Each year, tens of thousands of people in the United States are newly infected with viral hepatitis. It kills thousands of Americans a year and is a leading cause of liver cancer — yet many infected people have no symptoms and don't know it. Chronic hepatitis B and C can cause liver damage, cirrhosis, liver cancer and death.
The good news: hepatitis A and B are preventable by vaccine, hepatitis B can be treated, and hepatitis C can be cured. CDC sees a chance to eliminate viral hepatitis as a public health threat.
The three common types
| Hepatitis A (HAV) | Hepatitis B (HBV) | Hepatitis C (HCV) | |
|---|---|---|---|
| Becomes chronic? | never | for some people | in most people |
| Estimated acute infections, 2023 | 3,300 | 14,400 | 69,000 |
| Chronic infections | — | about 640,000 adults (Jan. 2017–Mar. 2020) | about 2.4 million, perhaps up to 4 million (2017–2020) |
| Outlook | most recover without lasting liver damage; death is uncommon, more likely in older people or those with liver disease | acute illness is rarely fatal; 15%–25% of chronically infected people develop chronic liver disease | — |
| Spread | fecal-oral: contaminated food or water, or close personal or sexual contact | infectious blood or body fluids through the skin, mucous membranes or broken skin | mainly blood through the skin; less often blood on mucous membranes |
| Vaccine | yes | yes | no |
Symptoms
If an acute infection causes symptoms, they can appear 2 weeks to 6 months after exposure. Chronic hepatitis can take decades to cause symptoms, which are usually the same:
- abdominal pain, nausea or vomiting
- dark urine or clay-colored stools
- diarrhea (hepatitis A only)
- fatigue, fever, joint pain, loss of appetite
- jaundice
Testing
Testing is the only way to diagnose viral hepatitis.
| Acute infection | Chronic infection | |
|---|---|---|
| Hepatitis A | IgM anti-HAV | doesn't become chronic |
| Hepatitis B | HBsAg plus IgM anti-HBc | first-time screening should use the triple panel |
| Hepatitis C | no serologic marker | HCV antibody test, with reflex to an HCV RNA test (NAT) if positive |
After a suspected exposure, testing and treatment can prevent complications and stop further spread.
Treatment
| Hepatitis A | supportive care — rest, fluids, a balanced diet |
| Acute hepatitis B | supportive care |
| Chronic hepatitis B | monitor for liver disease progression and treat with antivirals |
| Acute and chronic hepatitis C | treat without waiting |
More: CDC's clinical overviews of hepatitis A, hepatitis B and hepatitis C, and on preventing hepatitis C.
Sources
Based on "Clinical Overview of Viral Hepatitis," Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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