What’s the Difference Between Hepatitis A, B, and C?

Your liver, the largest organ in your body, plays an enormous role in keeping you healthy. It assists digestion, filters toxins, stores some nutrients and helps regulate certain hormones and cholesterol levels. It also acts as a chemistry lab, transforming substances like proteins into compounds your body needs to function.

But when hepatitis strikes, all these vital functions slow down.

Hepatitis is the general term for inflammation of the liver. “Hepatitis occurs for a variety of reasons, including infections, medications, alcohol or drug use,” says Elaine A. Leigh, DNP, RN, FNP-BC, at Mercy Health Hepatitis C Clinic in Muskegon, Michigan.

Three different viruses cause the three most common kinds of infectious hepatitis in the United States. They're known by the letters A, B and C.

Acute hepatitis symptoms

All three hepatitis viruses cause acute (short-term) infection at first. In the cases of hepatitis B and C, the illness may eventually become chronic (long-term). There are often no symptoms in the beginning, especially with hepatitis B and C.

If you do have symptoms, however, they are initially similar across all three types of hepatitis. You may develop a fever, a sick-all-over feeling, appetite loss, diarrhea, vomiting, stomach pain, dark-colored urine and jaundice (when your skin and the whites of your eyes become yellow). These symptoms can be mild to severe.

Three different diseases, three different treatments

Hepatitis A is caused by the hepatitis A virus (HAV). You can be infected when you eat food or drink water contaminated with the feces of an infected person. You can also contract it through sexual contact or other very close contact with someone who has the disease. Risks for hepatitis A include poor sanitation, an unsafe water supply and substandard hygiene.

A vaccine, which American children receive in two doses starting between ages 12 and 23 months, can prevent the illness. Kids aged 2 to 18 years who weren’t previously vaccinated should receive the shots, too.

While unvaccinated adults can choose to be immunized for hepatitis A, it’s specifically recommended for certain groups, including international travelers, men who have sex with men and people with HIV or chronic liver disease, among others. Speak with a healthcare provider (HCP) to find out if the vaccine is right for you.

Unlike the two other forms of hepatitis, hepatitis A doesn’t cause chronic disease. The virus usually clears in several weeks or a few months without treatment; it’s rarely deadly. In less than 1 percent of cases, people with hepatitis A develop fulminant hepatitis, a frequently fatal syndrome in which the liver fails completely. Often, these people are older or have other chronic liver infections.

Hepatitis B is caused by the hepatitis B virus (HBV). It begins as an acute infection, often showing no symptoms. In about 5 percent of infections contracted by adults, hepatitis B becomes chronic and continues to attack the liver. For children infected between ages 1 and 5, however, the rate of chronic infection is up to 50 percent, and for babies, it’s about 90 percent. In some cases, hepatitis B can lead to cirrhosis or cancer and may be life-threatening.

You acquire hepatitis B through blood—often, via shared needles—or through the other body fluids of an infected person. Pregnant women can pass it to their babies during delivery, as well.

Official guidelines from the Centers for Disease Control and Prevention (CDC) call for infants to be fully vaccinated by 6 months old. Kids through age 18 who haven’t already been immunized should receive the vaccine, as well. Unvaccinated adults may choose to get it, and it’s expressly advised for people who have been in close contact with someone with hepatitis B, along with the following groups:

• People who are sexually active with more than one person
• Men who have sex with men
• Intravenous drug users
• People who are traveling to regions with high rates of hepatitis B
• People who have been sexually abused or assaulted
• People in correctional facilities
• Workers and residents in facilities for the developmentally disabled
• Healthcare and public safety workers who may come into contact with bodily fluids
• People with diabetes, HIV, hepatitis C or liver or kidney disease

There is no treatment for acute hepatitis B, but you may need treatment if it becomes chronic. The majority of adults exposed to the virus “can spontaneously clear it on their own, meaning their bodies are able to successfully beat the disease without medication,” says Leigh. "Once you have the virus for at least 6 months, your doctor will treat you based on your individual condition."

Medication for hepatitis B is often taken for life.

Hepatitis C is caused by the hepatitis C virus (HCV). Like hepatitis B, it begins as an acute, often symptomless infection, and can progress to chronic hepatitis—a serious, life-long illness. You can contract the disease from the blood of an infected person, through unsafe injection of recreational drugs or possibly via intranasal drug use (sharing straws to snort drugs). Blood transfusions done before 1992—when blood wasn’t screened—were also responsible for transmitting hepatitis C.

Some of those with hepatitis C are able to clear the virus within 6 months of infection without being treated. Still, the CDC says 75 to 85 percent of people who are infected will develop a chronic HCV infection. They have a 5 to 25 percent risk for developing cirrhosis of the liver within 10 to 20 years.

Hep C screening is recommended for all people between the ages of 18 and 79 years old, according to the U.S. Preventive Services Task Force. Treatment has vastly improved in recent years, and drug therapies can now cure the disease for many people.

How to slash your hepatitis risk

You can protect yourself from hepatitis A and B by making sure your vaccines are up-to-date. There is no vaccine for hepatitis C as of yet. To safeguard against contracting the disease, follow these rules:

• Avoid unprotected sex.
• Don’t share needles.
• If you get a tattoo, make sure it’s at a licensed facility.
• Use gloves and wash your hands carefully if you’re in contact with blood or fluids from an infected person.
• Avoid sharing utensils and personal items, such as toothbrushes or drinking glasses, with someone who has hepatitis.

Correction: A previous version of this article broadly stated that hepatitis B infection becomes chronic in 10 percent of cases. That statement was amended to provide differential rates of chronic infection for adults, children, and infants.