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The ABCs (and D’s and E’s) of viral hepatitis

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Hepatitis can be scary, but vaccines and treatments are available.
Written by Mark Ray
Updated on November 28, 2022

If you watch television, you’ve probably seen ads about treatments for hepatitis C. The liver disease is on the rise in the U.S. But it’s just 1 form of hepatitis caused by a virus. By learning more, you can protect yourself and your loved ones. Here’s what you need to know.

What is hepatitis?

Hepatitis is a broad term for inflammation of the liver. The causes can include:

  • A virus
  • Alcohol or drug use
  • Genetics
  • An autoimmune problem (when your body’s immune system attacks your liver)

Left untreated, hepatitis can lead to fibrosis (scarring), cirrhosis (extensive scarring) or liver cancer.

Here’s a rundown of the 5 types of viral hepatitis:

Hepatitis A

Hepatitis A is mainly spread by consuming food or water that’s contaminated with fecal matter that contains the hepatitis A virus. It can also spread through contact with the fecal matter of someone who has the virus.

Washing your hands thoroughly after using the bathroom and practicing safe sex are the best methods of prevention. But that won’t help if you eat contaminated food, which sometimes happens.

Most people have acute symptoms. “You can end up in the hospital with severe abdominal pain, nausea and diarrhea,” says Rachel Melson, DNP. She’s the clinical director at Swope Health in Kansas City, Missouri.

Usually people get better on their own. “We will closely monitor their liver function. But most cases don’t need any treatment,” says Tzu-Hao (Howard) Lee, MD. He’s an assistant professor of hepatology at Baylor College of Medicine in Houston.

People with chronic liver disease or HIV face a higher risk of severe symptoms. So they may need hospital care. There’s no specific treatment. The focus is on comfort and maintaining a good nutritional balance.

The good news is that vaccines (Vaqta®, Havrix®) are available. They’re recommended for children ages 12 months to 18 years and high-risk adults. High-risk people include:

  • International travelers
  • Men who have sex with men
  • People who use illegal drugs
  • People experiencing homelessness
  • People with jobs that carry the risk of exposure (such as health care workers)

Recommended reading: Could you have this common liver disease and not know it?

Hepatitis B

The hepatitis B virus is transmitted through contact with infected bodily fluids. Sexual partners and people who share needles are at risk. But pregnant mothers who are infected can also pass the virus on to their babies at birth.

“It can cause symptoms that at times make you feel very sick very quickly,” says Melson. “But most of the time, it turns into more of a chronic infection and people need to take medication for it.” Your doctors may prescribe any of the following antivirals:

  • Epivir® (lamivudine)
  • Baraclude® (entecavir)
  • Viread® (tenofovir disoproxil fumarate)
  • Vemlidy® (tenofovir alafenamide)

Hepatitis B vaccines (Engerix-B, Recombivax HB®, Heplisav-B®) are available for people of all ages, though you should check with your doctor to see which ones are right for you and your family. They’re also recommended for older adults with risk factors. The Twinrix vaccine covers both the hepatitis A and B viruses.

(If you’re prescribed a medication to treat hepatitis, show your pharmacist this free prescription discount card. It could save you up to 80%.)

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Hepatitis C

The hepatitis C virus spreads through exposure to blood and other bodily fluids. As with hepatitis B, it can be spread from mother to child at birth. In most cases, the virus is spread through sharing needles or other equipment that’s used to prepare and inject drugs. That’s according to the Centers for Disease Control and Prevention.

Hepatitis C can be a short-term illness. But it becomes a chronic condition in more than half of the people who get it. There’s no vaccine, but effective treatments are available. Your doctor would likely prescribe a combination antiviral medication such as:

  • Mavyret® (glecaprevir/pibrentasvir)
  • Epclusa® (sofosbuvir/velpatasvir)
  • Harvoni® (ledipasvir/sofosbuvir)
  • Vosevi® (sofosbuvir/velpatasvir/voxilaprevir)

Hepatitis D

The hepatitis D virus is also spread through contact with blood or other bodily fluids. The big difference is that hepatitis D occurs only in people who’ve already been infected with the hepatitis B virus. That means vaccination against hepatitis B effectively prevents hepatitis D as well.

The virus can cause either an acute infection or a chronic infection that causes liver damage. If you have both hepatitis B and D, you’re at a higher risk for developing complications. “Usually the treatment is with interferon, an injection therapy,” Dr. Lee says. “It’s the same therapy as for hepatitis B and C in the past.”

Hepatitis E

The hepatitis E virus is uncommon in the U.S. It’s mostly spread through eating raw or undercooked pork, venison, wild boar meat or shellfish. In less developed countries, it often spreads through drinking water contaminated with fecal matter. The best ways to avoid the virus are to cook meat thoroughly and steer clear of unsafe water sources. There’s no vaccine available in the U.S.

Patients typically have only short-term symptoms. Most recover fully without liver damage. “It’s generally acute, much like hepatitis A,” Melson says.

“If you’re immunosuppressed, you might need treatment with ribavirin (Virazole®),” Dr. Lee says, “but most patients don’t require that.”

The bottom line: Now that you know how each type of hepatitis virus is transmitted, you have the power to avoid the disease. And consider getting vaccinated — it’s an easy way to cross 2 types off the list.

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