Expert Answers: What Are the Differences Between Hepatitis A, B, and C?

Most people have heard of hepatitis, B, and C, but the differences between types can be confusing. Several of our community members have asked us to explain, so here is what our expert, Sue Simon, had to say:

Understanding hepatitis viruses

Hepatitis A, B and C are all caused by viruses. However, there are many differences between these viral infections. They do share some of the same risk factors, as well as some symptoms, but they differ in many important ways.

What is hepatitis A?

The virus may cause a mild illness with few symptoms, or it may cause a person to feel seriously ill. Symptoms often include nausea, pain in upper right quadrant of the abdomen, fever, joint pain, loss of appetite, and jaundice. Some people feel better after a very short illness, while others may stay extremely ill for many weeks.

What are hep A risks?

The following put a person at a high risk of acquiring hepatitis A: Traveling in areas where hepatitis A is common, living with an infected person, injecting illicit drugs, having oral/anal contact with another person, working in crowded unsanitary conditions, and even working in a child care facility. The virus is transmitted mainly through the fecal-oral route. Patients may become infected through eating food handled by an infected person, eating shellfish from waters that contain raw sewage, having sex with an infected patient, or and just being in close contact with a person suffering from hepatitis A.

How is hep A cured?

Hepatitis A is self-limiting, which means a patient becomes ill, and then gets over it. In other words, there is no chronic stage. Treatment is supportive and includes rest, proper nutrition, and protection of the liver from alcohol and other substances that are known to cause liver damage. There are no lasting effects and once infected, the antibodies protect people from another hepatitis A infection down the road, so the patient becomes immune. There is a vaccine that protects from hepatitis A virus.

What is hepatitis B?

Hepatitis B is a serious, viral infection. When an infant becomes ill with hepatitis B, there is a 90% chance he will become chronic. Young children go on to develop chronic hepatitis B about 50% of the time. When the patient acquires the virus in adulthood, 90% - 95% get over the virus fully in the acute stage (meaning they do not go on to the chronic stage). If you believe you were exposed, contact a physician immediately, as there are preventative treatments that cut down the risk of getting the virus.

Symptoms of hepatitis B

Symptoms of hepatitis B are the same as those of hepatitis A: Jaundice, fever, loss of appetite, abdominal pain, joint pain, nausea and vomiting, and weakness and fatigue are common. Some of the more common ways to acquire hepatitis B are through sex with an infected person where sexual body fluids can enter your body, use of IV drugs and/or sharing needles, being born to a hepatitis B positive mother, being a man who has sex with men, traveling to an area such as Africa, Asia or Eastern Europe, and being stuck with a needle in a healthcare setting. Hepatitis B is considered a sexually transmitted infection.

Chronic hepatitis B may lead to cirrhosis, liver cancer, and/or liver failure. Hepatitis B may also lead to kidney disease, and anemia. There are treatments for hepatitis B, but there is no cure, and a liver transplant may be required for the patient to live. There is a preventative vaccine for hepatitis B.

What is hepatitis C?

Hepatitis C is the most common blood borne virus in the USA. It is considered to be the most serious of the hepatitis viruses. Once exposed, the majority of people (60-85%) go on to develop chronic hepatitis C. Many people do not develop symptoms until serious liver damage occurs, which may take several decades to occur. Those who do experience early onset symptoms usually complain of fatigue, muscle and joint pain, and digestive upsets. Jaundice is not a common finding in hepatitis C. Over time, as the liver develops more and more fibrosis, symptoms may include easy bruising, ascites (accumulation of fluid in the abdomen), hemorrhaging, and encephalopathy (confusion and possibly coma).

How is hep C transmitted?

Hepatitis C is transmitted when people come in contact with infected blood. Risks factors include IV drug use and sharing of needles, or having a blood transfusion or being an organ recipient before June of 1992. Other risk factors include use of clotting factors before 1987, being born to a hepatitis C positive mother, and receiving a tattoo or a piercing in unsanitary conditions. Having rough sex where blood is exchanged, or having multiple partners, may also put a person at risk. However, hepatitis C is NOT considered a sexually transmitted disease. Baby Boomers, those born between 1945 and 1965, are at increased risk as well.

What are hep C side effects?

Untreated, hepatitis C may cause patients to progress to cirrhosis and possibly liver failure, and/or develop liver cancer, called hepatocellular carcinoma. Hepatitis C is the main reason for adult liver transplantation in the United States. Recently, direct-acting antivirals have become available and are curing over 90% of previously difficult to treat genotype 1 patients. There is also no immunity conferred on patients who are cured, meaning that they may get the virus again if they come in contact with infected blood. There is NO preventative vaccine for hepatitis C.^1,2,3