Viral Hepatitis: 

A through E and Beyond

 National Digestive Diseases Information Clearinghouse 

NATIONAL 

INSTITUTES 

OF HEALTH 

U.S. Department 

of Health and 

Human Services 

What is viral hepatitis? 

Viral hepatitis is inflammation of the liver 

caused by a virus. Several different viruses, 

named the hepatitis A, B, C, D, and E 

viruses, cause viral hepatitis. 

All of these viruses cause acute, or shortterm, viral hepatitis. The hepatitis B, C, and 

D viruses can also cause chronic hepatitis, 

in which the infection is prolonged, sometimes lifelong. Chronic hepatitis can lead to 

cirrhosis, liver failure, and liver cancer. 

Researchers are looking for other viruses 

that may cause hepatitis, but none have 

been identified with certainty. Other 

viruses that less often affect the liver include 

cytomegalovirus; Epstein-Barr virus, also 

called infectious mononucleosis; herpesvirus; parvovirus; and adenovirus. 

What are the symptoms of 

viral hepatitis? 

Symptoms include 

•	 jaundice, which causes a yellowing 


of the skin and eyes 


•	 fatigue 

•	 abdominal pain 

•	 loss of appetite 

•	 nausea 

•	 vomiting 

•	 diarrhea 

•	 low grade fever 

•	 headache 

However, some people do not have 

symptoms. 

Hepatitis A 

How is hepatitis A spread? 

Hepatitis A is spread primarily through 

food or water contaminated by feces from 

an infected person. Rarely, it spreads 

through contact with infected blood. 

Who is at risk for hepatitis A? 

People most likely to get hepatitis A are 

•	 international travelers, particularly 

those traveling to developing countries 

•	 people who live with or have sex with 

an infected person 

•	 people living in areas where children 

are not routinely vaccinated against 

hepatitis A, where outbreaks are more 

likely 

•	 day care children and employees, 


during outbreaks
 

•	 men who have sex with men 

•	 users of illicit drugs
How can hepatitis A be 

prevented? 

The hepatitis A vaccine offers immunity to 

adults and children older than age 1. The 

Centers for Disease Control and Prevention 

recommends routine hepatitis A vaccination for children aged 12 to 23 months and 

for adults who are at high risk for infection. Treatment with immune globulin can 

provide short-term immunity to hepatitis A 

when given before exposure or within 

2 weeks of exposure to the virus. Avoiding 

tap water when traveling internationally and 

practicing good hygiene and sanitation also 

help prevent hepatitis A. 

What is the treatment for 

hepatitis A? 

Hepatitis A usually resolves on its own over 

several weeks. 

Hepatitis B 

How is hepatitis B spread? 

Hepatitis B is spread through contact with 

infected blood, through sex with an infected 

person, and from mother to child during 

childbirth, whether the delivery is vaginal or 

via cesarean section. 

Who is at risk for hepatitis B? 

People most likely to get hepatitis B are 

• people who live with or have sexual 

contact with an infected person 

•	 men who have sex with men 

•	 people who have multiple sex partners 

•	 injection drug users 

•	 immigrants and children of immigrants 

from areas with high rates of 

hepatitis B 

•	 infants born to infected mothers 

•	 health care workers 

•	 hemodialysis patients 

•	 people who received a transfusion of 

blood or blood products before 1987, 

when better tests to screen blood 

donors were developed 

•	 international travelers 

How can hepatitis B 

be prevented? 

The hepatitis B vaccine offers the best protection. All infants and unvaccinated children, adolescents, and at-risk adults should 

be vaccinated. For people who have not 

been vaccinated, reducing exposure to the 

virus can help prevent hepatitis B. Reducing exposure means using latex condoms, 

which may lower the risk of transmission; 

not sharing drug needles; and not sharing 

personal items such as toothbrushes, razors, 

and nail clippers with an infected person. 

What is the treatment for 

hepatitis B? 

Drugs approved for the treatment of 

chronic hepatitis B include alpha interferon 

and peginterferon, which slow the replication of the virus in the body and also boost 

the immune system, and the antiviral drugs 

lamivudine, adefovir dipivoxil, entecavir, 

and telbivudine. Other drugs are also being 

evaluated. Infants born to infected mothers 

should receive hepatitis B immune globulin 

and the hepatitis B vaccine within 12 hours 

of birth to help prevent infection. 

2	 Viral Hepatitis: A through E and Beyond 
People who develop acute hepatitis B are 

generally not treated with antiviral drugs 

because, depending on their age at infection, the disease often resolves on its own. 

Infected newborns are most likely to progress to chronic hepatitis B, but by young 

adulthood, most people with acute infection 

recover spontaneously. Severe acute hepatitis B can be treated with an antiviral drug 

such as lamivudine. 

Hepatitis C 

How is hepatitis C spread? 

Hepatitis C is spread primarily through contact with infected blood. Less commonly, 

it can spread through sexual contact and 

childbirth. 

Who is at risk for hepatitis C? 

People most likely to be exposed to the 

hepatitis C virus are 

•	 injection drug users 

•	 people who have sex with an infected 

person 

•	 people who have multiple sex partners 

•	 health care workers 

•	 infants born to infected women 

•	 hemodialysis patients 

•	 people who received a transfusion of 

blood or blood products before July 

1992, when sensitive tests to screen 

blood donors for hepatitis C were 

introduced 

•	 people who received clotting factors 

made before 1987, when methods 

to manufacture these products were 

improved 

How can hepatitis C 

be prevented? 

There is no vaccine for hepatitis C. The 

only way to prevent the disease is to reduce 

the risk of exposure to the virus. Reducing exposure means avoiding behaviors like 

sharing drug needles or personal items such 

as toothbrushes, razors, and nail clippers 

with an infected person. 

What is the treatment for 

hepatitis C? 

Chronic hepatitis C is treated with peginterferon together with the antiviral drug 

ribavirin. 

If acute hepatitis C does not resolve on its 

own within 2 to 3 months, drug treatment is 

recommended. 

Hepatitis D 

How is hepatitis D spread? 

Hepatitis D is spread through contact with 

infected blood. This disease only occurs at 

the same time as infection with hepatitis B 

or in people who are already infected with 

hepatitis B. 

Who is at risk for hepatitis D? 

Anyone infected with hepatitis B is at risk 

for hepatitis D. Injection drug users have 

the highest risk. Others at risk include 

•	 people who live with or have sex with a 

person infected with hepatitis D 

•	 people who received a transfusion of 

blood or blood products before 1987 

3	 Viral Hepatitis: A through E and Beyond 
How can hepatitis D 

be prevented? 

People not already infected with hepatitis 

B should receive the hepatitis B vaccine. 

Other preventive measures include avoiding 

exposure to infected blood, contaminated 

needles, and an infected person’s personal 

items such as toothbrushes, razors, and nail 

clippers. 

What is the treatment for 

hepatitis D? 

Chronic hepatitis D is usually treated with 

pegylated interferon, although other potential treatments are under study. 

Hepatitis E 

How is hepatitis E spread? 

Hepatitis E is spread through food or water 

contaminated by feces from an infected 

person. This disease is uncommon in the 

United States. 

Who is at risk for hepatitis E? 

People most likely to be exposed to the 

hepatitis E virus are 

•	 international travelers, particularly 

those traveling to developing countries 

•	 people living in areas where hepatitis 

E outbreaks are common 

•	 people who live with or have sex with 

an infected person 

How can hepatitis E 

be prevented? 

There is no U.S. Food and Drug Administration (FDA)-approved vaccine for hepatitis E. The only way to prevent the disease 

is to reduce the risk of exposure to the virus. 

Reducing risk of exposure means avoiding 

tap water when traveling internationally and 

practicing good hygiene and sanitation. 

What is the treatment for 

hepatitis E? 

Hepatitis E usually resolves on its own over 

several weeks to months. 

Points to Remember 

•	 Viral hepatitis is inflammation of the 

liver caused by the hepatitis A, B, C, 

D, or E viruses. 

•	 Depending on the type of virus, viral 

hepatitis is spread through contaminated food or water, contact with 

infected blood, sexual contact with 

an infected person, or from mother 

to child during childbirth. 

•	 Vaccines offer protection from hepatitis A and hepatitis B. 

•	 No vaccines are available for hepatitis C, D, and E. Reducing exposure 

to the viruses offers the best protection. 

•	 Hepatitis A and E usually resolve on 

their own. Hepatitis B, C, and D can 

be chronic and serious. Drugs are 

available to treat chronic hepatitis. 

4	 Viral Hepatitis: A through E and Beyond 
What else causes viral 

hepatitis? 

Some cases of viral hepatitis cannot be 

attributed to the hepatitis A, B, C, D, or E 

viruses, or even the less common viruses 

that can infect the liver, such as cytomegalovirus, Epstein-Barr virus, herpesvirus, 

parvovirus, and adenovirus. These cases 

are called non-A–E hepatitis. Scientists 

continue to study the causes of non-A–E 

hepatitis. 

Hope through Research 

The National Institute of Diabetes and 

Digestive and Kidney Diseases, through its 

Division of Digestive Diseases and Nutrition, supports basic and clinical research 

into the nature and transmission of the hepatitis viruses, and the activation and mechanisms of the immune system. Results from 

these basic and clinical studies are used in 

developing new treatments and methods of 

prevention. 

For More Information 

American Liver Foundation 

75 Maiden Lane, Suite 603 

New York, NY 10038–4810 

Phone: 1–800–GO–LIVER (465–4837), 

1–888–4HEP–USA (443–7872), 

or 212–668–1000 

Fax: 212–483–8179 

Email: info@liverfoundation.org 

Internet: www.liverfoundation.org 

Centers for Disease Control and Prevention 

Division of Viral Hepatitis 

1600 Clifton Road 

Mail Stop C–14 

Atlanta, GA 30333 

Phone: 1–800–CDC–INFO (232–4636) 

Fax: 404–371–5488 

Email: cdcinfo@cdc.gov 

Internet: www.cdc.gov/hepatitis 

Hepatitis Foundation International 

504 Blick Drive 

Silver Spring, MD 20904–2901 

Phone: 1–800–891–0707 or 301–622–4200 

Fax: 301–622–4702 

Email: hfi@comcast.net 

Internet: www.hepatitisfoundation.org 

5 Viral Hepatitis: A through E and Beyond 
You may also find additional information about this 

topic by visiting MedlinePlus at www.medlineplus.gov.

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For updates or for questions about any medications, 

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U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES

National Institutes of Health

NIH Publication No. 08–4762

February 2008