Chronic persistent hepatitis can be caused by hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), autoimmune diseases such as lupus, various medications, and unknown (cryptogenic) causes. Most people have no symptoms.

Risk factors include previous viral hepatitis, having lupus or other autoimmune disease, and taking certain medications.

• Fatigue
• Lack of appetite
• Nausea and vomiting

• Hepatitis B surface antigen (may be positive)
• Hepatitis C antibody (may be positive)
• Hepatitis D antibody (may be positive)
• Tests for lupus or other autoimmune disease (may be positive)
• Liver biopsy
• Liver enzymes (mildly elevated)

Treatment is not always needed and depends on the underlying cause of the hepatitis. Each case should be reviewed to determine whether treatment would be helpful. New therapies for chronic viral infections are now able to stop or reverse some liver damage caused by certain viruses.

Most people recover from symptoms of chronic hepatitis. However, if the condition is caused by a virus such as HCV that can cause progressive liver damage, the hepatitis may worsen and cause severe liver scarring, liver failure, and potentially death.

Progression to liver failure is uncommon with many causes of chronic hepatitis. However, people with viral hepatitis or depressed immune systems, including those with HIV, are at higher risk.

Call for an appointment with your health care provider if symptoms of hepatitis worsen or persist.

People in high-risk groups such as health care workers can receive a hepatitis B immunization. Safer sex techniques decrease the risk of acquiring hepatitis through sexual contact. Intravenous drug users should seek addiction treatment or avoid sharing needles and any other injection-related paraphernalia.

You may contract hepatitis by simply handling an infected person's injection paraphernalia. Several forms of viral hepatitis are hundreds of times more transmissible via blood than HIV, and they can live for hours, even in dried blood.