What’s the Difference Between Hepatitis A, B, and C?

Hepatitis is a condition that occurs when your liver becomes inflamed. There are several things that can cause hepatitis, including viral infections, autoimmune conditions, and heavy alcohol use.

Many times, hepatitis is caused by a virus. When this happens, it’s called viral hepatitis. The most common types of viral hepatitis in the United States are:

  • hepatitis A
  • hepatitis B
  • hepatitis C

These forms of hepatitis are each caused by a different virus and are spread in different ways. Some infections caused by these viruses may only last a short amount of time (acute), while others may be long-lasting (chronic).

In this article, we’ll break down the differences between hepatitis A, B, and C in greater detail.

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What is hepatitis?

Viral hepatitis is a condition that causes inflammation of your liver. When a hepatitis virus enters your body, it travels to the liver. It can then enter liver cells (hepatocytes) and begin to replicate, making more of itself.

The activity of the virus can cause damage to your liver cells. Immune cells begin to travel to your liver to fight the infection. This can also contribute to inflammation.

Liver damage and inflammation can affect your liver’s ability to function, which can in turn affect your overall health. This is because your liver has several important functions for your body, including:

  • breaking down or filtering various substances in the body, such as drugs and toxins
  • producing bile, which is important for digestion
  • making important blood proteins, including those that help your blood to clot
  • storing additional blood sugar (glucose) as glycogen, which can be used for energy later
  • synthesizing immune system factors that are important for fighting infections

Symptoms of viral hepatitis

The symptoms of hepatitis A, B, and C are all fairly similar. They may include:

  • fever
  • fatigue
  • pain in the upper right area of your abdomen
  • joint pain
  • nausea or vomiting
  • diarrhea (usually only with hepatitis A)
  • loss of appetite
  • yellowing of the skin or eyes (jaundice)
  • dark urine
  • pale, clay-colored stool

However, it’s possible to contract viral hepatitis and not have any noticeable symptoms. Because of this, some people are unaware that they have viral hepatitis.

Hepatitis A

Hepatitis A is caused by the hepatitis A virus (HAV) and has become relatively uncommon in the United States. According to the Centers for Disease Control and Prevention (CDC), there were only about 24,900 hepatitis A infections in the United States in 2018.

Areas of the world where hepatitis A is more common include certain parts of:

  • Africa
  • Asia
  • Central and South America
  • Eastern Europe

How do you get it?

HAV can be present in the stool (poop) and blood of someone with the virus. It’s mainly transmitted through the fecal-oral route, which involves ingesting virus that’s present in the stool of someone with hepatitis A.

There are several ways you can get hepatitis A:

  • having close person-to-person contact with someone who has hepatitis A, such as:
    • taking care of someone who’s currently sick
    • having sex with someone who has the virus
  • consuming contaminated food or drink, including:
    • eating food that’s been prepared by someone with hepatitis A who didn’t wash their hands after using the bathroom
    • drinking untreated, infected water
    • eating food that’s been washed or prepared using untreated water
    • eating undercooked shellfish that was sourced from sewage-contaminated water
  • having contact with contaminated objects, such as toilets and diaper changing areas and then not washing your hands

How does it affect the body?

The incubation period for hepatitis A can be between 15 and 50 days (the average is 28 days). After this time, you may experience symptoms. Unlike hepatitis B and C, hepatitis A only causes an acute or short-term illness.

What are the risk factors?

Some people are at an increased risk for contracting HAV, including:

  • people traveling to areas of the world where hepatitis A is common
  • men who have sex with men
  • people who use injectable or noninjectable drugs
  • caregivers for those who have hepatitis A
  • people who are experiencing homelessness
  • people living with a child who’s been adopted from an area where hepatitis A is common

How is it treated?

Hepatitis A is treated using supportive methods. These can include things like rest, fluids, and healthy foods. Medications can also help to ease some symptoms like fever, aches, and pains.

There’s a vaccine available to protect against infection with HAV. This is typically recommended for children as well as for people at an increased risk for contracting the virus.

Also, receiving a single dose of the hepatitis A vaccine may prevent you from becoming ill if you’ve been exposed to HAV. For it to be effective, the vaccine needs to be given within 2 weeks of exposure.

What is the outlook?

Most people with hepatitis A recover without any complications. Once you’ve had hepatitis A, you can’t get it again. Antibodies to the virus will protect you for life.

Some people may be at an increased risk for serious illness from hepatitis A. These include:

  • older adults
  • people living with HIV
  • people who already have liver disease

Hepatitis B

Hepatitis B is caused by the hepatitis B virus (HBV). The CDC estimates that there were about 21,600 acute hepatitis B infections in the United States in 2018.

How do you get it?

You can contract HBV by coming into contact with the blood or bodily fluids of someone with hepatitis B. This can happen by:

  • having sex with someone with hepatitis B
  • sharing injectable drug equipment
  • being born to a mother with hepatitis B
  • having direct contact with blood or open sores of someone with hepatitis B
  • getting accidental injuries, such as needle sticks or sharps injuries
  • sharing personal items that may come into contact with blood or other bodily fluids, such as razors, toothbrushes, or nail clippers

How does it affect the body?

The incubation period for hepatitis B can range from 60 to 150 days (90 days on average). However, not everyone who has acute hepatitis B will experience symptoms.

About 95 percent of adults completely recover from hepatitis B. However, hepatitis B can also become chronic.

The risk of chronic hepatitis B is greatest in those who were exposed to HBV as young children. Many people with chronic hepatitis B don’t have symptoms until significant liver damage has occurred.

In some people who’ve had hepatitis B, the virus can reactivate later on. When this happens, symptoms and liver damage may occur. People with a weakened immune system and those being treated for hepatitis C are at a higher risk for HBV reactivation.

What are the risk factors?

The groups at an increased risk of contracting HBV are:

  • sexual partners of someone with hepatitis B
  • men who have sex with men
  • infants born to a mother with hepatitis B
  • people who use injectable drugs
  • those with an increased risk for occupational exposure to HBV, such as healthcare workers
  • people receiving dialysis

How is it treated?

Similarly to hepatitis A, acute hepatitis B is typically treated using supportive measures. Antiviral medications are available for people with chronic hepatitis B. Some examples of these medications include:

  • entecavir (Baraclude)
  • tenofovir alafenamide (Vemlidy)
  • tenofovir disoproxil fumarate (Viread)

People with chronic hepatitis B will need to be monitored by a healthcare professional. This is necessary to detect any signs of liver damage or liver cancer.

A vaccine is available for hepatitis B. It’s typically given to all infants, children, and teens in the United States. Vaccination is also recommended for adults who are at a higher risk for contracting HBV.

What is the outlook?

The symptoms of acute hepatitis B can last for weeks to months and are often mild. More serious illness can happen in older adults.

Having chronic hepatitis B can increase your risk for developing cirrhosis or liver cancer. However, when HBV is diagnosed and treated early, the chances of serious complications are lower.

According to the CDC, about 862,000 people in the United States were living with chronic hepatitis B in 2016. The condition contributed to a total of 1,649 deaths in the United States in 2018.

Hepatitis C

Hepatitis C is caused by the hepatitis C virus (HCV). The CDC estimates that about 50,300 new acute hepatitis C infections occurred in the United States in 2018.

How do you get it?

HCV is transmitted by blood and bodily fluids that can contain blood. Some of the ways that you can contract HCV include:

  • sharing injectable drug equipment
  • being born to a mother with hepatitis C
  • having sex with someone who has hepatitis C
  • getting a piercing or tattoo with equipment that’s been reused or hasn’t been properly sterilized
  • getting accidental injuries, such as needle sticks or sharps injuries
  • sharing personal items that may come in contact with blood or other body fluids, such as razors, toothbrushes, or nail clippers
  • receiving donated blood, blood products, or organs prior to the 1990s

How does it affect the body?

The average incubation period for hepatitis C is between 14 and 84 days, but it can last up to 182 days. Some people only experience an acute illness, after which the body clears the virus. Like hepatitis B, acute hepatitis C can last from weeks to months.

More than half of people with hepatitis C develop a chronic form of the disease. Many people with chronic hepatitis C don’t have symptoms, while some may have nonspecific symptoms like fatigue or feelings of depression.

People with chronic hepatitis C can eventually develop cirrhosis or liver cancer. This often takes many years to happen. Some factors that can put you at increased risk for developing cirrhosis include:

  • being over 50 years old
  • being male
  • drinking alcohol
  • taking immunosuppressive medications
  • having another type of liver disease

What are the risk factors?

The following groups are at increased risk for contracting hepatitis C:

  • injectable drug users
  • people living with HIV
  • infants born to mothers with HCV
  • those with an increased risk for occupational exposure to HCV, such as healthcare workers
  • people who’ve received dialysis
  • people who received a blood transfusion or an organ transplant prior to 1992
  • those who’ve received clotting factors before 1987

How is it treated?

Effective antiviral drugs are available for people with HCV. Currently, the same antiviral drugs are recommended for both acute and chronic hepatitis C.

A course of antiviral therapy for HCV typically includes 8 to 12 weeks of oral medication. A few examples of antiviral drugs used to treat hepatitis C include:

  • daclatasvir (Daklinza)
  • elbasvir/grazoprevir (Zepatier)
  • ledipasvir/sofosbuvir (Harvoni)
  • simeprevir (Olysio)
  • sofosbuvir (Sovaldi)

It’s estimated that over 90 percent of people with HCV can be cleared of the virus with a course of antiviral drugs. However, it’s still possible to contract HCV again after you’ve completed treatment.

There’s currently no vaccine for HCV.

What is the outlook?

Some people with hepatitis C will have an acute illness that resolves on its own. However, most people develop chronic hepatitis C.

Regardless of whether it’s acute or chronic, hepatitis C is treatable with antiviral drugs. Early diagnosis and treatment are important to prevent liver damage from occurring.

The CDC reports that about 2.4 million people in the United States were living with chronic hepatitis C from 2013 to 2016. Chronic hepatitis C contributed to 15,713 deaths in the United States in 2018.

Finding help for hepatitis

If you’ve been diagnosed with viral hepatitis, there are a variety of resources that are available to help you. Let’s explore a few of them below:

  • Your doctor. Your doctor is a great first point of contact for questions and concerns. They can help you to better understand the type of hepatitis you have, as well as how it will be treated.
  • American Liver Foundation (ALF). ALF is dedicated to ending liver disease through education, research, and advocacy. Their site has educational material about viral hepatitis, as well as ways to find doctors, support groups, and clinical trials in your area.
  • Patient assistance programs. If you have hepatitis C, the cost of antiviral drugs can be high. The good news is that many drug manufacturers have patient assistance programs that can help you pay for these medications.
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Hepatitis A vs. B vs. C

The chart below is an at-a-glance summary of some of the key differences between hepatitis A, B, and C.

Hepatitis A Hepatitis B Hepatitis C
Transmission mainly fecal-oral contact with blood and other bodily fluids that contain HBV contact with blood that contains HCV
Incubation period 15–50 days 60–150 days 14–84 days
Acute vs. chronic acute only can be acute or chronic; most adults clear the virus, but children who contract HBV are more likely to have chronic hepatitis B can be acute or chronic; over half of people that contract the virus will develop a chronic hepatitis C
Treatment supportive care acute: supportive care; chronic: antiviral drugs may be used a course of antiviral drugs, which can clear the virus in most people
Vaccine available? yes yes no

The takeaway                                        

Hepatitis is a condition that causes your liver to become inflamed. Hepatitis A, B, and C are all caused by different viruses.

While these three viruses can cause similar symptoms, they differ in several ways, including how they’re transmitted and treated. Additionally, hepatitis A only causes an acute illness while hepatitis B and C can become chronic.

Contracting viral hepatitis can potentially lead to liver damage. See your doctor if you believe you’ve been exposed to a hepatitis virus or if you have symptoms of hepatitis.

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