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Hepatitis A, B and C: What Is the Difference?

A, B, C … D and E.

Aside from the letters associated with it, how much do you know about hepatitis? What’s the difference between the types? And if you get a vaccination for hepatitis, which are you protected from?

We spoke with Moises Ilan Nevah, MD, a transplant hepatologist/gastroenterologist and medical director of the Liver Transplant Program at Banner – University Medical Center Phoenix, to help better understand the similarities and differences between the various types of hepatitis, who is at risk and when to get vaccinated.

What is hepatitis?

“Hepatitis” means inflammation of the liver. It can have many causes, including viruses, medications, fatty infiltration (an accumulation of excess fat in the liver) and alcohol. Most commonly, however, we think of the viruses, called hepatitis A, hepatitis B and hepatitis C. There are several other viruses that cause inflammation of the liver, including hepatitis D and hepatitis E, but they are not as common in the United States as in other parts of the world.

The A, B, Cs of hepatitis

Hepatitis A

The hepatitis A virus causes acute inflammation of the liver that almost always gets better on its own, although it can be more serious if you get it when you are older or if you already have liver disease. It is easily spread from person to person, in food and water, and can infect many people at once. For example, if a food handler at a restaurant is infected with hepatitis A, those who eat food prepared by that handler may be infected. Hepatitis A can be prevented by getting vaccinated.

Hepatitis B

The hepatitis B virus (HBV) can be both acute (short-term illness) and chronic (ongoing illness) and is spread through blood or other bodily fluids in various ways. Hepatitis B is very common in Asia and Africa and those who were born or lived in these areas should be checked for hepatitis B.  Like hepatitis A, a vaccine is available to prevent HBV infection as long as you have not been previously exposed.  Although chronic HBV cannot be cured, there are oral medications available for controlling to treating hepatitis.

Hepatitis C

The hepatitis C virus (HCV) is almost always chronic and spreads mostly by direct blood to blood contact.  Although hepatitis A and B can be prevented by vaccination, hepatitis C cannot. However, there are currently oral medications available that are able to cure hepatitis C in 95% of all cases regardless of prior treatment history.

Recognizing the symptoms of hepatitis

The symptoms of acute hepatitis include yellowing of the skin and eyes, nausea, fever and fatigue. On the other hand, chronic hepatitis may have no symptoms and can last many years.

Knowing your risk for chronic hepatitis C

Because chronic hepatitis may have no symptoms, it is important to know your risk for chronic hepatitis C virus (HCV). Risk factors include:

  • Those who had a transfusion of blood or blood products before 1992 (when the HCV was identified).
  • Those born between the years of 1945-1965.
  • Those who have or are experimenting with intravenous drugs.
  • Those who have snorted or are snorting cocaine.
  • Those who have gotten tattoos with a non-sterile needle.
  • Those who have had unprotected multiple sexual partners.
  • Those with HIV.
  • Children born to mothers with HCV infection.

Although these are the most common ways to acquire hepatitis C, there are other risk factors that can lead to infection. Thus, in 2020 the Centers for Disease Control and Prevention (CDC) updated its screening guidelines to recommend all adults 18 years or older get screened at least once in their lifetime for HCV.

According to the CDC, in the United States there are about 2.4 million people living with hepatitis C and 1.2 million with hepatitis B. Both viruses are even more common in other parts of the world.

Chronic HBV and chronic HCV can lead to liver damage, cirrhosis or scarring of the liver. In some cases, it can lead to liver cancer or liver failure, both of which may require a liver transplant.

How to prevent hepatitis

“Prevention is key,” Dr. Nevah said. Vaccinations are available for both hepatitis A and B.

The CDC recommends that all children between the ages of 12 months and 23 months get vaccinated for hepatitis A, as well as any infants 6 to 11 months old who are traveling internationally. If you have children 2 to 18 years of age who have not been vaccinated, they too should be vaccinated.

For hepatitis B, the CDC recommends all babies be vaccinated with the first dose given as newborns. However, all children younger than 19 years of age who have not yet gotten the hepatitis B vaccine should be vaccinated.

Visit the CDC website for additional information regarding high risk groups and recommendations regarding vaccines for both hepatitis A and hepatitis B.

“In addition to getting vaccinated, practicing good hygiene is very important to preventing hepatitis A. For example, be sure to wash your hands after using the restroom.” said Dr. Nevah. “In addition, hepatitis B and C can be transmitted by sex or sharing needles, razors, or toothbrushes with an infected person who has the disease.”

To learn more about your risk for viral hepatitis, talk to your health care provider or visit bannerhealth.com to find a provider near you.

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