What is hepatitis?

Hepatitis is inflammation of the liver. It can cause liver damage, affecting its vital functions. It is often caused by various forms of hepatitis viruses; the most common in the U.S. are hepatitis A, B, and CPeople can also get inflammation of the liver from heavy alcohol use, toxins, some medications, and some medical conditions, such as diabetes and obesity. It is estimated that 115,900 new cases of Hepatitis A, B and C occur annually in the U.S.

What is the difference between hepatitis A, B, C, D, and E?

Hepatitis A, hepatitis B, and hepatitis C are caused by three different viruses that cause liver damage. They are spread in different ways and can affect the liver differently. Hepatitis A is usually a short-term infection. Hepatitis B and hepatitis C can begin as short-term, but in some people, the virus stays in the body, causing chronic infection. There are vaccines to prevent hepatitis A and hepatitis B, but no vaccine for hepatitis C. Hepatitis D and E are not common in the U.S. but do occur.

More than half of people with hepatitis do not know that they have it. They can be at risk for liver disease and cancer and can unknowingly transmit it to others. 67% of persons living with hepatitis B and 51% of persons with hepatitis C infections do not know they have the virus.

Hepatitis A (HAV; Hep A)

Hepatitis A is a highly contagious, usually short-term, liver infection that can be spread person-to-person and through tainted food or drink. It is preventable by vaccine.

Hepatitis B (HBV; Hep B)

Hepatitis B is a type of liver infection caused by the hepatitis B virus (HBV); it can be short-term, but can progress to a life-long illness. Hepatitis B is spread with blood, semen, or other body fluids. It is the world’s most common serious liver infection and is preventable through vaccines.
Between 850,000 (CDC) and 2.4 million (The Hepatitis B Foundation) people in the U.S. are living with chronic hepatitis B infection.*
At risk for hepatitis B: Anyone can get hepatitis B, but high-risk people include: people who inject drugs or share needles, syringes, drug equipment (the most common risk factor for acute HBV infection, because of the opioid crisis); infants of infected mothers; sex partners of infected people, esp. men who have sex with men; people living with someone who has hepatitis B; healthcare and public-safety workers exposed to blood; hemodialysis patients; people who have gotten tattoos with infected needles.
About 70% of adults with acute hepatitis B develop symptoms, which tend to appear an average of 90 days (1-4 months) after exposure to the virus. Symptoms include: abdominal pain; dark urine; fever; joint pain; appetite loss; nausea/vomiting; fatigue/weakness; jaundice (yellowing of skin and whites of eyes).
67% of persons living with chronic hepatitis B infection do not know they have the virus and are not receiving the appropriate care and treatment.
A person can spread the hepatitis B virus and not know it.
In 2019, more than half of acute hepatitis B cases reported to CDC were among persons 30–49 years old.
A one-time universal screening for hepatitis B could save 23,000 lives and nearly $600 million in the U.S.
The largest group affected by acute hepatitis B was Non-Hispanic White people (1.0 cases per 100,000).
In 2016, Asian Americans and Pacific Islanders (AAPIs) represented about 5% of the U.S. population, but about half of all persons with hepatitis B. As a result, 1 in 12 AAPIs were living with hepatitis B.
Asian Americans were almost eight times more likely to die from hepatitis B than non-Hispanic Whites, in 2018.
Hepatitis B and C can cause cirrhosis and liver cancer.

Hepatitis C (HCV; Hep C)

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV) and is spread through contact with blood from an infected person. Most people become infected by sharing needles or other equipment used to prepare and inject drugs; the opioid crisis has accelerated the spread of this virus. For some, hepatitis C is a short-term illness, but for more than half it becomes a long-term, chronic infection. Chronic hepatitis C can result in cirrhosis and liver cancer.
There is no HCV vaccine, but treatments, called Direct Acting Antivirals (DAAs) can cure it.
2.4 million people are estimated to be living with hepatitis C in the United States. The actual number may be as high as 4.7 million or as low as 2.5 million.*
The CDC estimated that 2.4 million adults in America—approximately 1% of the adult population—were living with hepatitis C during 2013–2016.
At risk for HCV: Current or former IV drug users, even those who injected only once many years ago; people with HIV; maintenance hemodialysis patients; patients with persistently abnormal alanine aminotransferase (ALT) levels; people with multiple sexual partners/men who have sex with men; organ transplant recipients esp. before July 1992 ; people who had transfusions including those who received clotting factor concentrates produced before 1987 or blood/blood components before July 1992; people who received blood from a donor positive for hepatitis C; healthcare, emergency medical, and public safety personnel exposed to HCV infected blood; children of mothers with HCV; people who received a piercing or tattoo in an unclean environment using unsterile equipment.
HCV symptoms (once liver damage is advanced): bleeding or bruising easily; fatigue; loss of appetite; yellow skin and eyes (jaundice); dark urine; itchy skin; fluid buildup in the abdomen (ascites); swelling in legs; weight loss; confusion, drowsiness and slurred speech (hepatic encephalopathy); spiderlike blood vessels on skin (spider angiomas).
40%-51% of persons living with HCV have no symptoms and do not know they have it, so they are not receiving treatment to prevent disease progression and liver damage, including cirrhosis and liver cancer. They are also risk transmitting the virus to others.
The highest rates of hepatitis C in the U.S. are among American Indian/Alaska Native peoples (3.6 cases per 100,000).
The rate of new hepatitis C infections in 2018 was four times as high as 2010, according to CDC. 2018 also marked a decade of increases in new hepatitis C infections in people in their 20s and 30s, mostly because of injection drug use (IDU).
Newly reported HCV infections by age (2018): Millennials (most adults in their 20s and 30s) 36.5%; Baby Boomers (most adults in their mid-50s to early 70s) 36.3%; and Generation X (adults in their late 30s to early 50s) 23.1%.
”Baby Boomers” (born 1945 through 1965) were formerly the highest risk group for HCV. They are now being equaled in infection rates by Millennials (born 1981-1996). Gen Xers (born 1966-1980) are heavily affected as well.
In 2019, an estimated 57,500* new Hepatitis C infections occurred in the United States.

Hepatitis D (HDV; Hep D; “delta hepatitis”)

Hepatitis D is most common in Eastern Europe, Southern Europe, the Mediterranean region, the Middle East, West and Central Africa, East Asia, and the Amazon Basin in South America. HDV is uncommon in the United States, where most cases occur among people who migrate or travel to the U.S. from countries with high HDV endemicity. The actual number of HDV cases in the U.S. is unknown.
Hepatitis D virus (HDV) affects globally nearly 5% of people who have a chronic infection with hepatitis B virus (HBV).
HDV has similar risk factors/groups and symptoms to hepatitis A,B,C. It can be a long or short-term illness. However, HDV is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing.
HDV can only infect people who are also infected by the hepatitis B virus (HBV); infection can occur simultaneously (co-infection) or after infection with hep B (super-infection). HDV is a “disease amplifier.” It causes HBV to progress more rapidly, causing cirrhosis and liver failure, making it more deadly.

Hepatitis E (HEV)

Hepatitis E is a liver infection caused by the hepatitis E virus (HEV). HEV is found in the stool of HEV infected people. It is uncommon in the U.S. and developed countries. It is most common in developing countries with inadequate water supply and poor environmental sanitation; people often get HEV from drinking contaminated water. People living in crowded camps or temporary housing, esp. refugees and displaced people, are at high risk. Symptoms of HEV are similar to other forms of hepatitis; however, many people especially young children, can have no symptoms. Most people with healthy immune systems fully recover; there is no vaccine for HEV.
For pregnant women, HEV can be a very serious illness, with a mortality rate of 10%–30% in their third trimester. HEV is also a serious health threat to people with preexisting chronic liver disease and organ transplant recipients on immunosuppressive therapy.

Last updated on September 12th, 2023 at 02:16 pm