Some people clear the infection, while others develop chronic hepatitis B. Chronic infection can increase the risk of cirrhosis and liver cancer.
Hepatitis C is primarily transmitted through contact with infected blood. It can become chronic and may cause progressive liver damage over many years.
One reason viral hepatitis deserves attention is that many infected people do not experience noticeable symptoms during the early stages.
A person can feel healthy while the virus continues to affect the liver.
Blood testing is therefore essential for diagnosis. Symptoms alone cannot reliably determine whether someone has hepatitis.
Vaccines are available for hepatitis A and hepatitis B. There is currently no widely available vaccine for hepatitis C, but modern antiviral treatments can cure most cases of hepatitis C infection.
4. MEDICATIONS AND SUPPLEMENTS
Another potential cause of liver injury is medication.
The liver plays a major role in processing many drugs, which means certain medications can occasionally cause liver-related side effects.
One well-known example is acetaminophen, also called paracetamol.
When taken according to recommended instructions, paracetamol is generally safe for most people. However, taking more than the recommended amount can cause severe liver damage.
An important risk is accidentally combining multiple products that contain the same ingredient.
For example, someone may take a pain reliever and a cold medication without realizing that both contain paracetamol.
This can lead to an unintended excessive dose.
Other prescription medications can also affect the liver in certain individuals. The risk varies according to the medication, dose, duration of use, and the patient's medical history.
Herbal products and dietary supplements should not automatically be considered harmless.
Some supplements contain concentrated ingredients that may cause liver injury. Products with unclear ingredient lists, unreliable manufacturing standards, or exaggerated health claims deserve particular caution.
If someone develops jaundice, dark urine, persistent nausea, or other concerning symptoms after starting a medication or supplement, they should contact a healthcare professional promptly.
They should not independently stop essential prescription medication unless advised to do so, except when emergency medical services provide specific instructions.
The safest approach is to tell doctors about every medication, supplement, and herbal product being used.
CAN YOUR LIVER BE DAMAGED WITHOUT CAUSING PAIN?
Yes. This is one of the most important facts about liver disease.
The liver is a large organ located mainly in the upper-right portion of the abdomen, beneath the diaphragm and behind the lower ribs.
Although liver disease can cause discomfort, the liver itself does not always produce obvious pain when its cells are injured.
Some people experience discomfort when the liver becomes enlarged and stretches the surrounding capsule. Others may develop pain because of inflammation or problems involving nearby structures.
However, many liver conditions produce no noticeable pain at all.
This explains why relying on abdominal discomfort as the main warning sign can be misleading.
A person may have fatty liver disease, chronic viral hepatitis, or even significant fibrosis without experiencing any obvious symptoms.
In some cases, the first indication of a problem comes from an abnormal blood test performed for an unrelated reason.
For example, a routine examination may reveal elevated liver enzymes. Further testing may then identify fatty liver disease, viral hepatitis, medication-related injury, or another condition.
This is why screening and medical assessment can be valuable for people with recognized risk factors.
People with diabetes, obesity, metabolic syndrome, a history of viral hepatitis, or substantial alcohol exposure may benefit from discussing liver assessment with their healthcare provider.
The absence of pain should never be treated as proof that the liver is healthy.
WHAT DO LIVER BLOOD TESTS ACTUALLY MEASURE?
When doctors suspect a liver problem, one of the first steps may involve blood testing.
Many people refer to these tests collectively as liver function tests. However, this phrase can be slightly misleading because not every test directly measures how well the liver performs its functions.
Different markers provide different information.
ALT AND AST: SIGNS OF LIVER-CELL INJURY
ALT stands for alanine aminotransferase.
AST stands for aspartate aminotransferase.
Both are enzymes found inside cells throughout the body, including liver cells.
When liver cells become injured, these enzymes may enter the bloodstream, causing their measured levels to rise.
ALT is generally more closely associated with liver injury, while AST is also present in muscles, the heart, and other tissues.
Elevated levels can occur for many reasons, including viral hepatitis, fatty liver disease, alcohol-related injury, medication reactions, and certain other medical conditions.
However, a high ALT or AST level does not automatically mean someone has severe liver disease.
The degree of elevation, the pattern of results, other blood markers, symptoms, and medical history all matter.
Interestingly, people with advanced chronic liver disease may sometimes have relatively modest enzyme elevations.
Therefore, normal enzyme levels do not always rule out significant fibrosis or cirrhosis.
BILIRUBIN: WHY THE EYES AND SKIN TURN YELLOW
Bilirubin is a yellow substance produced when the body breaks down old red blood cells.
The liver normally processes bilirubin so that it can be eliminated through bile.
When bilirubin accumulates in the bloodstream, it can cause jaundice.
This may make the whites of the eyes appear yellow before the change becomes obvious in the skin.
Blood testing can measure bilirubin levels and help doctors investigate the cause.
Elevated bilirubin may result from liver-cell injury, obstruction of bile flow, certain blood disorders, or other conditions.
This is why jaundice requires medical evaluation rather than an assumption that the liver is necessarily the only problem.
ALBUMIN: A CLUE ABOUT THE LIVER'S PROTEIN PRODUCTION
Albumin is an important protein produced by the liver.
It helps maintain fluid balance within blood vessels and carries various substances throughout the body.
When the liver's ability to produce albumin becomes significantly impaired, blood albumin levels may fall.
Low albumin can contribute to fluid accumulation in the legs and abdomen.
However, low albumin is not specific to liver disease. Kidney disorders, malnutrition, inflammation, and other conditions can also affect albumin levels.
Doctors interpret the result alongside other findings.
PT AND INR: HOW WELL BLOOD CLOTTING IS WORKING
The liver produces several proteins involved in blood clotting.
A test called prothrombin time, often reported together with the international normalized ratio, or INR, helps assess part of the blood-clotting process.
When the liver cannot produce enough clotting factors, PT or INR may become abnormal.
This can be an important sign of impaired liver function, particularly in acute or advanced disease.
However, medications such as warfarin can also affect INR, so doctors must consider the patient's treatment history.