Different types of hepatitis: What you need to know

Hepatitis is a type of inflammation that affects your liver – an essential organ that performs hundreds of functions to keep you healthy. Most importantly, it cleans harmful substances out of your blood, helps your body get rid of old red blood cells, and makes bile, a fluid that helps you digest food.

The good news is you can prevent two types of hepatitis with a vaccine. Plus, hepatitis is very treatable. But if left untreated, hepatitis can lead to serious long-term health complications.

Below, we’ll explain the different types of hepatitis, how it’s spread, symptoms and how it’s diagnosed. We’ll also go over treatment options and how to protect yourself from hepatitis.

The different types of hepatitis (and what causes them)

There are five kinds of viruses that cause hepatitis, known as hepatitis A, B, C, D and E. While there are also nonviral causes that we’ll go over, only the viral forms are contagious and can be spread from person to person.

Many people with hepatitis don’t experience any symptoms, but if they do, they can be noticeable. Symptoms of the different types of hepatitis are very similar to each other but have varying levels of severity and can affect the liver in different ways. Common symptoms of hepatitis of all forms can include:

• Dark urine or stool that is light-colored
• Diarrhea
• Fatigue
• Joint pain
• Loss of appetite
• Low-grade fever (100.4^oF or less)
• Nausea
• Stomach pain or an upset stomach
• Vomiting
• Yellow skin or eyes (jaundice)

Viral types of hepatitis and how they spread

The three types of hepatitis most commonly seen in the United States are hepatitis A, B and C. Hepatitis D and E can also occur, but hepatitis D can only occur alongside hepatitis B, and hepatitis E tends to be more related with travel outside of the country.

Hepatitis A

Hepatitis A is one of two forms of viral hepatitis that’s preventable with a vaccine. It’s also the only form of hepatitis that’s primarily transmitted through the fecal-oral route. This means you’re most likely to get hepatitis A by consuming food or water that’s contaminated by the stool of someone that’s infected.

It’s not common in the U.S., and it’s mainly associated with travel outside of the country. It can also be transmitted from person to person in other ways, because it’s highly contagious. While hepatitis A doesn’t usually cause lasting liver damage, it can cause liver failure and even death in older people and people with serious health issues.

Hepatitis A is usually an acute (short-term) infection and doesn’t typically result in a chronic (long-term) infection. If you currently have or have had hepatitis A and cleared the virus, it’s likely that you won’t get reinfected – your body will develop antibodies to protect you for life.

Early symptoms of hepatitis A

With hepatitis A, most people, particularly children, don’t experience any symptoms. But if they develop, it can happen anywhere from 2-7 weeks after infection. Early symptoms can include:

• Unusual tiredness or weakness
• Nausea, vomiting and diarrhea
• Pain in the stomach where your liver is located
• Dark urine and light-colored stool
• Low-grade fever
• Pain in the joints

Hepatitis B

Hepatitis B is the other type that can be prevented with a vaccine. If you’ve had hepatitis B in the past and completely cleared the infection, you likely wouldn’t get it again. But rarely, some people can experience a reactivation of the virus, especially if they’re immunocompromised.

Hepatitis B can be acute or chronic. An acute infection isn’t likely to cause long-term liver damage, but chronic hepatitis B can result in liver cancer, liver failure and even death.

It’s typically spread from contact with the blood of an infected person. The most common way that Hepatitis B is transmitted is during childbirth, called neonatal hepatitis, when a mother can pass it to their baby. But it can also be spread by contact with infected bodily fluids, though this is less likely.

Neonatal hepatitis

This can occur when a mother passes hepatitis B (and rarely hepatitis D) to her baby during childbirth. The best way to prevent a baby from becoming infected is screening for hepatitis B during pregnancy, with repeated screening for people who are more at risk of contracting it.

If an expectant mother tests positive, it’s possible to use antiviral therapy during pregnancy in certain conditions. And within 12 hours of birth, the hepatitis B vaccine and an injection that contains antibodies to hepatitis B should be given to the baby.

Getting treatment as soon as possible is very important. If left untreated, almost half of babies will develop a chronic hepatitis B infection, which can be fatal.

Hepatitis B symptoms typically develop in stages

It’s not typical to experience symptoms, especially early on. But the older a person is, the more likely they’ll experience symptoms.

Early symptoms can take around 12 weeks to develop and include:

• Fever
• Joint and muscle pain

If left untreated, more serious symptoms can develop, such as:

• Cough
• Dark urine
• Light stool
• Fatigue
• Nausea, vomiting, stomach pain and loss of appetite

And if a hepatitis B infection progresses, early symptoms may disappear and other symptoms may include:

• Jaundice
• Severe loss of appetite
• Worsening nausea and vomiting

Hepatitis C

Hepatitis C is spread through the blood of an infected person. Unlike hepatitis A and B, there is no vaccine to prevent it, and even if you’ve had and recovered from hepatitis C or cured it with medication, you can get it again.

Since it’s spread through contact with infected blood, it can be transmitted in a number of ways, including by sharing injectable needles, and during pregnancy or childbirth. The hepatitis C virus can also survive outside of the body for several days.

Infections can range from mild, where people may not even know they have it, to a serious, persistent infection. Only a small number of people will clear the virus on their own, and without proper treatment it’s likely they’ll develop a chronic infection.

Early hepatitis C symptoms are similar to the flu

When you’re first diagnosed with hepatitis C, it’s considered an acute infection. Symptoms can show up as early as two weeks after exposure, and can include:

• Clay-colored stool and dark urine
• Fatigue
• Low-grade fever
• Joint pain
• Nausea and vomiting
• Reduced appetite

However, if you aren’t diagnosed and treated, hepatitis C can become a chronic infection and lead to more severe symptoms such as:

• Buildup of fluid in your stomach (ascites)
• Bleeding or bruising more easily
• Confusion, slurred speech and drowsiness (hepatic encephalopathy)
• Hives, rashes or itchy skin
• Jaundice
• Swollen legs
• Unintended weight loss

Hepatitis D

Hepatitis D can only occur in people who have chronic hepatitis B, and it’s transmitted the same way. There’s no vaccine specifically for hepatitis D, but the vaccine for hepatitis B protects against a potential hepatitis D infection.

Hepatitis D is uncommon in the U.S. and usually occurs in people who migrate or travel to the U.S. from countries where hepatitis D is considered widespread.

Hepatitis E

The hepatitis E virus is found in the stool of an infected person and occurs when people unknowingly ingest contaminated feces. There’s no vaccine for it, and it’s extremely rare in the U.S.

It most commonly occurs in developing countries when people drink contaminated water. But it can occur in the U.S. from eating contaminated shellfish and raw or undercooked animal meat, like pork.

Most people will only have an acute infection, and clear the virus with no long-term problems. But pregnant women who have it are at increased risk for severe health complications for both them and their baby.

Nonviral types of hepatitis that can occur

Although hepatitis A through E are caused by viruses, hepatitis can be caused by other situations than a viral infection. Because a virus doesn’t cause these forms of hepatitis, they’re not contagious. But they’re similar to viral forms of hepatitis.

Alcoholic hepatitis

This is caused by drinking too much alcohol over any period of time, even just 1-2 years. The liver breaks down alcohol, and if more alcohol is consumed than the liver can break down, it can cause swelling and inflammation of the liver.

Symptoms of alcoholic hepatitis may not appear right away, or even for a long time. If symptoms do appear, it’s usually after chronic heavy drinking. If cirrhosis hasn’t occurred, the liver may heal itself gradually if you stop drinking alcohol.

Complications can occur if alcohol use continues. If you’re a long-term, heavy alcohol user, there are resources available to help you safely quit.

Toxic hepatitis

Toxic hepatitis, also known as drug-induced hepatitis, happens when the liver becomes inflamed due to exposure to substances like alcohol, certain medications and chemicals, or certain herbal or dietary supplements.

Your liver filters everything that goes in your body, but sometimes, toxins form that can irritate or damage the liver. This can happen with both short- and long-term use of whatever substance is causing liver damage.

Autoimmune hepatitis

This can occur when your body’s immune system attacks your liver and causes inflammation, swelling and damage. It’s considered a chronic liver disease and can happen at any age.

It’s not known exactly what causes autoimmune hepatitis, but it’s more likely to show up in people with other autoimmune conditions like lupus. It’s also more likely to affect women than men.

How hepatitis is diagnosed

To diagnose hepatitis, your doctor will likely ask about your possible exposure to the virus, and if there is any exposure to risk factors, like travel to a developing country. Then, they’ll likely order a blood sample to be taken to test for the presence of hepatitis in the blood.

If diagnosed with hepatitis B or C, blood samples may need to be taken again later on to see if your infection was acute or chronic. Your doctor may also order imaging testing, like an ultrasound, to check for liver damage.

Who should be screened for hepatitis?

Anyone can get hepatitis, but there are certain groups that are more at risk. HealthPartners tends to align with the U.S. Preventive Services Task Force (USPSTF) guidelines for who should get screened for hepatitis B and C.

Currently, the USPSTF recommends screening for hepatitis B in adolescents and adults at increased risk of infection. This includes:

• Pregnant women at their first neonatal visit, then subsequent visits if they’re exposed to new or ongoing risk factors
• People who were born in a country that has high hepatitis B infection rates
• Those born in the U.S. who weren’t vaccinated as infants, and whose parents are from a country with high infection rates
• People who use injectable drugs
• People living with HIV
• Men who have sex with men
• People who have an infected partner
• People who live in the same household as someone who has hepatitis B

The USPSTF also recommends screening for hepatitis C at least once in their lives for all adults ages 18-79, including asymptomatic people with no known liver disease.

The CDC also has these screening recommendations for hepatitis A, D and E:

• Hepatitis A – If you’re experiencing symptoms, you know you’ve been exposed, you have or have had hepatitis B or C, or you have the same risk factors as hepatitis B, it’s recommended you get screened for hepatitis A.
• Hepatitis D – Since hepatitis D can only occur if you have or have had hepatitis B, screening is recommended if you test positive for hepatitis B.
• Hepatitis E – Currently, there aren’t any Food and Drug Administration (FDA) approved testing methods for hepatitis E, so screening isn’t available in the U.S.

Treatment options for hepatitis

If you think you’ve been exposed to hepatitis, it’s important to get tested. Speak to your doctor about your treatment options because they vary for the different types of hepatitis.

• Hepatitis A – If you test positive for hepatitis A, there isn’t medication to treat it. Instead, your doctor will likely advise you to avoid alcohol and recuperate at home with plenty of rest, fluids and proper nutrition to help relieve symptoms.
• Hepatitis B – For acute hepatitis B, the treatment is the same as hepatitis A, as there’s no specific medication available. And it depends on the individual situation, but for chronic hepatitis B, there are antiviral drugs available.
• Hepatitis C – Treatment for hepatitis C should happen right away. This may include taking antiviral pills for around 8-12 weeks until the infection clears. These antivirals can cure more than 95% of people who take them, and side effects are typically mild.

Finally, how hepatitis D and E are treated depends on the individual. And treatment for the other types of hepatitis mainly depends on the cause.

Prevent hepatitis A and B by getting vaccinated

For children, it’s extremely important to follow the recommended vaccine schedule to give your child the best possible lifelong protection against hepatitis A and B. This schedule includes getting the hepatitis B vaccine within 12 hours of birth, and then follow-up doses at two, four and six months of age. It also includes the hepatitis A vaccine, which can be given as soon as 12 months old, with a follow-up dose at 18 months old.

If you’re an adult and you haven’t been vaccinated or are unsure if you have been, speak to your doctor at your yearly health screening. They can help advise you on whether or not you should get the vaccine, as it’s important for everyone to protect themselves against preventable diseases.

Protect yourself from getting hepatitis

Getting the vaccines are the best way to protect yourself and your loved ones from preventable illness.

If your child needs their next hepatitis vaccine dose, or if they need to get caught up on their vaccines, make a kids’ health appointment to get them immunized.

And if you’re unsure of your vaccination status, make a primary care appointment with your primary care doctor to talk about next steps so you can stay healthy.