Hepatitis involves inflammation of the liver cells and damage to the liver. There are different types and causes of hepatitis, but the symptoms can be similar.
The liver is essential for removing toxins from the blood, storing vitamins, and producing hormones. Hepatitis, however, can disrupt these processes.
At least five viruses can cause hepatitis. The three most common are hepatitis A, B, and C. Infection with any of these three viruses can lead to life threatening complications.
Each type has different characteristics, and transmission happens in different ways, but the symptoms tend to be similar.
This article covers the different types of hepatitis, including their symptoms, treatments, and outlooks.
The Centers for Disease Control and Prevention (CDC) estimate that there are around 6,700 new hepatitis A infections each year in the United States.
Overall, the number of U.S. cases has declined during the past 20 years — largely due to immunization — but outbreaks do sometimes occur.
Hepatitis A usually transmits through contaminated food or water. It is common in many countries, especially those that do not have effective sanitation systems.
- abdominal pain
- low appetite
However, many people do not experience symptoms at all. Those who do usually make a full recovery within a few weeks to several months. After this, they have immunity to it. Children under 6 years do not usually show any symptoms.
In rare cases, hepatitis A can be fatal. However, there are safe and effective vaccines that protect against this virus.
There is no cure for hepatitis A, but treatment can help manage symptoms. Avoiding alcohol can help with recovery, but most people recover without intervention.
Infection with hepatitis B is usually acute, or short-term, but it can become chronic — especially in children.
Long-term complications, such as liver cancer or cirrhosis, can affect around 15–25% of people with chronic hepatitis B. There is no cure, but treatment can help manage the condition.
The CDC estimate that in the U.S., around 862,000 people are currently living with hepatitis B.
The virus can transmit through:
- having unprotected sexual intercourse
- sharing needles
- having a tattoo with unsterilized needles
- sustaining accidental skin pricks with medical equipment
- sharing personal items, such as a toothbrush or razor
- breastfeeding, if the mother has the virus
The symptoms are similar to those of other types of hepatitis. They include abdominal pain and jaundice.
A safe and effective vaccine is available that can protect people from hepatitis B infection. The number of cases has fallen dramatically in countries where the vaccine is available.
There is no cure for hepatitis B, but supportive care can help manage symptoms. In cases of chronic illness, a doctor may prescribe antiviral medication, and they will monitor the liver regularly to check for damage over time.
A person should also avoid alcohol during treatment and recovery.
Hepatitis C is a blood-borne virus that usually transmits through sharing needles or other drug-related equipment.
Other people who may be at risk include healthcare workers who handle sharps and children whose mothers have the virus.
It can be a short-term condition, but up to 85% of people will develop a chronic, long-term infection.
A person may have no symptoms, and around half of people living with the virus do not know they have it. They may transmit it to another person without realizing it.
The CDC estimate that there are around 44,300 new cases of hepatitis C each year, and that around 2.4 million people are currently living with this virus in the U.S. The number has been growing since 2010.
In around 25% of people, the body will eliminate the virus over time. In others, however, it can remain in the body and become chronic.
According to the CDC, a doctor will not treat hepatitis C unless chronic hepatitis develops. Then, they may prescribe a course of oral medication for 8–12 weeks, after which 9 out of 10 people will no longer have symptoms.
Combination therapy can eliminate the virus in some people with certain strains of the virus.
As with other types of hepatitis, people who have hepatitis C should avoid alcohol.
Many people with hepatitis experience either mild or no symptoms. If symptoms do appear, they can do so 2 weeks to 6 months after infection. This applies to all types of hepatitis.
- pale stools
- a loss of appetite and weight
- a fever
- muscle or joint aches
- nausea and vomiting
- abdominal pain
- jaundice, or a yellowing of the eyes
- itchy skin
- malaise, or a general feeling of being unwell
The acute phase is not usually dangerous, but chronic infection and severe liver complications can develop over time. These can take decades to appear.
A person with chronic hepatitis may experience progressive liver failure, which can include the following symptoms:
- swelling of the lower extremities
- blood in the feces or vomit
Some symptoms of jaundice include:
- dark urine
- itchy skin
- light colored feces
- yellow skin, whites of the eyes, and tongue
The symptoms of the different types of hepatitis are similar, but laboratory tests can identify the specific type a person has.
A doctor will perform a physical examination and ask questions to find out about a person’s possible exposure to hepatitis.
They may recommend blood tests or nucleic acid tests. Blood tests can detect antibodies and assess liver function, while nucleic acid tests can — for hepatitis B and C — confirm the speed at which the virus is reproducing in the liver, which will show how active it is.
Ways to prevent hepatitis transmission will depend on the type.
For those at higher risk, experts recommend undergoing regular screening for hepatitis B and C. Also, doctors routinely screen for hepatitis B and C during pregnancy.
The sections below will discuss means of prevention by type.
Hepatitis A mostly spreads through infected food and water.
Some ways of preventing infection include:
- washing the hands carefully after using the bathroom and before eating
- ensuring that food is fully cooked and appropriately stored
- drinking only bottled water when traveling
- avoiding or peeling fruits and vegetables that may have been washed or grown in contaminated water
A person may wish to ask their doctor about the hepatitis A vaccine, especially if they are traveling to an area where the virus is prevalent.
Hepatitis B and C
To minimize the risk of transmission:
- A person should talk openly with any sexual partners about any viruses they may have.
- Use a barrier method, such as a condom, during sex.
- Only use previously unused, clean needles.
- Avoid sharing toothbrushes, razors, and manicure instruments.
- Check that any tattoo or acupuncture equipment is sterile.
People with a high risk of exposure to hepatitis B can ask their doctor about a vaccination, but there is no vaccination for hepatitis C.
Anyone who believes that they may have any type of hepatitis should seek medical help, as a doctor can advise on how to reduce the risk of complications and avoid transmitting the virus.
In people with HIV, there is a higher risk of contracting a hepatitis B or C infection. The impact can also be more severe, as the body is less able to fight the infection.
To lower their risk of hepatitis infection and complications, people with HIV should:
- take precautions to prevent infection and transmission of hepatitis
- attend all health checks
- adhere to their treatment plan
Immunization can prevent hepatitis A and B, but not C. Treatment is available for hepatitis B and C, but not A.
Some factors affecting the outcome include the type of hepatitis a person has and whether or not they have symptoms and seek treatment.
Some people do not know that they have chronic hepatitis until liver failure occurs.
Different types of hepatitis have different chances of recovery. For example:
- Hepatitis A: This type normally resolves within 2 months without having any long-term effects, and the person will have lifelong immunity afterward.
- Hepatitis B: Most adults recover within 90 days and have lifelong immunity. However, 90% of infants, 20% of older children, and 5% of adults develop a chronic infection. This can lead to severe complications, such as liver cancer or cirrhosis.
- Hepatitis C: The infection is chronic in 75–85% of people who have it, and 1–5% of people will experience life threatening complications. Treatment is available, but 15–25% of people will recover without it.