Hepatitis D may cause acute hepatitis in someone who is a carrier of the hepatitis B virus. The combination of hepatitis B and D is potentially more serious then hepatitis B alone and is more likely to cause serious chronic hepatitis and cirrhosis. IV drug users have a high incidence of hepatitis D. Viruses of the herpes family, which cause cold sores, genital herpes, chicken pox, shingles and infectious mononucleosis, can cause acute hepatitis, especially when the immune system is not functioning properly. It is unlikely that they will produce chronic hepatitis. Other viruses, as yet undiscovered, may be responsible for some cases of chronic hepatitis.
Some medications can also cause chronic hepatitis.
These medications must be taken for long periods of time to produce chronic hepatitis. The number of actual cases caused by these medications is small. Chronic hepatitis caused by drugs is usually recognized early, and stopping the medication before cirrhosis has developed usually reverses the disease. Some patients have no symptoms or only mild ones, including fatigue, discomfort in the upper abdomen, loss of appetite and aching joints. Currently, the treatment for hepatitis C is three million units, three times weekly for 24 weeks or longer.