Viral hepatitis is an infection of the liver. There are several different viruses that cause hepatitis. They are called
C, D, and E viruses. The viruses are transmitted in different ways. Complications include chronic liver disease, liver failure, and
for some types of hepatitis.
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is caused by the hepatitis A virus (HAV), which is usually found in the stool of infected people. It is spread by: Putting something in your mouth that has been infected with the hepatitis A virusDrinking water contaminated by raw sewageEating food contaminated by the hepatitis A virus, especially if it has not been properly cookedEating raw or partially cooked shellfish contaminated by raw sewageChanging diapers and not adequately washing your hands—Food or work areas can be contaminated by the hepatitis A virus when food is handled.Having anal sex with a partner infected with the hepatitis A virus
is caused by the hepatitis B virus (HBV). This virus is spread through contact with bodily fluids of an infected person, such as blood, semen, vaginal fluids, and saliva. Hepatitis B can be spread by: Having sex with someone infected with hepatitis B or who is a carrier of hepatitis B.Injecting illicit drugs, especially with shared needles.Having a job that involves contact with bodily fluids.Giving birth—A woman infected with hepatitis can pass the virus on to her baby during childbirth.
(especially prior to 1992 when better screening tests for hepatitis viruses were developed) or multiple transfusions of blood or blood products—This risk is greatly reduced with careful blood screening using modern techniques.
Being bitten by someone whose saliva contains the virus.
treatment—The dialysis machine can be tainted with HBV-infected blood.
Receiving a tattoo, body piercing, or
with unsterilized or improperly sterilized equipment.
Receiving an HBV-infected organ transplant.Sharing toothbrushes, razors, nail clippers, or other personal hygiene items that have HBV-infected blood or bodily fluids on them.
is caused by the hepatitis C virus (HCV). Hepatitis C virus is carried in the blood of people infected with the virus. It is primarily spread through contact with infected blood. It can occasionally be spread other ways. HCV can be spread by: Injecting illicit drugs with shared needles or sharing inhalation tubes when inhaling drugsReceiving HCV-infected blood transfusions, especially before 1992 when better screening tests were developedReceiving blood clotting products, especially older types that have not gone through modern purification and production methodsReceiving an HCV-infected organ transplant
kidney dialysis treatmentSharing toothbrushes, razors, nail clippers, or other personal hygiene items that have HCV-infected blood on themBeing accidentally stuck by an HCV-infected needle (a concern for healthcare workers)Receiving a tattoo, body piercing, or acupuncture with unsterilized or improperly sterilized equipmentGiving birthHaving sexual contact with someone infected with HCV
is caused by the hepatitis D virus (HDV). It occurs only in people who have hepatitis B. Patients may have more severe disease and a higher risk of liver damage than those infected with HBV alone. It is spread through contact with infected blood and through: Having sexual contact with someone infected with HDV.Living with an HDV-infected person—Close personal contact has been found to cause hepatitis D.Sharing toothbrushes, razors, nail clippers, or other personal hygiene items that have HDV-infected blood on them.
is caused by the hepatitis E virus (HEV), which can be found in the stool of infected people. It is uncommon in the US, but it is a risk to international travelers. The virus is spread by: Putting something in your mouth that has been infected with the hepatitis E virusDrinking water contaminated by raw sewageEating food contaminated by the hepatitis E virus, especially if it has not been properly cookedEating raw or partially cooked shellfish contaminated by raw sewage
Overview of acute viral hepatitis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/hepatitis/overview-of-acute-viral-hepatitis. Updated July 2016. Accessed February 7, 2017.
Overview of chronic viral hepatitis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/hepatitis/overview-of-chronic-hepatitis. Updated July 2016. Accessed February 7, 2017.
Viral hepatitis. Centers for Disease Control and Prevention website. Available at:
Updated December 9, 2016. Accessed February 7, 2017.
Last reviewed February 2017 by David L. Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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