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What is Viral Hepatitis?

Illustration of liver positioned in lower right side of human upper body

Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

What is Viral Hepatitis?

Hepatitis A

Hepatitis B

Hepatitis C

What causes it? Hepatitis A virus Hepatitis B virus Hepatitis C virus
Number of U.S. cases
  • About 4,000 new infections each year
  • Estimated 850,000 people living with hepatitis B
  • About 21,000 new infections each year
  • Estimated 3.5 million people living with hepatitis C
  • About 41,000 new infections each year
Key facts
  • Effective vaccine available
  • Outbreaks still occur in the United States; many are foodborne, but recently there are isolated outbreaks among people who inject drugs and men who have sex with men
  • Common in many countries, especially those without modern sanitation
  • 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
  • 3 in 4 people with hepatitis C were born from 1945-1965
  • Hepatitis C is a leading cause of liver transplants and liver cancer
How long does it last? 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 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
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.

Hepatitis C is spread when blood – even in microscopic amounts – from a person infected with the hepatitis C virus 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?
  • All children at age 1 year
  • Travelers to countries where hepatitis A is common
  • Family and caregivers of adoptees from countries where hepatitis A is common
  • Men who have sexual encounters with other men
  • Users of recreational drugs, whether injected or not
  • People with chronic or long-term liver disease, including hepatitis B or hepatitis C
  • People with clotting-factor disorders
  • People with direct contact with others who have hepatitis A
  • Any person wishing to obtain immunity (protection)
  • 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 share needles, syringes, or other drug preparation equipment, 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
There is no vaccine available for hepatitis C.
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
  • 75%-85% of people who get infected with the hepatitis C virus develop a chronic  infection
  • 5%-20% of people with chronic hepatitis C develop cirrhosis
  • 1%–5% will die from cirrhosis or liver cancer.
Treatment 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 i.

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? 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
  • People who are incarcerated
  • Pregnant women
  • Infants born to HBV-infected mothers
CDC recommends hepatitis C testing for:
  • Current or former injection drug users, including those who injected only once many years ago
  • Everyone born from 1945  to 1965
  • Anyone who received clotting factor concentrates made before 1987
  • Recipients of blood transfusions or solid organ transplants before July 1992
  • Long-term hemodialysis patients
  • People with known exposures to hepatitis C virus, such as health care workers or public safety workers after needle sticks involving blood from someone infected with hepatitis C virus and recipients of blood or organs from a donor who tested positive for the hepatitis C virus
  • People with HIV
  • Children born to mothers with hepatitis C

The U.S. Preventive Services Task Force recommends hepatitis C testing for additional groups including:

  • People in jails or prisons
  • People who use drugs snorted through the nose (in addition to people who inject drugs),
  • People who get an unregulated tattoo
Symptoms: Many people with hepatitis do not have symptoms and do not know they are infected. If symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6 months after exposure. Symptoms of chronic viral hepatitis can take decades to develop.

Symptoms of hepatitis can include:  fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, grey-colored stools, joint pain, and jaundice.

Should you get vaccinated or tested for viral hepatitis?

Take the 5 minute CDC Hepatitis Risk Assessment to get a personalized report of your recommendations for vaccination and/or testing. Start assessment now.

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