Chronic viral hepatitis (CVH) is a chronic inflammatory reaction of the liver due to hepatitis B (HBV), hepatitis c (HCV), or hepatitis d ( HDV), occurring for more than 3 to 6 months. Chronic viral hepatitis is the leading cause of chronic liver disease, cirrhosis and hepatocellular cancer (Porth, p962). According to a media report on “the growing burden of chronic liver disease is a high price to pay”; Liver disease affects more than 6 million Australians and costs the government $50.70 a year. Marriott (2013) stated that chronic viral hepatitis is still called the silent epidemic due to lack or low levels of risk awareness. The manifestations and changes occurring in the liver and the treatment options will be further explored to provide awareness of the condition. Etiology The most common cause of chronic viral hepatitis is hepatitis B and hepatitis C. Hepatitis B delta virus can cause CVH (LeMore et al, p716). As demonstrated, patients transplanted for idiopathic fulminant hepatitis develop CVH even if they have yet to discover the virus. Risk factors Patients at high risk of contracting chronic viral hepatitis. are listed below Risk factors for suspected chronic viral hepatitis (British Columbia Medical Association 2012) High-risk sexual activity or sexual partner with viral hepatitis Immigration from countries endemic for hepatitis B and C Recipient of unscreened blood products Children born to mothers with chronic hepatitis B or C infection Tattoos and body piercings History of incarceration HVI or other sexually transmitted infections In family with an infected person, especially if sharing personal items such as razors, nail clippers or toothbrushes Hemodialysis Pathophysiology Life...... center of paper......HBV and HCV viruses end up with cirrhosis that develops into hepatocellular carcinoma, so they should be vaccinated (LeMone et al, p719). Health promotion and education Patients with CVH may experience anxiety, social isolation, so they may need to be referred to support services or counseling centers and should be informed about helplines and community organizations ( ). Patients experience nausea and may have intolerance to some foods and drinks and therefore need to be educated on the importance of a protein-rich diet. Nurses must emphasize the importance of infection control, i.e. hand washing and condom use. Skin integrity must be maintained due to the presence of rashes and itching which affect body image (LeMone et al, p721). Alcohol and smoking therefore reduce the response to treatment (Amanetal,2012).