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The ABCs of hepatitis A, B, and C

Published June 28, 2024

Hepatitis A, B, and C are 3 viral infections that target one of the body’s most important organs—the liver. Though they share the same destination, they differ in significant ways. Understanding how they differ is crucial to prevent, detect, and treat these infections that impact millions of lives nationwide.¹

What is hepatitis? What causes it?

Hepatitis means inflammation of the liver. There are many causes of hepatitis, including²:

  • Heavy alcohol use
  • Some medications or supplements
  • Exposure to certain toxins or poisons
  • Autoimmune diseases or health conditions

But, the most common cause of hepatitis is a viral infection. There are 5 main types of hepatitis viruses²:

  1. Hepatitis A (HAV)
  2. Hepatitis B (HBV)
  3. Hepatitis C (HCV)
  4. Hepatitis D (HDV)
  5. Hepatitis E (HEV)

When any of these viruses cause hepatitis, it's called viral hepatitis. This type of hepatitis can be acute (lasting less than 6 months) or chronic (lasting more than 6 months).³ In the United States, the most common forms of viral hepatitis are hepatitis A, B, and C

What’s the difference between hepatitis A, B, and C?

While hepatitis A, B, and C all cause hepatitis, they're not the same virus and they act in different ways. Here’s a breakdown of 5 ways they differ[¹ ⁴]: 

1. Transmission (how the virus spreads)

Hepatitis A | Feces (contaminated food, water, objects), close personal contact, sexual contact

Hepatitis B | Blood, certain body fluids, childbirth, sexual contact, sharing used needles or syringes

Hepatitis C | Blood, sharing used needles or syringes, needlestick injuries

2. Infection

Hepatitis A | Acute

Hepatitis B | Acute or chronic

Hepatitis C | Most often chronic

3. Prevention

Hepatitis A | Vaccine available

Hepatitis B | Vaccine available

Hepatitis C | No vaccine available

4. Treatment

Hepatitis A | Supportive care (rest, fluids, nutrition)

Hepatitis B | Supportive care for acute infections or medication for chronic infections

Hepatitis C | Most people (over 95%) can be cured with timely treatment

5. Complications

Hepatitis A | Rarely causes complications

Hepatitis B | Chronic infections can lead to cirrhosis (scarring of the liver), liver failure, and liver cancer

Hepatitis C | If untreated, chronic infections can lead to cirrhosis, liver failure, and liver cancer

How can hepatitis damage the liver?

Your liver, like other parts of your body, uses inflammation as a defense mechanism. It needs a small amount of inflammation to stay healthy by removing toxins, repairing damaged cells, and fighting off threats.

But there's a catch. If this inflammatory response becomes excessive or chronic, it can actually start doing more harm than good. Chronic inflammation can eventually take a toll and lead to excessive liver damage and scarring over time.⁵ 

What are the symptoms of hepatitis A, B, and C?

Though all types of viral hepatitis share similar symptoms, many people with the infection never experience any. If symptoms do appear, they can include¹:

  • Feeling sick to your stomach (nausea)
  • Diarrhea (HAV only)
  • Vomiting
  • Stomach pain
  • Loss of appetite
  • Feeling tired
  • Fever
  • Joint pain
  • Jaundice (jawn-dis): yellow skin or eyes, dark urine, pale or clay-colored stools

How long can you have hepatitis A, B, or C without symptoms?

Viral hepatitis can often go undetected because many people don't experience any symptoms, at least initially. For those with acute infections, symptoms can take anywhere from 2 weeks to 6 months to appear, if they develop at all. And with chronic infections, it can take many years—even decades—before noticeable symptoms finally surface.¹

The average time from exposure to symptoms (incubation period)¹:

Hepatitis A

15 to 50 days (28 days, on average)

Hepatitis B

60 to 150 days (90 days, on average)

Hepatitis C

14 to 182 days (14 to 84 days, on average)

The incubation period is when the virus is actively multiplying in your body. Once the virus has replicated enough to be detected as a threat, your immune system will initiate an attack against it. The symptoms you experience are a result of this immune response.⁶

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References

  1. Centers for Disease Control and Prevention (CDC). Clinical overview of viral hepatitis. Accessed June 20, 2024. https://www.cdc.gov/hepatitis/hcp/clinical-overview/index.html 
  2. MedlinePlus. Hepatitis. Accessed June 20, 2024. https://medlineplus.gov/hepatitis.html 
  3. Cleveland Clinic. Viral hepatitis. Accessed June 20, 2024. https://my.clevelandclinic.org/health/diseases/4245-hepatitis-viral-hepatitis-a-b--c 
  4. Centers for Disease Control and Prevention (CDC). Viral hepatitis basics. Accessed June 20, 2024. https://www.cdc.gov/hepatitis/about/index.html
  5. American Liver Foundation. Hepatitis (inflammation). Accessed June 20, 2024. https://liverfoundation.org/about-your-liver/how-liver-diseases-progress/hepatitis-inflammation  
  6. Cleveland Clinic. Hepatitis A. Accessed June 20, 2024. https://my.clevelandclinic.org/health/diseases/21198-hepatitis-a 
  7. Centers for Disease Control and Prevention (CDC). STI awareness week. Know the facts. Accessed June 20, 2024. https://www.cdc.gov/sti-awareness/gyt/know-the-facts.html