Millions of people are living with viral hepatitis, and many do not know they have it. Because some forms of hepatitis may not cause noticeable symptoms for years, understanding your risks and knowing when to get tested can help protect your liver and your overall health.
Hepatitis means inflammation of the liver. It can be caused by viruses, certain medications, alcohol use, toxins and some medical conditions. The most common types of viral hepatitis in the United States are hepatitis A, hepatitis B and hepatitis C.
Although all three affect the liver, they spread differently and may have very different effects on a person’s long-term health.
What Is Hepatitis A?
Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It is usually spread when someone unknowingly ingests a small amount of the virus through contaminated food, drinks, hands or objects.
The virus may spread through close personal contact with someone who is infected or through food and water contaminated with microscopic amounts of stool.
In 2023, 1,648 hepatitis A cases were reported in the United States. The Centers for Disease Control and Prevention estimates that the actual number of infections was closer to 3,300 because not every infection is diagnosed or reported.
Symptoms may last for several weeks or months and can include:
- Fatigue
- Fever
- Loss of appetite
- Nausea or vomiting
- Abdominal pain
- Dark urine
- Pale or clay-colored stool
- Yellowing of the skin or eyes, also called jaundice
Most people with hepatitis A recover completely without lasting liver damage. Unlike hepatitis B and hepatitis C, hepatitis A does not usually become a chronic infection.
Vaccination is the best way to prevent hepatitis A. The vaccine is routinely recommended for children and may also be recommended for adults who were not previously vaccinated or who have certain risk factors.
What Is Hepatitis B?
Hepatitis B is caused by the hepatitis B virus and spreads through infected blood, semen and certain other body fluids.
The virus may be transmitted through sexual contact, sharing needles or other drug-injection equipment, accidental exposure to infected blood or from a pregnant patient to their baby during childbirth. It is not spread through casual contact such as hugging, coughing, sharing food or using the same eating utensils.
Hepatitis B may cause a short-term infection, known as acute hepatitis B, or it may become a lifelong chronic infection.
In 2023, 2,214 acute hepatitis B cases were reported in the United States. However, the CDC estimates that approximately 14,400 acute infections occurred. About 640,000 adults in the United States are estimated to be living with chronic hepatitis B.
Many people with hepatitis B have no symptoms. When symptoms do occur, they may include fatigue, fever, nausea, abdominal discomfort, dark urine or jaundice.
Chronic hepatitis B can lead to serious complications, including:
- Liver scarring
- Cirrhosis
- Liver failure
- Liver cancer
A vaccine is available to prevent hepatitis B. Vaccination is recommended for infants, children and many adults. Testing is also important because people can have hepatitis B without knowing it.
Talk with your healthcare provider about testing if you are pregnant, have been exposed to blood or body fluids, have a sexual partner with hepatitis B or believe you may be at increased risk.
What Is Hepatitis C?
Hepatitis C is a bloodborne infection caused by the hepatitis C virus. It is most commonly spread when blood from someone with the virus enters another person’s bloodstream.
This may occur through sharing needles or drug-injection equipment, accidental needlesticks, unregulated tattoos or piercings, or sharing personal items that may have come in contact with blood. Although less common, hepatitis C can also be passed from a pregnant patient to their baby.
Hepatitis C often causes few or no symptoms. As a result, someone may live with the infection for years without realizing it.
The CDC estimates that approximately 69,000 acute hepatitis C infections occurred in the United States in 2023, although fewer than 5,000 were reported and identified through surveillance.
More than half of people who develop hepatitis C will develop a chronic infection. Without treatment, chronic hepatitis C may eventually cause cirrhosis, liver failure or liver cancer.
There is currently no vaccine for hepatitis C. However, antiviral medications can cure most infections.
The CDC recommends hepatitis C screening for all adults age 18 and older at least once. Screening is also recommended during every pregnancy and more frequently for people with ongoing risk factors or possible exposure.
What About Hepatitis D and Hepatitis E?
Hepatitis D and hepatitis E are less common in the United States, but they can also affect the liver.
Hepatitis D occurs only in people who have hepatitis B. It is spread through infected blood and body fluids and may occur at the same time as a hepatitis B infection or develop later. Because hepatitis D requires hepatitis B to survive, the hepatitis B vaccine also helps prevent hepatitis D.
Hepatitis E is generally spread through contaminated food or water. It is more common in areas of the world with limited access to clean water and proper sanitation. Most people recover without long-term liver problems, but the infection can be more serious for pregnant patients and people with weakened immune systems.
Could You Have Hepatitis Without Knowing It?
Yes. Many people with hepatitis B or hepatitis C do not experience symptoms until the liver has already been damaged.
When symptoms are present, they may include:
- Unusual tiredness
- Fever
- Loss of appetite
- Nausea or vomiting
- Pain in the upper-right side of the abdomen
- Joint pain
- Dark urine
- Pale stool
- Jaundice
These symptoms can also be caused by many other conditions, so testing is the only way to know whether you have viral hepatitis.
When Should You Talk With a Healthcare Provider?
Talk with your primary care provider if you are unsure whether you have been vaccinated against hepatitis A or hepatitis B, believe you may have been exposed to viral hepatitis or have symptoms that concern you. Your provider can review your health history, recommend appropriate blood tests and discuss vaccination or treatment options. Early testing matters. When hepatitis is identified and treated appropriately, patients can lower their risk of serious liver damage and take steps to protect the people around them. FIND A PROVIDER HERE.
