigue or itching.

Primary Sclerosing Cholangitis (PSC). Inflammation and scarring of bile ducts causing narrowing of bile ducts both inside and outside the liver. Symptoms are fatigue, itching and jaundice. This condition is usually seen among men in the 30-50 age group and is often associated with inflammatory bowel disease.