What’s the difference between hepatitis A, B, and C?

Your liver, the largest internal organ in your body, plays an enormous role in keeping you healthy. It assists digestion, filters toxins out of your blood, stores 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 if you develop hepatitis, all these vital functions slow down.

“Hepatitis occurs for a variety of reasons, including infections, medications, alcohol use, or drug use,” says Elaine A. Leigh, DNP, RN, a nurse with 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

Hepatitis is the general term for inflammation of the liver. All three hepatitis viruses cause acute (short-term) infection and inflammation 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 for all three types of hepatitis. You may develop a fever, a generally sick feeling, loss of appetite, diarrhea, vomiting, stomach pain, dark-colored urine, and jaundice (when the skin and whites of the eyes become yellow). These symptoms can be mild to severe.

Three different diseases, three different treatments

Here’s what to know about each of the three types of hepatitis, including how they can be treated and managed.

Hepatitis A

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 inadequate hygiene.

A vaccine, which children in the U.S. typically receive in two doses starting between ages 12 and 23 months, can prevent the illness. Kids ages 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 members of certain groups. These include 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, however, 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

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 by age 6, however, the rate of chronic infection is roughly 33 percent and for babies it’s about 90 percent. In some cases, hepatitis B can lead to cirrhosis (scarring of the liver) or liver cancer and may be life-threatening.

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

Official guidelines from the Centers for Disease Control and Prevention (CDC) call for all infants to be fully vaccinated. Kids through age 19 who haven’t already been immunized should receive the vaccine, as well. Adults ages 19 to 59 years should also get the vaccine, as should those aged 60 or older who have risk factors.

People at increased risk for hepatitis B include:

• People with diabetes, HIV, hepatitis C, or liver or kidney disease
• People who are sexually active with someone with hepatitis B
• People who have sexually transmitted infections
• Men who have sex with men
• People who inject drugs
• People who are traveling to regions with high rates of hepatitis B
• People born in countries with high rates of hepatitis B
• People who have been sexually abused or assaulted
• People in correctional facilities or those who have been incarcerated
• Workers and residents in long-term care facilities
• Healthcare and public safety workers who may come into contact with bodily fluids

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

Hepatitis C is caused by the hepatitis C virus (HCV). Like hepatitis B, hepatitis C begins as an acute, often symptomless infection, and can progress to chronic hepatitis—a serious, lifelong illness.

Infants born to mothers with hepatitis C may contract the virus. You can also get 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).

The virus can also spread through unclean equipment used in tattoos or body piercings or through sharing personal items that come into contact with infected blood. These include razors, nail clippers, toothbrushes, or blood glucose monitors. In rarer cases, hepatitis C may be spread through sex or among healthcare workers who come into contact with the blood of infected patients.

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 that more than half of people who are infected will develop a chronic HCV infection. They have about a 5 to 25 percent risk for developing cirrhosis of the liver within 10 to 20 years, as well as an increased chance of liver cancer.

Hep C screening is recommended at least once for all people aged 18 or older, as well as during each pregnancy, according to the CDC.

Treatment for hepatitis C has vastly improved in recent years. A round of oral drugs taken over the course of 8 to 12 weeks can now cure the disease for more than 90 percent of people. People who have chronic hepatitis C should see their HCP on a regular basis to check for complications or problems with the liver. They should also be vaccinated for hepatitis A and B if they have not been so already. This helps prevent further damage to the liver.

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 yet for hepatitis C. To safeguard against contracting the disease, follow these guidelines:

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

Take charge of your health by staying up to date with recommended vaccines for yourself and loved ones. If you have hepatitis B or C, consult regularly with your HCP about maintaining your treatment plan.

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.