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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 most often caused by a virus. In the United States, the most common types of viral hepatitis are Hepatitis A, Hepatitis B, and Hepatitis C.

 
   

Hepatitis A

 

Hepatitis B

 

Hepatitis C

             
What causes it?   Hepatitis A virus   Hepatitis B virus   Hepatitis C virus
             
Number of U.S. cases  
  • About 2,500 new infections each year
 
  • Estimated 850,000 - 2.2 million people living with chronic Hepatitis B.
  • About 19,200 new infections each year
 
  • Estimated 2.7-3.9 million people living with chronic Hepatitis C.
  • About 30,500 new infections each year
             

Key facts

 
  • Effective vaccine available
  • Outbreaks still occur in the United States
  • Common in many countries, especially those without modern sanitation
 
  • About 2 in 3 people with Hepatitis B do not know they are infected
  • 1 in 12 Asian Americans has chronic Hepatitis B
  • 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 or chronic condition.

More than 90% of unimmunized infants who get infected develop a chronic infection occurs, whereas 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 infection. Most people who get infected 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 from a person infected with the Hepatitis B virus - even in microscopic amounts - 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.

This can happen through multiple ways including:

  • 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
             
Who should be vaccinated?  
  • All children at age 1
  • Travelers to regions where Hepatitis A is common
  • Family and caregivers of recent adoptees from countries where Hepatitis A is common
  • Men who have sex with men
  • Users of certain recreation  drugs, whether injected or not  
  • People with certain medical conditions including chronic liver disease, clotting-factor disorders
 
  • All infants at birth
  • Unvaccinated adults with diabetes
  • Uninfected household members and sexual partners with Hepatitis B
  • Persons with multiple sex partners
  • Persons seeking evaluation or treatment for an STD
  • Men who have sex with men
  • People who inject drugs
  • People with certain medical conditions, including HIV, chronic liver disease
  • Travelers to regions where Hepatitis B is common
 

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
 
  • The risk for chronic infection depends on age when infected. When infected as an infant, 90% will develop a chronic infection
  • 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: Antivirals and supportive care

Chronic: Regular monitoring for signs of liver disease progression; Some patients are treated with antiviral drugs including new medications that can cure Hepatitis C and offer shorter length of treatment and increased effectiveness.

             
Who should be tested?  

Testing for Hepatitis A is not routinely recommended.

 

 
  • People born in regions with moderate or high rates of Hepatitis B
  • U.S.–born people not vaccinated as infants whose parents were born in regions with high rates of Hepatitis B
  • Household, needle-sharing, or sex contacts of anyone with Hepatitis B
  • Men who have sex with men
  • People who inject drugs
  • Patients with abnormal liver tests
  • Hemodialysis patients
  • People needing immunosuppressive or cytotoxic therapy
  • HIV-infected people
  • All pregnant women
 
  • People born during
    1945-1965
  • Recipients of clotting factor concentrates before 1987
  • Recipients of blood transfusions or donated organs before July 1992
  • People who have injected drugs
  • Long-term hemodialysis patients
  • People with known exposures to Hepatitis C (e.g., healthcare workers after needlesticks, recipients of blood or organs from a donor who later tested positive for Hepatitis C)
  • HIV-infected persons
  • People with signs or symptoms of liver disease
             
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.


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