What causes it?
Number of U.S. cases
- About 24,900 new infections each year
- About 22,600 new infections in 2018
- Estimated 862,000 people living with hepatitis B
- About 50,300 new infections in 2018
- Estimated 2.4 million people living with hepatitis C
Key facts
- Effective vaccine available
- Outbreaks still occur in the United States; currently there are are widespread person-to-person outbreaks
- Recent foodborne outbreaks in US traced to imported food
- Common in many countries, especially those without modern sanitation
- Effective vaccine available
- About 2 in 3 people with hepatitis B do not know they are infected
- About 50% of people with hepatitis B in the U.S are Asian
- Hepatitis B is a leading cause of liver cancer
- About 50% of people with hepatitis C do not know they are infected
- Hepatitis C is a leading cause of liver transplants and liver cancer
How long does it last?
How is it spread?
- Birth to an infected mother
- Sex with an infected person
- Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
- Sharing personal items such as toothbrushes or razors
- Poor infection control has resulted in outbreaks in health care facilities
- Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
- Receiving a blood transfusion or organ transplant before 1992 (when widespread screening virtually eliminated hepatitis C from the blood supply)
- Poor infection control has resulted in outbreaks in health care facilities
- Birth to an infected mother
Who should be vaccinated?
- All children aged 12–23 months
- All children and adolescents 2–18 years of age who have not previously received hepatitis A vaccine (known as “catch up” vaccination)
People at increased risk for hepatitis A
- International travelers
- Men who have sex with men
- People who use or inject drugs (all those who use illegal drugs)
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
- Any person who requests vaccination
- All infants
- All children and adolescents younger than 19 years of age who have not been vaccinated
- People at risk for infection by sexual exposure including: people whose sex partners have hepatitis B, sexually active people who are not in a long-term, mutually monogamous relationship, people seeking evaluation or treatment for an STD, and men who have sex with men
- People at risk for infection by exposure to blood including: people who inject drugs, people who live with a person who has hepatitis B, residents and staff of facilities for developmentally disabled people, health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids on the job
- Hemodialysis patients and predialysis, peritoneal dialysis, and home dialysis patients
- People with diabetes aged 19–59 years; people with diabetes aged 60 or older should ask their doctor.
- International travelers to countries where hepatitis B is common
- People with hepatitis C
- People with chronic liver disease
- People with HIV
- People who are in jail or prison
- All other people seeking protection from hepatitis B virus infection
How serious is it?
- People can be sick for a few weeks to a few months
- Most recover with no lasting liver damage
- Although very rare, death can occur
- 15%–25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
- More than 50% of people who get infected with the hepatitis C virus develop a chronic infection
- 5%-25% of people with chronic hepatitis C develop cirrhosis over 10–20 years
Treatment
Who should be tested?
- People born in countries with 2% or higher HBV prevalence
- Men who have sex with men
- People who inject drugs
- People with HIV
- Household and sexual contacts of people with hepatitis B
- People requiring immunosuppressive therapy
- People with end-stage renal disease (including hemodialysis patients)
- People with hepatitis C
- People with elevated ALT levels
- Pregnant women
- Infants born to HBV-infected mothers
- All adults aged 18 years and older
- All pregnant women during each pregnancy
- People who ever injected drugs and shared needles, syringes, or other drug preparation equipment, including those who injected once or a few times many years ago. Regular testing is recommended for people who currently inject and share needles, syringes, or other drug preparation equipment.
- People with HIV
- People who have ever received maintenance hemodialysis. Regular testing is recommended for people who currently receive maintenance hemodialysis.
- People with persistently abnormal ALT levels
- People who received clotting factor concentrates produced before 1987
- People who received a transfusion of blood or blood components before July 1992
- People who received an organ transplant before July 1992
- People who were notified that they received blood from a donor who later tested positive for HCV infection
- Healthcare, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV‑positive blood
- Children born to mothers with HCV infection
- Any person who requests hepatitis C testing should receive it.