Viral Hepatitis – What Do You Need to Know

Viral Hepatitis

Viral hepatitis is an infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs. Researchers have discovered several different viruses that cause hepatitis, including hepatitis A, B, C, D, and E.
In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

The difference between hepatitis A, hepatitis B, and hepatitis C.

Hepatitis A and hepatitis E typically spread through contact with food or water that has been contaminated by an infected person’s stool. People may also get hepatitis E by eating undercooked pork, deer, or shellfish.
Hepatitis B, hepatitis C, and hepatitis D spread through contact with an infected person’s blood. Hepatitis B and D may also spread through contact with other body fluids. This contact can occur in many ways, including sharing drug needles or having unprotected sex.
The hepatitis A and E viruses typically cause only acute, or short-term, infections. In an acute infection, your body is able to fight off the infection and the virus goes away.
The hepatitis B, C, and D viruses can cause acute and chronic, or long-lasting, infections. Chronic hepatitis occurs when your body isn’t able to fight off the hepatitis virus and the virus does not go away. Chronic hepatitis can lead to complications such as cirrhosis, liver failure, and liver cancer . Early diagnosis and treatment of chronic hepatitis can prevent or lower your chances of developing these complications.
When doctors can’t find the cause of a person’s hepatitis, they may call this condition non-A–E hepatitis or hepatitis X. Experts think that unknown viruses other than hepatitis A, B, C, D, and E may cause some cases of hepatitis. Researchers are working to identify these viruses.
Although non-A–E hepatitis is most often acute, it can become chronic.

Question & Answer

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Hepatitis A

What is hepatitis A?

Hepatitis A is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis A virus typically spreads through contact with food or water that has been contaminated by an infected person’s stool.
Hepatitis A is an acute or short-term infection, which means people usually get better without treatment after a few weeks. Hepatitis A does not lead to long-term complications, such as cirrhosis, because the infection only lasts a short time.
You can take steps to protect yourself from hepatitis A, including getting the hepatitis A vaccine. If you have hepatitis A, you can take steps to prevent spreading hepatitis A to others.

What causes hepatitis A?

The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected person’s stool. Contact can occur by:

  • eating food made by an infected person who did not wash his or her hands after using the bathroom
    drinking untreated water or eating food washed in untreated water.
  • Placing a finger or an object in your mouth that came into contact with an infected person’s stool.
  • Having close personal contact with an infected person, such as through sex or caring for someone who is ill.

You cannot get hepatitis A from:

  • Being coughed on or sneezed on by an infected person.
  • sitting next to an infected person
  • hugging an infected person
  • A baby cannot get hepatitis A from breast milk.

Who is more likely to get hepatitis A?

People more likely to get hepatitis A are those who:

  • travel to developing countries
  • have sex with an infected person
  • are men who have sex with men
  • use illegal drugs, including drugs that are not injected
  • live with or care for someone who has hepatitis A

What are the symptoms of hepatitis A?

Some people have symptoms 2 to 6 weeks after they come in contact with the virus.2 People with hepatitis A typically get better without treatment after a few weeks. In some cases, symptoms can last up to 6 months. These symptoms may include:

  • dark yellow urine
  • feeling tired
  • fever
  • gray- or clay-colored stools
  • joint pain
  • loss of appetite
  • nausea
  • pain in the abdomen
  • vomiting
  • yellowish eyes and skin, called jaundice
  • Some people infected with hepatitis A have no symptoms, including many children younger than age 6.Older children and adults are more likely to have symptoms.

How can I protect myself from hepatitis A infection?

You can protect yourself from hepatitis A by getting the hepatitis A vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.
If you have had hepatitis A in the past, you cannot get hepatitis A again. You can still get other types of viral hepatitis though.

Hepatitis A vaccine

All children should receive the hepatitis A vaccine between 12 and 23 months of age. People who are more likely to be infected and people with chronic liver disease should also receive the vaccine.
Doctors give the hepatitis A vaccine in two shots. You should get the second shot 6 to 12 months after the first shot. You need to get both shots to be fully protected against the virus.
If you are traveling to a developing country where hepatitis A is common and you haven’t received the hepatitis A vaccine, try to get both shots before you go. If you don’t have time to get both shots, get the first shot as soon as you can. Most people gain some protection within 2 weeks of the first shot.

Reduce your chance of infection

You can reduce your chance of hepatitis A by:

  • washing your hands thoroughly with soap and warm water for 15 to 30 seconds
  • after using the toilet
  • after changing diapers
  • before and after handling or preparing food

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Prevent infection after contact with the virus

If you think you have come in contact with the hepatitis A virus, see your doctor right away. A dose of the hepatitis A vaccine or a medicine called hepatitis A immune globulin may protect you from getting the infection. Your doctor may recommend a vaccine dose or medicine if:

  • you live with, have had sex with, or have had close contact with someone who has hepatitis A
  • you shared illegal drugs with someone who had hepatitis A
  • you ate food or drank water possibly containing the hepatitis A virus

You must get the vaccine dose or medicine shortly after coming into contact with the virus to prevent infection.

Hepatitis B

What is hepatitis B?

Hepatitis B is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis B virus spreads through contact with an infected person’s blood, semen, or other body fluids.
The hepatitis B virus can cause an acute or chronic infection.

Acute hepatitis B

Acute hepatitis B is a short-term infection. If you have symptoms, they may last several weeks. In some cases, symptoms last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away. Most healthy adults and children older than 5 years old who have hepatitis B get better without treatment.

Chronic hepatitis B

Chronic hepatitis B is a long-lasting infection. Chronic hepatitis B occurs when your body isn’t able to fight off the virus and the virus does not go away.
Your chances of developing chronic hepatitis B are greater if you are infected with the virus as a young child. About 90 percent of infants infected with hepatitis B develop a chronic infection. About 25 to 50 percent of children infected between the ages of 1 and 5 years develop chronic infections. However, among people infected during adulthood, only about 5 percent develop chronic hepatitis B.

What causes hepatitis B?

The hepatitis B virus causes hepatitis B. The hepatitis B virus spreads through contact with an infected person’s blood, semen, or other body fluids. Contact can occur by:

  • being born to a mother with hepatitis B
  • having unprotected sex with an infected person
  • sharing drug needles or other drug materials with an infected person
  • getting an accidental stick with a needle that was used on an infected person
  • being tattooed or pierced with tools that were used on an infected person and weren’t properly sterilized, or cleaned in a way that destroys all viruses and other microbes
  • having contact with the blood or open sores of an infected person
  • using an infected person’s razor, toothbrush, or nail clippers

You can’t get hepatitis B from:

  • being coughed on or sneezed on by an infected person
  • drinking water or eating food
  • hugging an infected person
  • shaking hands or holding hands with an infected person
  • sharing spoons, forks, and other eating utensils
  • sitting next to an infected person

A baby can’t get hepatitis B from breast milk.

Should I be screened for hepatitis B?

Your doctor may recommend screening for hepatitis B if you:

  • are pregnant
  • were born in an area of the world where chronic hepatitis B is more common
  • didn’t receive the hepatitis B vaccine as an infant and have parents who were born in an area where chronic hepatitis B was especially common, such as sub-Saharan Africa, parts of Asia, or the Pacific Islands
    are HIV positive
  • have injected drugs
  • are a man who has sex with men
  • have lived with or had sex with a person who has hepatitis B
  • have an increased chance of infection due to other factors

Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis B. Many people who have hepatitis B don’t have symptoms and don’t know they have hepatitis B. Screening tests can help doctors diagnose and treat hepatitis B, which can lower your chances of developing serious health problems.

What are the symptoms of hepatitis B?

Some people infected with hepatitis B have no symptoms. Some people have symptoms of acute hepatitis B within 2 to 5 months after they come in contact with the virus. These symptoms may include:

  • dark yellow urine
  • feeling tired
  • fever
  • gray- or clay-colored stools
  • joint pain
  • loss of appetite
  • nausea
  • pain in your abdomen
  • vomiting
  • yellowish eyes and skin, called jaundice

Infants and children younger than age 5 typically don’t have symptoms of acute hepatitis B. Older children and adults are more likely to have symptoms.
If you have chronic hepatitis B, you may not have symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis B screening is important, even if you have no symptoms.
If you have ever had hepatitis B, certain medicines may cause the hepatitis B virus to begin damaging your liver and causing symptoms. These medicines include:

  • immunosuppressants—medicines that weaken your immune system—which doctors prescribe to treat many diseases, including cancer , rheumatoid arthritis , and inflammatory bowel disease
  • hepatitis C medicines

Your doctor may test you for hepatitis B before you begin taking these medicines, even if you have no hepatitis B symptoms.

How can I protect myself from hepatitis B infection?

You can protect yourself from hepatitis B by getting the hepatitis B vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.

Hepatitis B vaccine

The hepatitis B vaccine has been available since the 1980s and should be given to newborns, children, and teens in the United States. Adults who are more likely to be infected with hepatitis B should also get the vaccine. The hepatitis B vaccine is safe for pregnant women.
Doctors most often give the hepatitis B vaccine in three shots over 6 months. You must get all three shots to be fully protected.
If you are traveling to countries where hepatitis B is common and you haven’t received the hepatitis B vaccine, try to get all the shots before you go. If you don’t have time to get all the shots before you travel, get as many as you can. Even one shot may give you some protection against the virus.

Reduce your chance of infection

You can reduce your chance of hepatitis B infection by:

  • not sharing drug needles or other drug materials
  • wearing gloves if you have to touch another person’s blood or open sores
  • making sure your tattoo artist or body piercer uses sterile tools
  • not sharing personal items such as toothbrushes, razors, or nail clippers
  • using a latex or polyurethane condom during sex

Prevent infection after contact with the virus

If you think you have been in contact with the hepatitis B virus, see your doctor right away. A dose of the hepatitis B vaccine and, in some cases, a medicine called hepatitis B immune globulin (HBIG), may protect you from getting sick. You must get the vaccine dose and HBIG shortly after coming into contact with the virus, preferably within 24 hours.

Hepatitis C

What is hepatitis C?

Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person’s blood.
Hepatitis C can cause an acute or chronic infection.
Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.

Acute hepatitis C

Acute hepatitis C is a short-term infection. Symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away.

Chronic hepatitis C

Chronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when your body isn’t able to fight off the virus. About 75 to 85 percent of people with acute hepatitis C will develop chronic hepatitis C.
Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer .

What causes hepatitis C?

The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected person’s blood. Contact can occur by:

  • sharing drug needles or other drug materials with an infected person
  • getting an accidental stick with a needle that was used on an infected person
  • being tattooed or pierced with tools or inks that were not kept sterile—free from all viruses and other microorganisms—and were used on an infected person before they were used on you
  • having contact with the blood or open sores of an infected person
  • using an infected person’s razor, toothbrush, or nail clippers
  • being born to a mother with hepatitis C
  • having unprotected sex with an infected person

You can’t get hepatitis C from:

  • being coughed or sneezed on by an infected person
  • drinking water or eating food
  • hugging an infected person
  • shaking hands or holding hands with an infected person
  • sharing spoons, forks, and other eating utensils
  • sitting next to an infected person

A baby can’t get hepatitis C from breast milk.

Who is more likely to get hepatitis C?

People more likely to get hepatitis C are those who:

  • have injected drugs
  • had a blood transfusion or organ transplant before July 1992
  • have hemophilia and received clotting factor before 1987
  • have been on kidney dialysis
  • have been in contact with blood or infected needles at work
  • have had tattoos or body piercings
  • have worked or lived in a prison
  • were born to a mother with hepatitis C
  • are infected with HIV
  • have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
  • are men who have or had sex with men

In the United States, injecting drugs is the most common way that people get hepatitis C.

What are the symptoms of hepatitis C?

Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include

If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.

How can I protect myself from hepatitis C infection?

If you don’t have hepatitis C, you can help protect yourself from hepatitis C infection by:

  • not sharing drug needles or other drug materials
  • wearing gloves if you have to touch another person’s blood or open sores
  • making sure your tattoo artist or body piercer uses sterile tools and unopened ink
  • not sharing personal items such toothbrushes, razors, or nail clippers

Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices , such as using a latex or polyurethane condom to help prevent the spread of hepatitis C.
If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection.
If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.

Hepatitis D

What is hepatitis D?

Hepatitis D is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can spread from person to person.
The hepatitis D virus is unusual because it can only infect you when you also have a hepatitis B virus infection. In this way, hepatitis D is a double infection. You can protect yourself from hepatitis D by protecting yourself from hepatitis B by getting the hepatitis B vaccine.
Hepatitis D spreads the same way that hepatitis B spreads, through contact with an infected person’s blood or other body fluids.
The hepatitis D virus can cause an acute or chronic infection, or both.

Acute hepatitis D

Acute hepatitis D is a short-term infection. The symptoms of acute hepatitis D are the same as the symptoms of any type of hepatitis and are often more severe.19 Sometimes your body is able to fight off the infection and the virus goes away.
In rare cases, acute hepatitis D can lead to acute liver failure, a condition in which the liver fails suddenly. Although acute liver failure is uncommon, hepatitis D and B infections are more likely to lead to acute liver failure than hepatitis B infection alone.

Chronic hepatitis D

Chronic hepatitis D is a long-lasting infection. Chronic hepatitis D occurs when your body is not able to fight off the virus and the virus does not go away. People who have chronic hepatitis B and D develop complications more often and more quickly than people who have chronic hepatitis B alone.
Chronic hepatitis D may lead to cirrhosis, liver failure, and liver cancer. People who have chronic hepatitis B and D are more likely to develop these complications than people who have chronic hepatitis B alone. Early diagnosis and treatment of chronic hepatitis B and D can lower your chances of developing serious health problems.

    • Cirrhosis

Cirrhosis is a condition in which the liver slowly breaks down and is unable to work normally. Scar tissue replaces healthy liver tissue, partly blocking the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to work. As cirrhosis gets worse, the liver begins to fail.

    • Liver failure

Also called end-stage liver disease, liver failure progresses over months or years. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

    • Liver cancer

Having chronic hepatitis B and chronic hepatitis D increases your chance of developing liver cancer . Your doctor may suggest an ultrasound or other type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What causes hepatitis D?

The hepatitis D virus causes hepatitis D. The hepatitis D virus spreads through contact with an infected person’s blood or other body fluids. Contact can occur by:

  • sharing drug needles or other drug materials with an infected person
  • having unprotected sex with an infected person
  • getting an accidental stick with a needle that was used on an infected person

The hepatitis D virus rarely spreads from mother to child during birth.
You can’t get hepatitis D from:

  • being coughed on or sneezed on by an infected person
  • drinking water or eating food
  • hugging an infected person
  • shaking hands or holding hands with an infected person
  • sharing spoons, forks, and other eating utensils
  • sitting next to an infected person

What are the symptoms of hepatitis D?

Most people with acute hepatitis D have symptoms, which may include:

  • feeling tired
  • nausea and vomiting
  • poor appetite
  • pain over the liver, in the upper part of the abdomen
  • darkening of the color of urine
  • lightening of the color of stool
  • yellowish tint to the whites of the eyes and skin, called jaundice

In contrast, most people with chronic hepatitis D have few symptoms until complications develop, which could be several years after they were infected. Some symptoms of cirrhosis include:

  • weakness and feeling tired
  • weight loss
  • swelling of the abdomen
  • swelling of the ankles, called edema
  • itching skin
  • jaundice

Who is more likely to have hepatitis D?

Hepatitis D infection occurs only in people who have hepatitis B. People are more likely to have hepatitis D in addition to hepatitis B if they:

  • are injection-drug users
  • have lived with or had sex with someone who has hepatitis D
  • are from an area of the world where hepatitis D is more common

How do hepatitis D and hepatitis B infections occur together?

Hepatitis D and hepatitis B infections may occur together as a coinfection or a superinfection. People can only become infected with hepatitis D when they also have hepatitis B.

    • Coinfection

A coinfection occurs when you get both hepatitis D and hepatitis B infections at the same time. Coinfections usually cause acute, or short-term, hepatitis D and B infections. Coinfections may cause severe acute hepatitis.
In most cases, people are able to recover from and fight off the acute hepatitis D and B infections and the viruses go away. However, in less than 5 percent of people with a coinfection, both infections become chronic and do not go away.

    • Superinfection

A superinfection occurs if you already have chronic hepatitis B and then become infected with hepatitis D. When you get a superinfection, you may have severe acute hepatitis symptoms.Up to 90 percent of people with a superinfection are not able to fight off the hepatitis D virus, and develop chronic hepatitis D. As a result, these people will have both chronic hepatitis D and chronic hepatitis B.

How can I protect myself from hepatitis D infection?

If you have hepatitis D, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they aren’t infected, get the hepatitis B vaccine. Preventing hepatitis B will also prevent hepatitis D.
You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis D. Don’t donate blood or blood products, semen, organs, or tissue.

Hepatitis E

What is hepatitis E?

Hepatitis E is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. The hepatitis E virus has different types that spread in different ways.

  • Some types are spread by drinking contaminated water. These types are more common in developing countries, including parts of Africa, Asia, Central America, and the Middle East.
  • Other types are spread by eating undercooked pork or wild game, such as deer. These types are more common in developed countries, such as the United States, Australia, Japan, and parts of Europe and East Asia.

Hepatitis E typically causes acute, or short-term, infection.

Acute hepatitis E

Acute hepatitis E is a short-term infection. In most cases, people’s bodies are able to recover and fight off the infection and the virus goes away. People usually get better without treatment after several weeks.
Most people recover from acute hepatitis E without complications. In some cases, acute hepatitis E may cause acute liver failure, a condition in which the liver fails suddenly. Acute liver failure due to hepatitis E is more common in pregnant women and people who have other liver diseases.
In pregnant women, hepatitis E can cause other complications for the mother and baby, such as stillbirth, premature birth, or low birthweight .

Chronic hepatitis E

Chronic hepatitis E is a long-lasting infection that occurs when your body isn’t able to fight off the virus and the virus does not go away. Chronic hepatitis E is rare and only occurs in people with weakened immune systems. For example, hepatitis E may become chronic in people taking medicines that weaken their immune system after an organ transplant, or in people who have HIV or AIDS .

What causes hepatitis E?

The hepatitis E virus causes hepatitis E. In developing countries, hepatitis E typically spreads through drinking contaminated water. In developed countries, such as the United States, hepatitis E typically spreads from animals to people, when people eat undercooked pork or wild game, such as deer.
Research suggests that hepatitis E can also spread through blood transfusion , but this is very rare.

Who is more likely to get hepatitis E?

Different types of hepatitis E are more likely to affect different groups of people. The types of hepatitis E that are more common in developing countries are more likely to affect adolescents and young adults.
In contrast, the types of hepatitis E that are more common in developed countries most often affect older men.

What are the symptoms of hepatitis E?

Many people infected with hepatitis E have no symptoms. Some people have symptoms 15 to 60 days after they become infected with the virus. These symptoms may include:

  • feeling tired
  • nausea and vomiting
  • poor appetite
  • pain over the liver, in the upper part of the abdomen
  • darkening of the color of urine
  • lightening of color of stool
  • yellowish tint to the whites of the eyes and skin, called jaundice

People with hepatitis E typically get better without treatment after several weeks.

How can I protect myself from hepatitis E infection?

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.
Also, make sure any pork or deer you eat is thoroughly cooked, both in developing countries and in developed countries such as the United States.

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Source:

  • The National Institute of Diabetes and Digestive and Kidney Diseases
  • CDC
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