The 5 Types of Viral Hepatitis, Explained
Hepatitis C may be the most famous (or infamous) hepatitis virus, but it’s just one of several that can make you sick. Hepatitis really means an inflamed liver. All of the hepatitis viruses can do this, although the viruses themselves are unrelated.
“The only thing the viruses really have in common is that they affect the liver,” says David Bernstein, MD, chief of hepatology at Northwell Health in Manhasset, New York. “It’s like saying you have a flat tire. There are lots of different ways you can get a flat tire, which are all separate and distinct.”
The various hepatitis viruses are transmitted differently and cause different types of illnesses. Hepatitis A, B, and C are the most common causes of liver inflammation; D and E are relatively uncommon. Meanwhile, unchecked hepatitis B and C can lead to cirrhosis of the liver and even liver cancer.
Here’s a guide to the alphabet soup of hepatitis viruses, how you can recognize them, and how you can stay safe.
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Hepatitis A
Hepatitis A is a common cause of food poisoning. It is usually passed through food or water that is somehow contaminated with feces, although it can sometimes be transmitted through sex as well.
“It tends to be self-limited,” says Dr. Bernstein. “It never becomes a chronic disease, and the vast majority of people don’t even know they’re exposed.”
If you do have symptoms, they can include a low-grade fever, generally feeling unwell, nausea, abdominal pain, diarrhea, and yellowing of the skin or eyes, called jaundice (which is common with hepatitis).
Most people make a full recovery from hepatitis A in a short period of time—and have the extra bonus of becoming immune to future entanglements with the virus. (Every once a while a second bout of the illness will show up a few months later before the person gets better for good.)
There’s no treatment for hepatitis A, but there is an effective vaccine to prevent it, which, says Dr. Bernstein, everyone should get, especially if you’re going overseas to areas with poor sanitation.
Other precautions? Wash your hands, wash your hands, wash your hands.
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Hepatitis B
Unlike hepatitis A, the second virus in the hepatitis alphabet can cause severe, chronic illness leading sometimes to cirrhosis of the liver and liver cancer. It’s spread through bodily fluids such as blood, semen, urine, and saliva. Common modes of transmission include transfusions, dirty needles (from using IV drugs or even unclean tattoo or piercing needles), and from mother to baby. Most chilling, it can survive for days on objects like toothbrushes and razors, which is why it’s a really bad idea to share them.
“Hepatitis B can cause acute disease, meaning you get sick just like hepatitis A,” says Dr. Bernstein. “Ninety-eight to 99% of people who get it when they’re a teenager or older get over it, but 1 to 2% will develop chronic disease.” Those are the cases that may lead to liver failure. Hepatitis B can also hang out in your body with no symptoms for years.
There’s an easy way to prevent all of this though: Get the vaccine, which is now part of the regular schedule of childhood vaccines.
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Hepatitis C
Hepatitis C doesn’t have a vaccine, but it does have a cure, which is considered one of the major medical advances of the past several decades. There are different subtypes of the hepatitis C virus, but all of them are transmitted in the same way, through blood-to-blood contact—most commonly in the U.S. via shared needles.
Up to 85% of the people who contract hepatitis C end up with chronic infection and run the risk of liver cancer and cirrhosis, even though there may be no symptoms for decades. Along with hepatitis B, hepatitis C is among the most common causes of cirrhosis and liver cancer. The remaining cases of hepatitis C are acute, meaning they pass on their own in a few weeks.
The different subtypes of hepatitis C used to be critical in determining what kind of treatment you would get, but no longer. “We used to base therapy on the specific genotype,” says Dr. Bernstein. “Now, the therapies work for all genotypes.”
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Hepatitis D
Hepatitis D is unusual in that you can’t contract it by itself. You have to first have hepatitis B.
“You can get it at the same time or after you’ve already had hepatitis B,” says Dr. Bernstein. It usually goes away quickly on its own, he adds, but the dual infection with B and D can also make a person’s illness worse.
Hepatitis D is spread the same way as B—through bodily fluids—and causes many of the same symptoms. The good news is that the hepatitis B vaccine will also protect you against D.
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Hepatitis E
Hepatitis E is very similar to A. “It’s another one of these that can cause acute hepatitis but not chronic disease,” says Dr. Bernstein.
It’s usually transmitted through contaminated drinking water. The hepatitis E virus also likes to infect pregnant women in their third trimester, which can be dangerous to the baby.
“We’re seeing an uptick of hepatitis E in the U.S. for unclear reasons,” Dr. Bernstein says. “It’s extraordinarily common when you go to Mexico or India or Pakistan,” he adds. Your doctor might recommend not traveling to places where hepatitis E is common if you’re pregnant.
Hepatitis E usually gets better on its own within four to six weeks. You can prevent contracting hepatitis E with good hand hygiene.
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