Hepatitis A is caused by eating food and drinking water infected with a virus called HAV. It can also be caused by anal-oral contact during sex. Tens of millions of individuals worldwide are estimated to be infected with Hep A each year. Hepatitis A infection causes no clinical signs and symptoms in over 90% of infected children. Although it can cause swelling and inflammation in the liver, it doesn't generally lead to chronic, or life long, disease. Almost everyone who gets hepatitis A has a full recovery. Early symptoms of hepatitis A infection can be mistaken for influenza, but some sufferers, especially children, exhibit no symptoms at all. Symptoms typically appear 2 to 6 weeks, (the incubation period), after the initial infection. They usually last less than 2 months, although some people can be ill for as long as 6 months. Symptoms include: Fatigue, Fever, Abdominal pain, Nausea, Appetite loss, and Jaundice (a yellowing of the skin or whites of the eyes). Bile is removed from the blood stream and excreted in urine, giving it a dark amber color and likely a Clay-colored feces.
It has been noted that itchy skin has been an indication as a possible symptom of all hepatitis virus types. Use caution with personal-care items such as razors, toothbrushes, and manicure or pedicure equipment as it can be contaminated with blood. Tattooing is associated with two to three times higher risk of contracting hepatitis B & C viruses.
Hepatitis B is caused by the virus HBV. About a third of the world population have been infected at one point in their lives, including 350 million who are chronic carriers. It is spread by contact with an infected person's blood, semen, or other bodily fluid. It is considered a sexually transmitted disease (STD). You can get hepatitis B by:
- Having unprotected sex (not using a condom) with an infected person.
- Sharing drug needles (for illegal drugs like heroin and cocaine or legal drugs like vitamins and steroids).
- Getting a tattoo or body piercing with dirty (unsterile) needles and tools that were used on someone else.
- Getting pricked with a needle that has infected blood on it (health care workers can get hepatitis B this way).
- Sharing a toothbrush, razor, or other personal items with an infected person.
- An infected woman can give hepatitis B to her baby at birth or through her breast milk.
- Getting a bite from another person.
Acute hepatitis B causes the liver to swell and inflame, also causing vomiting and jaundice. Chronic hepatitis B may eventually cause cirrhosis and liver cancer.
Hepatitis C is caused by the virus HCV. An estimated 130–170 million people worldwide are infected with hepatitis C. It is spread the same way as hepatitis B, through contact with an infected person's blood, semen, or body fluid (see above). Symptoms are generally mild and vague, including a decreased appetite, fatigue, nausea, muscle or joint pains, and weight loss. Most cases of acute infection are not associated with jaundice. The infection resolves spontaneously in 10-50% of cases, occurring more frequently in individuals who are young and female. Like hepatitis B, hepatitis C causes swelling of the liver and can cause liver damage that can lead to cancer. Most people who have hepatitis C develop a chronic infection that slowly (over decades) leads to scarring of the liver, called cirrhosis.
Hepatitis D is caused by the virus HDV. You can only get hepatitis D if you are already infected with hepatitis B. It is spread through contact with infected blood, dirty needles that have HDV on them and unprotected sex (not using a condom) with a person infected with HDV. Hepatitis D causes swelling of the liver and results in more severe complications compared to infection with HBV alone. These complications include a greater likelihood of experiencing liver failure in acute infections and a rapid progression to liver cirrhosis, with an increased chance of developing liver cancer in chronic infections.
Hepatitis E is caused by the virus HEV. HEV has a fecal-oral transmission route. You get hepatitis E by drinking water infected with the virus or contamination with infected feces. This type of hepatitis doesn't often occur in the U.S. It causes swelling of the liver, but no long-term damage. It can also be spread through oral-anal contact.