What is Viral Hepatitis?

By | August 23, 2020

What causes it?

Hepatitis A Hepatitis B Hepatitis C Hepatitis A virus Hepatitis B virus Hepatitis C virus

Number of U.S. cases

Hepatitis A Hepatitis B Hepatitis C
  • 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

Hepatitis A Hepatitis B Hepatitis C
  • 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?

Hepatitis A Hepatitis B Hepatitis C Hepatitis A can last from a few weeks to several months. Hepatitis B can range from a mild illness, lasting a few weeks, to a serious, life-long (chronic) condition. More than 90% of unimmunized infants who get infected develop a chronic infection, but 6%–10% of older children and adults who get infected develop chronic hepatitis B. Hepatitis C can range from a mild illness, lasting a few weeks, to a serious, life-long (chronic) infection. Most people who get infected with the hepatitis C virus develop chronic hepatitis C.

How is it spread?

Hepatitis A Hepatitis B Hepatitis C Hepatitis A is spread when a person ingests fecal matter—even in microscopic amounts—from contact with objects, food, or drinks contaminated by feces or stool from an infected person. Hepatitis B is primarily spread when blood, semen, or certain other body fluids- even in microscopic amounts – from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus can also be transmitted from:

  • 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
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Hepatitis C is spread when blood from a person infected with the Hepatitis C virus – even in microscopic amounts – enters the body of someone who is not infected. The hepatitis C virus can also be transmitted from:

  • 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?

Hepatitis A Hepatitis B Hepatitis C Children

  • 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
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There is no vaccine available for hepatitis C.

How serious is it?

Hepatitis A Hepatitis B Hepatitis C
  • 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

Hepatitis A Hepatitis B Hepatitis C Supportive treatment for symptoms Acute: No medication available; best addressed through supportive care Chronic: Regular monitoring for signs of liver disease progression; some patients are treated with antiviral drugs Acute: There is not a recommended treatment for acute hepatitis C. People should be considered for treatment if their infection becomes chronic. Chronic: There are several medications available to treat chronic hepatitis C. Current treatments usually involve 8-12 weeks of oral therapy (pills) and cure over 90% of people with few side effects

Who should be tested?

Hepatitis A Hepatitis B Hepatitis C Testing for hepatitis A is not routinely recommended. CDC recommends hepatitis B testing for:

  • 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
CDC recommends hepatitis C testing for:

  • 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.
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