Is Hepatitis Different For Men And Women?

By Lauren Steele

Although you have certainly heard of hepatitis, do you actually know what it is? According to the World Health Organization, hepatitis is an inflammation of the liver. In fact, that’s what the word translates to. The word is derived from the Greek hêpar, meaning "liver"—and -itis, meaning "inflammation."

And although it is a condition all its own, hepatitis can progress to other complications and illnesses without appropriate health care, such as fibrosis (scarring), cirrhosis, liver failure, and liver cancer.

What is hepatitis?

Hepatitis can be caused by five different viruses, but there are three other forms of hepatitis that are not caused by infection. In total, there are eight main types of hepatitis: 

1. Hepatitis A 

2. Hepatitis B

3. Hepatitis C

4. Hepatitis D

5. Hepatitis E

6. Autoimmune hepatitis

7. Alcoholic hepatitis

8. Nonalcoholic fatty liver disease

Each of these forms of hepatitis have their own cause, routes of transmission, and treatment.

“Hepatitis A, B, C, D, and E are caused by different viruses,” explains Steven-Huy B. Han, MD, the program director of the Advanced Transplant Hepatology Fellowship at the David Geffen School of Medicine at UCLA. “Alcoholic hepatitis is liver inflammation caused by excessive alcohol consumption. Autoimmune hepatitis is liver inflammation caused by the person's own immune system attacking the liver because it does not recognize the liver as being part of the person.”

“Twenty-five to 30% of the adult population in the U.S. has nonalcoholic fatty liver disease,” says Juan Gallegos-Orozco, MD, the medical director for Hepatology and Liver Transplant at the University of Utah School of Medicine. “And 20% of those people have nonalcoholic steatohepatitis—another form of hepatitis. This is a chronic liver disease that leads to cirrhosis and liver cancer, and we must be aware of it.”

According to Mayo Clinic, the cause of non-alcoholic fatty liver disease (NAFLD) is unknown, but risk factors include obesity, gastric bypass surgery, high cholesterol, and Type 2 diabetes. Every year, more than 3 million Americans are diagnosed with NAFLD.

While alcoholic, nonalcoholic, and autoimmune hepatitis are not transmittable, viral hepatitis are transmitted and contracted in several different ways.

How is hepatitis transmitted?

“Hepatitis A is transmitted through close person-to-person contact with an infected person, sexual contact with an infected person, and/or ingesting contaminated food or water,” Dr. Gallegos-Orozco says. “Hepatitis B and C transmit through sexual intercourse and sharing contaminated needles. These both can cause acute or chronic infection and can lead to cirrhosis and liver cancer.” 

Dr. Gallegos-Orozco also explains that hepatitis D is very uncommon and only occurs in those who are already infected with chronic hepatitis B.

Hepatitis E is similar to hepatitis A and is passed through contaminated foods—especially undercooked venison and pork. “Hepatitis E is not as common in the US as other forms, but is more common in developing countries and fairly common in Europe,” Dr. Gallegos-Orozco says.

Hepatitis transmission is the same for men and women. Though men who have sex with men may be at higher risk of contracting heptatis A, B, and C, according to the Centers for Disease Control and Prevention (CDC).

The prevalence of hepatitis 

In fact, the prevalence rates for hepatitis A, B, C, D, and E vary from country to country. For example, hepatitis B is most prevalent in Asia and Africa, reaching rates ranging from 10% to as high as 20% in different studies. 

“Hepatitis C prevalence in the U.S. is likely around 1%-2% of the population but is much increased in at-risk individuals such as intravenous drug users, United States veterans, incarcerated individuals, and others,” Dr. Han says. “But there is not a significant difference between men and women as to who is more likely to develop hepatitis of any kind. Alcoholic hepatitis was previously more prevalent in men, but we are now seeing increased incidence of alcoholic hepatitis in young women. Meanwhile, autoimmune hepatitis is typically more prevalent in young women.”

Hepatitis treatment

When it comes to treatments, there are none for hepatitis A and B. But for these two infections, vaccinations will prevent infection. The hepatitis B vaccine also protects against the chance of a future hepatitis D infection. Currently, there is no vaccination for hepatitis C, but more than 90% of people infected with the hepatitis C virus can be cured in eight to 12 weeks with oral antiviral medication, according to the CDC. Hepatitis E usually resolves on its own within four to six weeks, according to the Mayo Clinic. 

Alcoholic hepatitis is treatable. Although scarring of the liver is permanent, the liver is often able to repair some of the damage caused by alcohol so patients can live a normal life if they stop drinking, according to Johns Hopkins Medicine.

Autoimmune hepatitis is chronic and cannot be cured, but patients can control it and keep it in remission with medications that suppress the immune system. 

For all of the differences in the forms of hepatitis, there are a few similarities that link them all.

Hepatitis symptoms in men vs. women

First, as Dr. Han says, there is not a significant difference between men and women in terms of likelihood of contracting or developing acute hepatitis of any kind. Secondly, the symptoms of all forms of hepatitis are the same—and are the same for both men and women.

Symptoms of hepatitis for both men and women are, in general, flu-like symptoms. These include:

• Fatigue

• Weakness

• General malaise

• Fever (uncommon) 

Other symptoms include:

• Nausea

•  Abdominal pain or tenderness

• Jaundice (yellowing of the eyes and skin)

• Vomiting blood or gritty bile 

However, men may be more likely to suffer liver damage from the hepatitis B virus or chronic hepatitis C than women. In fact, women are likely to recover from hepatitis C without treatment.

One of the most peculiar things about hepatitis is that a person can have it for many years and not realize it. “Hepatitis can actually be asymptomatic, and only diagnosed on blood tests showing extremely abnormal liver test values,” Dr. Han says. “All of the symptoms listed above usually occur with more severe hepatitis.”

I have hepatitis symptoms. Now what? 

But don’t worry, because catching any potentially abnormal liver test values is as simple as requesting a blood panel test during your yearly physical or wellness checkup. “It’s a common blood panel that is tested during a normal physical,” Dr. Gallegos-Orozco says. “It’s worth noting that the CDC recommends that every adult be checked for hepatitis C at least once in their lifetime, and that nowadays, the official recommendation is for infants to be tested early in life to prevent the disease presenting later in life after many years of being undetected—which leads to complications.”

If you believe that you might have a form of hepatitis, it is recommended that you visit your primary care provider and have a blood test conducted to determine if your liver enzyme levels are normal.