Center for Liver Disease and Transplantation

Hepatitis & Cirrhosis

Symptoms of Liver Diseases

Each patient's liver disease develops differently. This means that there is no one pattern of symptoms to anticipate. As the disease progresses the liver is unable to perform its many functions adequately. Patients may develop any of the following symptoms:

  • Fatigue
  • Forgetfulness or mental confusion
  • Loss of consciousness (coma)
  • Sleep reversal (inability to sleep at night but wanting to sleep all day)
  • Ascites (fluid in the abdomen)
  • Spontaneous bacterial peritonitis (infection of the ascites)
  • Edema (swelling of the legs)
  • Bleeding gums
  • Vomiting of blood
  • Bleeding from rectum or passing black stools (from internal bleeding)
  • Itching of the skin
  • Enlarged breasts in male patients
  • Jaundice or "liver spots" (spider angiomata, and petechiae)


Meaning literally inflammation of the liver, hepatitis refers to a group of conditions, most of which are caused by one of many viruses. Hepatitis can also be inherited (congenital hepatitis) or brought on by excess alcohol consumption.

Viral hepatitis is often cleared from the body by the immune system in a period ranging from weeks to months, but when it is not (chronic hepatitis), it must be managed medically. The most well-known forms of hepatitis are hepatitis B and hepatitis C because of the liver damage caused by their chronic forms.

Hepatitis B and Hepatitis C

What is Hepatitis B and C?

New Hepatitis C Treatment Therapies

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Hepatitis B is caused by a HBV, "hepatitis B virus," a member of the hepadnavirus family. Spread through contact with blood, it has symptoms in its acute stage. Chronic hepatitis B leads to cirrhosis and may then advance to liver cancer.

Hepatitis C is caused by HCV, "hepatitis C virus," a member of the Flavivirus family. Spread through contact with infected blood, the disease can lead to cirrhosis or liver cancer. Because most people do not have symptoms during the early stage of the disease, hepatitis C is usually diagnosed when its damage is well advanced. Because both viruses are transmitted by blood, many people infected with HIV are also infected with hepatitis.


Because they are caused by different types of viruses, hepatitis B and hepatitis C are treated differently, however both are diagnosed by blood tests—we use both serologies and viral load testing.

Dr. Robert Brown - What is hepatitis B?

Dr. Robert Brown - How is hepatitis B diagnosed?

Dr. Robert Brown - How is hepatitis B treated?

Dr. Robert Brown - What is hepatitis C (HCV)?

Dr. Robert Brown - How is hepatitis C (HCV) diagnosed?

Dr. Robert Brown - How is hepatitis C (HCV) treated?


Cirrhosis, scarring of the liver caused by injury over a period of time, is a consequence of chronic hepatitis, excessive alcohol use, and other less common causes including infections, drug toxins, and inherited diseases.

The liver is unique in its ability to regenerate in response to injury. However, with repeated injury over time the liver becomes unable to function properly and scarring develops. This is known as cirrhosis of the liver.

As cirrhosis worsens, almost all liver function is lost and the organ becomes harder and smaller. In the absence of a healthy liver, fluid accumulates in the abdomen and legs. Bile salts can build up in the skin causing itching and jaundice. Bleeding from large veins in the esophagus and GI tract may occur. Toxins can accumulate in the blood resulting in mental slowing and confusion.

Treatment for advanced cirrhosis is liver transplant.

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