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

What is hepatitis?

Hepatitis describes inflammation of the liver, the organ with important jobs such as turning food into energy, filtering toxins (like alcohol) out of the blood, and fighting infections. When the liver is damaged in any way, its ability to perform these functions is restricted. Hepatitis is a general term to describe this inflammation, but there are distinct types of inflammation.

Hepatitis is usually caused by heavy alcohol consumption or a viral infection.

How common is hepatitis?

It's uncommon in the UK but is more widespread in other parts of the world such as Europe, the Middle East, Africa, and South America.

What is hepatitis A?

Thorrun Govind, pharmacist and chair of the Royal Pharmaceutical Society, explains that the hepatitis A virus is easy to pass on during sex, or from contaminated food or water.

Symptoms of hepatitis A

These include:

• Extreme tiredness.

• Itchy skin.

• Stomach pain.

• Jaundice (where skin and whites of the eyes turn yellow, urine turns dark).

People with hepatitis A can have symptoms that last for several weeks and it can be months before you get back to your normal self.

Reducing your risk of hepatitis A

You can reduce your risk of being infected with hepatitis A or passing on hepatitis A by using condoms for anal sex, washing your hands after handling condoms, and using a latex barrier and gloves during sexual intercourse. Govind stresses the importance of avoiding sex that involves contact with faeces.

In most cases, hepatitis A is diagnosed by a GP rather than at sexual health clinics. This is because if a person feels unwell, they are likely to contact their doctor, who can perform a blood test to determine if hepatitis is present.

Most people tend to recover fully from hepatitis A without complications and once you have had it, it is extremely unlikely that you will get it again since antibodies from your previous infection can offer protection.

Who is most at risk of hepatitis A?

Some people have an increased risk of becoming seriously ill from hepatitis A. These people include elderly adults, people living with HIV, and anyone who already has liver disease.

What is hepatitis B?

Once again, hepatitis B is an infection of the liver - it is caused by the hepatitis B virus (HBV). Similar to hepatitis A, hepatitis B is easy to pass on via sex. However, a distinct risk for hepatitis B is the risk of infection by sharing injecting equipment such as needles and syringes, which can carry infected blood.

Symptoms of hepatitis B

Govind explains that a lot of people who contract hepatitis B do not notice any symptoms, or the symptoms can be mild and, therefore, easy to miss.

But, after weeks or months, hepatitis B can lead to:

• Stomach pains.

• Jaundice.

• Fever.

These symptoms can also last for several weeks and take months to recover from, but 95% of adults do recover fully from hepatitis B and symptoms tend to be mild¹.

Passing on hepatitis B

Hepatitis B can be passed on in bodily fluids, so via blood-to-blood contact, semen, pre-ejaculate, and vaginal secretions. It can be passed on through oral, vaginal, or anal sex without a condom.

Govind adds that it's important not to share items such as razors or toothbrushes, as these can have traces of blood on them too.

Hepatitis B vaccine

"There is a vaccine that can protect you against both hepatitis A and B and, if you are in a high-risk group, you can receive your hepatitis B vaccine for free, either via your GP or sexual health clinic," she explains.

The 6-in-1 vaccine is typically offered to all babies when they are 8, 12 and 16 weeks old, which includes the vaccination for hepatitis B. If babies have a higher chance of developing hepatitis B - perhaps if their mother is infected - then they are given extra doses at birth, four weeks, and one year of age.

Other ways to treat hepatitis B include avoiding recreational drugs if you have the infection, avoiding alcohol until your liver recovers, and avoiding smoking.

Patient picks for Hepatitis

Digestive health

How to look after your liver

Your liver is amazing. It helps you digest food, makes proteins that help your blood to clot and removes toxins and waste products from your body. It also helps control cholesterol levels and fight infection. It's constantly at work 'detoxing' your body 24 hours a day - you really don't need fad 'detox' diets! But you do need to know how to look after your liver - show your liver some lifestyle love and it will keep on looking after you.

by Dr Sarah Jarvis MBE, FRCGP

Digestive health

Hepatitis C

Hepatitis C is a blood-borne virus that infects the cells of the liver. Most cases occur in people who share needles or injecting equipment contaminated with traces of blood to inject 'street drugs'. Some people clear the infection naturally. Some people with persistent infection remain free of symptoms, although others have symptoms. Persistent hepatitis C infections can lead to 'scarring' of the liver (cirrhosis) and may lead to liver cancer. Treatment can clear the infection in around 9 out of 10 cases.

by Dr Rosalyn Adleman, MRCGP

What is hepatitis C?

Caused by the hepatitis C virus (HCV), hepatitis C is a blood-borne virus that attacks the liver. There is currently no vaccine available for hepatitis C, but there are tablets that can be prescribed to help treat it. These are called direct-acting antiviral (DAA) tablets and they are the safest and most effective medication for hepatitis C treatment. They have been found to clear the infection in 90% of people² .

Unlike hepatitis A and B, it can take years before a person starts to feel unwell with hepatitis C and most people have no symptoms at all. But, as the liver becomes more damaged with time, an individual can feel increasingly sick. Only 1 in every 3 or 4 people will have any symptoms during the first six months of a hepatitis C infection (known as acute hepatitis C).

Early symptoms of hepatitis C

These include:

• A high temperature.

• Fatigue.

• Loss of appetite.

• Stomach pains.

• Irritated skin.

• Nausea.

As with hepatitis A and B, jaundice is common too. This symptom is experienced by approximately 1 in 5 people.

As and when symptoms do start to present themselves, Govind adds that mental confusion such as brain fog is quite specific to hepatitis C.

Passing on hepatitis C

Hepatitis C is rarely passed on during sex like hepatitis A and B are, but is usually spread through blood-to-blood contact, which can include sharing needles.

There is no immunity to hepatitis C, and it is possible to get it again, even if previous infections have cleared. If left untreated, hepatitis C can be fatal. Hepatitis C can also be chronic, meaning it leaves long-term effects. In very serious cases, it can lead to liver failure or liver cancer.

If you have concerns about possible hepatitis, you should consult your GP or a sexual health professional.

You can also find advice below, with websites linking to support groups in various areas:

• British Liver Trust.

• The Hepatitis C Trust.

• Hepatitis B Positive Trust.

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

So, what are the main differences between hepatitis A, B, and C? Let's summarise ...

• Hepatitis A and B can be passed on via bodily fluids, whereas hepatitis C usually only spreads through blood-to-blood contact with an infected person.

• Unlike hepatitis A and B, it can take years for symptoms to present themselves in hepatitis C.

• A vaccine for hepatitis B is typically offered to babies to reduce their risk of contracting the virus.

• Hepatitis C has no immunity, and it is possible to get it again, whereas the risk of becoming infected again is lower with hepatitis A and B.

Further reading

1. Hepatitis B statistics.

2. Hepatitis C findings.