Hepatitis A-E

B

Hepatitis B

Hepatitis B is a liver disease caused by the hepatitis B virus. As many as 1.25 million people living in the United States have hepatitis B. Not all people who are infected with HBV look or feel sick; they can have the virus and not have symptoms or know they are sick. Hepatitis B can be either "acute" or "chronic."

• Acute hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis B virus. Acute infection can but does not always lead to chronic infection.
• Chronic hepatitis B virus infection is a long-term illness that occurs when the hepatitis B virus remains in a person's body.

Vaccination Information

Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences, including cirrhosis of the liver, liver cancer, liver failure, and death.

For more information about hepatitis vaccination for children, adolescents or adults, visit our Immunization Division or the Hepatitis B Foundation. The CDC is conducting a multilingual Know Hepatitis B campaign to encourage testing among Asian Americans.

Frequently Asked Questions

How likely is it that acute hepatitis B will become chronic?

The likelihood depends upon the age at which someone becomes infected. The younger a person is when infected with hepatitis B virus, the greater his or her chance of developing chronic hepatitis B. Approximately 90% of infected infants will develop chronic infection. The risk goes down as a child gets older. Approximately 25%–50% of children infected between the ages of 1 and 5 years will develop chronic hepatitis. The risk drops to 6%–10% when a person is infected over 5 years of age. Worldwide, most people with chronic hepatitis B were infected at birth or during early childhood.

How common is chronic hepatitis B in the United States?

In the United States, an estimated 800,000 to 1.4 million persons have chronic hepatitis B virus infection.

How common is chronic hepatitis B outside the United States?

Globally, chronic hepatitis B affects approximately 350 million people and contributes to an estimated 620,000 deaths worldwide each year.

C

Hepatitis C

Hepatitis C is a liver disease that results from infection with the Hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C was also commonly spread through blood transfusions and organ transplants.

Hepatitis C can be either “acute” or “chronic.” Acute hepatitis C virus infection is a short-term illness that occurs within the first six months after someone is exposed to the hepatitis C virus. For most people, acute infection leads to chronic infection. Chronic hepatitis C is a serious disease that can result in long-term health problems or even death.

There is no vaccine for hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injection drug use. Watch Hepatitis C: Did You Know? for more information.

Frequently Asked Questions

• Statistics
• Transmission/Exposure
• Symptoms
• Tests
• Treatment
• Vaccination

Statistics

How common is chronic hepatitis C in the United States?

An estimated 3.2 million persons in the United States have chronic hepatitis C virus infection. Most people do not know they are infected because they don’t look or feel sick. In 2013, hepatitis C-related mortality surpassed the total combined number of deaths from 60 other infectious diseases reported to the CDC, including HIV, pneumococcal disease, and tuberculosis.

How likely is it that acute hepatitis C will become chronic?

Approximately 75%–85% of people who become infected with hepatitis C virus develop chronic infection.

Transmission/Exposure

How is hepatitis C spread?

Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C was also commonly spread through blood transfusions and organ transplants.

People can become infected with the hepatitis C virus during such activities as:

• Sharing needles, syringes, or other equipment to inject drugs
• Needlestick injuries in health care settings
• Being born to a mother who has hepatitis C

Less commonly, a person can also get hepatitis C virus infection through:

• Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
• Having sexual contact with a person infected with the hepatitis C virus

Can hepatitis C be spread through sexual contact?

Yes, but the risk of transmission from sexual contact is believed to be low. The risk increases for those who have multiple sex partners, have a sexually transmitted disease, engage in rough sex, or are infected with HIV. More research is needed to better understand how and when hepatitis C can be spread through sexual contact.

Can you get hepatitis C by getting a tattoo or piercing?

A few major research studies have not shown hepatitis C to be spread through licensed, commercial tattooing facilities. However, the transmission of hepatitis C (and other infectious diseases) is possible when poor infection-control practices are used during tattooing or piercing. Body art is becoming increasingly popular in the United States, and unregulated tattooing and piercing are known to occur in prisons and other informal or unregulated settings. Further research is needed to determine if these types of settings and exposures are responsible for hepatitis C virus transmission.

Can hepatitis C be spread within a household?

Yes, but this does not occur very often. If hepatitis C virus is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.

How should blood spills be cleaned from surfaces to make sure that hepatitis C virus is gone?

Any blood spills — including dried blood, which can still be infectious — should be cleaned using a dilution of one part household bleach to 10 parts water. Gloves should be worn when cleaning up blood spills.

What are ways hepatitis C is not spread?

Hepatitis C virus is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.

Who is at risk for hepatitis C?

Some people are at increased risk for hepatitis C, including:

• Current injection drug users (currently the most common way hepatitis C virus is spread in the United States)
• Past injection drug users, including those who injected only one time or many years ago
• Recipients of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992)
• People who received a blood product for clotting problems made before 1987
• Hemodialysis patients or persons who spent many years on dialysis for kidney failure
• People who received body piercing or tattoos done with non-sterile instruments
• People with known exposures to the hepatitis C virus, such as
  • Health care workers injured by needlesticks
  • Recipients of blood or organs from a donor who tested positive for the hepatitis C virus
  • HIV-infected persons
  • Children born to mothers infected with the hepatitis C virus

Less common risks include:

• Having sexual contact with a person who is infected with the hepatitis C virus
• Sharing personal care items, such as razors or toothbrushes, that may have come in contact with the blood of an infected person

What is the risk of a pregnant woman passing hepatitis C to her baby?

Hepatitis C is rarely passed from a pregnant woman to her baby. About 4 of every 100 infants born to mothers with hepatitis C become infected with the virus. However, the risk becomes greater if the mother has both HIV infection and hepatitis C.

Can a person get hepatitis C from a mosquito or other insect bite?

Hepatitis C virus has not been shown to be transmitted by mosquitoes or other insects.

Can I donate blood, organs, or semen if I have hepatitis C?

No, if you ever tested positive for the hepatitis C virus (or hepatitis B virus), experts recommend never donating blood, organs, or semen because this can spread the infection to the recipient.

Symptoms

What are the symptoms of acute hepatitis C?

Approximately 70%–80% of people with acute hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms soon after being infected, including:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice (yellow color in the skin or eyes)

How soon after exposure to hepatitis C do symptoms appear?

If symptoms occur, the average time is 6–7 weeks after exposure, but this can range from 2 weeks to 6 months. However, many people infected with the hepatitis C virus do not develop symptoms.

Can a person spread hepatitis C without having symptoms?

Yes, even if a person with hepatitis C has no symptoms, he or she can still spread the virus to others.

Is it possible to have hepatitis C and not know it?

Yes, many people who are infected with the hepatitis C virus do not know they are infected because they do not look or feel sick.

What are the symptoms of chronic hepatitis C?

Most people with chronic hepatitis C do not have any symptoms. However, if a person has been infected for many years, his or her liver may be damaged. In many cases, there are no symptoms of the disease until liver problems have developed. In persons without symptoms, hepatitis C is often detected during routine blood tests to measure liver function and liver enzyme (protein produced by the liver) level.

How serious is chronic hepatitis C?

Chronic hepatitis C is a serious disease that can result in long-term health problems, including liver damage, liver failure, liver cancer, or even death. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. 

What are the long-term effects of hepatitis C?

Of every 100 people infected with the hepatitis C virus, about:

• 75–85 people will develop chronic hepatitis C virus infection; of those,
• 60–70 people will go on to develop chronic liver disease;
• 5–20 people will go on to develop cirrhosis over 20–30 years; and
• 1–5 people will die from cirrhosis or liver cancer.

Tests

Can a person have normal liver enzyme (e.g., ALT) results and still have hepatitis C?

Yes. It is common for persons with chronic hepatitis C to have a liver enzyme level that goes up and down, with periodic returns to normal or near normal. Some infected persons have liver enzyme levels that are normal for over a year even though they have chronic liver disease. If the liver enzyme level is normal, persons should have their enzyme level re-checked several times over a 6–12 month period. If the liver enzyme level remains normal, the doctor may check it less frequently, such as once a year.

Who should get tested for hepatitis C?

Talk to your doctor about being tested for hepatitis C if any of the following are true:

• You were born from 1945 through 1965.
• You are a current or former injection drug user, even if you injected only one time or many years ago.
• You were treated for a blood clotting problem before 1987.
• You received a blood transfusion or organ transplant before July 1992.
• You are on long-term hemodialysis treatment.
• You have abnormal liver tests or liver disease.
• You work in health care or public safety and were exposed to blood through a needlestick or other sharp object injury.
• You are infected with HIV.

If you are pregnant, should you be tested for hepatitis C?

No, getting tested for hepatitis C is not part of routine prenatal care. However, if a pregnant woman has risk factors for hepatitis C virus infection, she should speak with her doctor about getting tested.

What blood tests are used to test for hepatitis C?

Several different blood tests are used to test for hepatitis C. A doctor may order just one or a combination of these tests. Typically, a person will first get a screening test that will show whether he or she has developed antibodies to the hepatitis C virus. (An antibody is a substance found in the blood that the body produces in response to a virus.) Having a positive antibody test means that a person was exposed to the virus at some time in his or her life. If the antibody test is positive, a doctor will most likely order a second test to confirm whether the virus is still present in the person's bloodstream.

Treatment

How is chronic hepatitis C treated?

Each person should discuss treatment options with a doctor who specializes in treating hepatitis. This can include some internists, family practitioners, infectious disease doctors, or hepatologists (liver specialists). People with chronic hepatitis C should be monitored regularly for signs of liver disease and evaluated for treatment. The treatment most often used for hepatitis C is direct-acting antiviral treatment.

Is it possible to get over hepatitis C?

Yes, approximately 15%–25% of people who get hepatitis C will clear the virus from their bodies without treatment and will not develop chronic infection. Experts do not fully understand why this happens to some people.

What can a person with chronic hepatitis C do to take care of his or her liver?

People with chronic hepatitis C should be monitored regularly by an experienced doctor. They should avoid alcohol because it can cause additional liver damage. They also should check with a health professional before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially damage the liver. If liver damage is present, a person should check with his or her doctor about getting vaccinated against hepatitis A and hepatitis B.

Vaccination

Is there a vaccine that can prevent hepatitis C?

Not yet. Vaccines are available only for hepatitis A and hepatitis B. Research into the development of a vaccine is underway.

D & E

Hepatitis D

Hepatitis D, also known as "delta hepatitis," is a serious liver disease caused by infection with the hepatitis D virus (HDV), which is an RNA virus structurally unrelated to the hepatitis A, B, or C viruses. Hepatitis D, which can be acute or chronic, is uncommon in the United States. HDV is an incomplete virus that requires the helper function of HBV to replicate and only occurs among people who are infected with the hepatitis B virus (HBV). HDV is transmitted through percutaneous or mucosal contact with infectious blood and can be acquired either as a coinfection with HBV or as a superinfection in persons with HBV infection. There is no vaccine for hepatitis D, but it can be prevented in persons who are not already HBV-infected by hepatitis B vaccination.

Hepatitis E

Hepatitis E is a serious liver disease caused by the hepatitis E virus (HEV) that usually results in an acute infection. It does not lead to a chronic infection. While rare in the United States, hepatitis E is common in many parts of the world. Transmission occurs through ingestion of fecal matter, even in microscopic amounts; outbreaks are usually associated with contaminated water supply in countries with poor sanitation. There is currently no FDA-approved vaccine for hepatitis E.