What is the difference between Hepatitis A, B, and C?

Hepatitis A, B, and C are diseases caused by different viruses that all attack the liver. Although they can also cause similar symptoms, each type is transmitted differently and can affect the liver differently.

Hepatitis A appears only as an acute or newly occurring infection and does not become chronic. Most people with Hepatitis A can improve without treatment, although a small fraction may need supportive care or hospitalization to recover fully.

Hepatitis B and Hepatitis C can also begin as acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems including risk of liver cancer. There are vaccines to prevent Hepatitis A and B; however, there is no vaccine for Hepatitis C. If a person has had one type of viral hepatitis in the past, it is still possible to get the other types.

How the viruses are transmitted

Hepatitis A virus (HAV) is transmitted through several methods including consuming food contaminated due to poor hand-washing of a restaurant staff person, caring for someone who has the disease, or, less commonly, through sexual contact. Infections are often mild, with most people making a full recovery and remaining immune from further HAV infections.

Hepatitis B virus (HBV) is transmitted through exposure to infected blood, semen, and certain other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or among family member to infant in early childhood. Babies infected at the time of birth have a high rate of developing chronic hepatitis B infection.

Hepatitis C virus (HCV) is mostly transmitted through exposure to infected blood. In the US, this most commonly happens through injection drug use. Sexual transmission is also possible but is much less common. Transmission from infected mothers to infants at the time of birth is rare.

Symptoms

Hepatitis A, B and C share many of the same symptoms which can range from mild to severe and can take anywhere from a few weeks to a few months after infection before they appear.

 Diagnosis

Hepatitis A, B and C can all be diagnosed through blood tests that determines if the virus is in your system. Additional tests may be helpful in assessing whether there is ongoing liver damage and whether the function of the liver is being affected.

Treatment

Hepatitis A

Although there is no specific treatment for hepatitis A, the virus will go away on its own and does not cause any lasting damage to your liver. While you are recovering from hepatitis A it is helpful to get plenty of rest, eat small but nutritious meals and avoid alcohol which taxes your liver. You should also review a list of prescription and over-the-counter medications you are taking with your doctor to ensure that they are not putting any additional strain on your liver.

Hepatitis B

Hepatitis B is not curable, but it is treatable. If you know you’ve been exposed to the hepatitis B virus, call your doctor immediately. Depending on the type of exposure and the amount of time since the exposure, there may be useful treatments to reduce your risk of being infected.

If you have acute (short-term) hepatitis B, you may not need treatment other than taking care to eat a healthy diet, get plenty of rest and fluids, and avoid alcohol and acetaminophen (e.g., Tylenol or other brands).

If tests determine that you have chronic (long-term) hepatitis B, treatment may include an antiviral medication that can help fight the virus and slow the progression of liver damage. Depending on the severity of the liver problems and other medical conditions, you may be a candidate for injections of interferon alfa-2b, which is a synthetic version of a substance produced by the body to fight infection. Those with chronic hepatitis B should be screened for liver damage and liver cancer every 6 – 12 months, by some combination of blood tests and ultrasound imaging of the liver. Your doctor can determine the right monitoring if you have chronic hepatitis B. In cases where the liver has been severely damaged, a liver transplant may be considered.

Hepatitis C

Acute hepatitis C does not require any treatment aside from the self-care measures outlined for hepatitis A and B. Chronic hepatitis C infection can be cured with antiviral medication. The choice of medications and length of treatment depend on the strain of hepatitis C, presence of existing liver damage, other medical conditions and prior treatments. A person is considered cured if they have no sign of the hepatitis C virus in their body after 3 months of treatment. As with hepatitis B, a liver transplant may be considered for those with severe liver damage, but a liver transplant alone does not cure hepatitis C. Since the infection is likely to return, antiviral medication may be required to prevent damage to the transplanted liver.

Some Tips to Help Avoid Viral Hepatitis

• Vaccinations are available to prevent hepatitis A and B, but not for hepatitis C.  Infants in the US are routinely vaccinated against hepatitis B, with the first dose usually being given before the baby leaves the hospital. Hepatitis A vaccine is now part of the routine childhood vaccine schedule as well.
• When traveling to the developing world, it is important to keep in mind that not all places have access to clean water, and therefore your exposure to hepatitis A can be increased. Avoid tap water, ice cubes, and raw fruits and vegetables that may have been washed with contaminated water. Remember to brush your teeth with bottled water. If you haven’t been vaccinated against hepatitis A before, it’s a good idea before visiting developing countries.
• Practice safe sex. Having unprotected sex puts you at risk for contracting hepatitis A and B from someone who has the virus.
• Since only a trace amount of infected blood puts you at risk for contracting hepatitis B and C from someone who is infected, never share needles, razors or a toothbrush. If you are getting a tattoo or body piercing, be sure that all needles are sterilized.

For more information about hepatitis A, B and C, visit the CDC website.

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