Types of Hepatitis

Hepatitis means inflammation of the liver. Often, a viral infection is the cause of this inflammation. The viruses known as hepatitis A, hepatitis B, and hepatitis C are the most common causes. Hepatitis D and E can cause symptoms too, but they are rare. Other viruses, certain medications and toxins, some autoimmune conditions, and long-term, heavy use of alcohol can also cause hepatitis.

Hepatitis A often leaves the body on its own without any treatment. Inflammation caused by hepatitis B or C may become chronic and lead to long-term liver damage and other complications.

When a hepatitis virus enters the bloodstream and attacks liver cells, the body’s immune system responds to fight it. Temporary inflammation is part of this response. But if inflammation persists for months or years, it can damage or even destroy liver cells.

Liver damage can prevent the body from processing essential nutrients and from ridding the body of toxins. Without treatment, viral hepatitis can lead to scarring of the liver, also called cirrhosis, which interferes with liver function. Untreated hepatitis B or C can also lead to liver cancer.

Hepatitis A, B, C, D, and E are each caused by a specific type of hepatitis virus. All of these viruses are contagious. Hepatitis A can be spread through contaminated food, water, or personal contact with an infected person. Hepatitis B and D spread through contact with bodily fluids such as blood or semen. Hepatitis C, the most common cause of hepatitis, spreads primarily through blood. Contaminated food or water are potential sources of hepatitis E infection. These viruses can affect people of any age, including newborn babies if the virus passes from an infected mother to her child during birth.

Each type of hepatitis has distinct characteristics, and your doctor makes important decisions about treatment based on the type of virus affecting you.

Hepatitis A

Hepatitis A is an infection of the liver caused by the hepatitis A virus. Symptoms may not appear for weeks after infection, and some people have no symptoms at all.

This disease can be spread from one person to another even before symptoms develop, and a week or more after symptoms are evident. Hepatitis A can be spread through water and food that has been contaminated by microscopic amounts of feces containing the virus. This is more common in areas that have poor sanitation. Hepatitis A can also pass from person to person during unprotected sex.

Symptoms of hepatitis A include flu-like symptoms, such as fever, nausea, loss of appetite, and diarrhea. Hepatitis A may also cause jaundice, a condition that makes the skin and eyes look yellow and causes stool to become light in color and urine to become dark.

Hepatitis A is a short-lived, or acute, disease. When symptoms develop, they may cause severe illness requiring hospitalization and intravenous fluids.

In most people, the body overcomes the virus on its own after a few weeks or months. Occasionally, a person feels ill again a few months later and then gets better, usually for good after this second flare-up.

To protect yourself from hepatitis A, doctors recommend vaccination before traveling to a country where hepatitis A is common and avoiding easily contaminated food items. These include fresh vegetables and fruit (unless they can be peeled), raw shellfish, unpurified tap water, and ice cubes made from that tap water.

It is also important to vaccinate your baby against the hepatitis A virus for long-term immunity. The vaccine is recommended for children 12 months of age and older. Babies 6 to 11 months old may receive a first dose of the two-dose vaccine before traveling outside of the United States. However, the dose received before 12 months would not count as part of their primary vaccine series.

Hepatitis B

Hepatitis B is a liver infection caused by the hepatitis B virus. People infected with the virus may or may not have symptoms but can still transmit the virus to others. Symptoms include jaundice, loss of appetite, nausea, vomiting, abdominal pain, and joint pain.

The infection may be acute, meaning short-lived, or chronic, which means it persists for a long time, even if symptoms never appear. Hepatitis is considered chronic if it lasts longer than six months.

In most adults, the body succeeds in fighting the hepatitis B virus within a few months without any permanent liver damage. In some, though, hepatitis B becomes a long-term illness and can lead to liver damage or liver cancer.

Hepatitis B is spread through contact with bodily fluids, such as saliva, blood, and semen, or with a contaminated object, such as a toothbrush or razor, where the virus can live for days.

Certain factors increase the risk of infection. These include sharing needles when injecting drugs, having unprotected sex, having a tattoo or body piercing done by someone who doesn’t use clean needles, traveling to countries where hepatitis B is common, being on long-term dialysis, and sharing items such as a toothbrush or razor with someone who is infected. Men who have sex with other men are also at a higher risk.

Pregnant people with hepatitis B can pass the infection to their babies at birth. Babies born to mothers with high levels of hepatitis B in their blood are at greater risk of contracting the virus than those born to people with a lower “viral load.” When necessary, antiviral therapy is given in the third trimester of pregnancy to reduce the risk of passing the infection to the baby. Vaccination within 12 hours of birth, along with a shot of a medicine called hepatitis B immune globulin, is highly effective in preventing infection.

Hepatitis C

Hepatitis C is a liver infection caused by the hepatitis C virus. Often, this disease doesn’t cause symptoms, and a person may live with hepatitis C for years or decades without knowing it.

Hepatitis C is contagious and can cause serious liver damage even if a person never has symptoms. Without treatment, hepatitis C may lead to cirrhosis, which is scarring of the liver, and liver cancer.

If symptoms do develop, they typically include fatigue, joint pain, dark urine, muscle weakness, and jaundice.

Hepatitis C is spread from person to person, primarily through contact with contaminated blood. According to the Centers for Disease Control and Prevention, sharing needles during intravenous drug use is the most common way the hepatitis C virus is spread in the United States.

Other risk factors include having unprotected sex with multiple partners, sharing devices such as straws when snorting drugs through the nose, and having a tattoo or piercing done by someone who uses unclean equipment. Having received a blood transfusion before 1992 is also a risk factor for hepatitis C.

Doctors recommend that all adults get screened for hepatitis C at least once in their lifetime.

Hepatitis D

Hepatitis D, also known as hepatitis delta, is a liver infection caused by the hepatitis D virus. Only people who have hepatitis B can become infected with hepatitis D.

Its symptoms, such as fever, dark urine, and jaundice, are similar to those of hepatitis B. It is possible to have both hepatitis B and D at the same time, and this can lead to more severe illness.

Like hepatitis B, the virus that causes hepatitis D can be spread through blood or other body fluids, such as semen or saliva.

Some people with hepatitis B are at greater risk of becoming infected with hepatitis D. Risk factors include living with or having sex with someone with hepatitis B, sharing needles or syringes when injecting drugs, and traveling to an area where hepatitis D is common.

In people who have an acute, or short-lived, hepatitis B infection, hepatitis D usually resolves within weeks. Hepatitis D tends to become chronic, or longer-lasting, in people who have chronic hepatitis B.

Chronic hepatitis D can cause serious complications, including cirrhosis, or scarring of the liver, liver failure, and liver cancer.

Hepatitis E

Hepatitis E is a liver infection caused by the hepatitis E virus. These infections are usually acute, or short-lived. But if the body’s immune system cannot fight off the virus, hepatitis E can become chronic.

Often, people with hepatitis E have no symptoms. When symptoms occur, they can include fatigue, loss of appetite, abdominal pain, and jaundice.

The infection is spread through contaminated water, undercooked pork or wild game, and, in rare cases, blood.

People with weakened immune systems are at risk of developing complications, such as cirrhosis, meaning scarring of the liver, or liver failure.