Hepatitis is inflammation of the liver. In the United States, viral hepatitis is usually caused by the hepatitis A, B, or C virus. Different types of hepatitis are spread different ways, including having sex, sharing needles, or eating unclean food. Sometimes, viral hepatitis goes away on its own. In others, the virus is life long and can lead to serious health problems. Vaccines can prevent hepatitis A and B, but not C. There are medicines to treat and sometimes cure hepatitis B and C.

Viral hepatitis (HEP-uh-TY-tiss) is inflammation of the liver caused by the hepatitis virus. Inflammation happens when your immune system senses a danger, like a virus, and sends white blood cells to surround the area to protect your body. This causes redness, swelling, and sometimes pain.

Hepatitis damages the liver and can cause scarring of the liver, called cirrhosis (sur-ROH-siss). Cirrhosis can cause liver cancer, liver failure, and death. Your liver changes the food you eat into energy. It also cleans alcohol and other toxins from your blood, helps your stomach and intestines digest food, and makes proteins that your body needs to control and stop bleeding.

Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

Many people with hepatitis do not have symptoms and do not know they are infected. If symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6 months after exposure. Symptoms of acute hepatitis can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice. Symptoms of chronic viral hepatitis can take decades to develop.

What causes it?

Number of U.S. cases

Key facts

How long does it last?

How is it spread?

Who should be vaccinated?

How serious is it?

Who should be tested?

Treatment

Yes, certain types of viral hepatitis affect women differently than men.

Hepatitis A affects women and men in similar ways.

Hepatitis B affects women differently than men:

• Birth control. Women with severe liver damage may not be able to use birth control. This is because a damaged liver may have problems breaking down estrogen.
• Pregnancy. The risk of passing hepatitis B to your baby during pregnancy is high. Hepatitis B raises your risk for pregnancy complications. Talk to your doctor about taking hepatitis B medicine to lower the risk of passing hepatitis B to your baby. Certain hepatitis B medicines are safe to take during pregnancy but are not recommended for everyone. Learn more about hepatitis B during pregnancy.

Hepatitis C affects women differently than men:

• Younger women. Research shows that acute (short-term) hepatitis C goes away on its own more often for younger women than men. Also, in women with chronic hepatitis C, liver damage usually happens more slowly than it does for men. Researchers think the hormone estrogen may help protect the liver from damage.
• Menstrual cycles. You may miss menstrual periods or have shorter periods. This can happen as a side effect of hepatitis medicines. Since hepatitis C is spread through blood, the risk of passing hepatitis C to a partner is higher during your menstrual period.
• Birth control. Women with severe liver damage may not be able to use birth control that contains estrogen. This is because a damaged liver may have problems breaking down estrogen.
• Pregnancy. Experts think the risk of passing hepatitis C to your baby during pregnancy is low. But hepatitis C raises your risk for pregnancy complications such as premature birth and gestational diabetes. Some hepatitis C medicines can also cause serious harm to your baby if taken during pregnancy.
• Menopause. Liver damage happens more quickly for women after menopause. Hepatitis C medicines also may not work as well for women after menopause as they do for men.

The most common types of viral hepatitis in the United States are:

• Hepatitis A
• Hepatitis B
• Hepatitis C

Hepatitis A is a disease of the liver caused by hepatitis A virus. It may make you sick for a few weeks to a few months. Most recover with no lasting liver damage.

How is it spread?

Hepatitis A is spread by coming in contact with the hepatitis A virus. This includes:

• Contact with any person infected with the hepatitis A virus
• Sexual contact with an infected person
• Touching contaminated surfaces and then placing your hands near or in your mouth
• Sharing eating utensils that have virus on them
• Eating food or drinking water that has been contaminated by feces that contain the virus. The food and drinks most likely to be contaminated are:
  • Fruits
  • Vegetables
  • Shellfish
  • Ice
  • Water

In the United States, chlorine in the water kills hepatitis A virus. But infected food workers can still spread hepatitis A directly to food. This occurs when hands are not washed or cleaned before food is handled.

Infected people can spread the virus to others a few weeks before they begin to feel bad.

Who is at risk of hepatitis A?

Anyone can get hepatitis A if they have not been vaccinated. In the U.S., you are at a higher risk if you:

• Use illegal drugs, whether injected or not
• Live with someone who has hepatitis A
• Have bleeding problems and take clotting factors
• Have oral-anal sexual contact with someone who has hepatitis A
• Travel to areas that have high rates of hepatitis A

Travel to Africa, Asia, Eastern Europe, or Central and South America, including Mexico, increases the risk of getting hepatitis A.

What are signs of hepatitis A?

Hepatitis A does not always cause people to feel bad. It may make you sick for a few weeks to a few months. Older people can get sicker when they have hepatitis A. Young children with hepatitis A usually do not show any signs. Signs of hepatitis A include:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine
• Diarrhea

How do you know if you have hepatitis A?

The only way to know if you have hepatitis A is by a medical exam. Your health care provider can examine and test you for hepatitis A.

How is it treated?

There are no medicines for treating hepatitis A. If you have been exposed to hepatitis A virus, tell your health care provider. They may be able to give you a protein that fights hepatitis A virus to help keep you from getting sick. Most people with hepatitis A recover without treatment in a few months. A few people will need to be hospitalized for hepatitis A.

What can happen if you have hepatitis A for a long time?

People with hepatitis A usually improve without treatment and have no lasting liver damage. Symptoms usually last less than 2 months. A few people can be ill for as long as 6 months. Hepatitis A can sometimes cause liver failure and death. This is usually occurs in:

• People 50 years of age or older
• People with other liver diseases, such as hepatitis B or C

If you have hepatitis A

• Get plenty of rest.
• Eat healthy foods.
• Drink plenty of fluids.
• Avoid drinking any alcohol.
• Check with your health care provider before taking:
  • Medicines
  • Supplements and herbal medicines
  • Over-the-counter drugs
• Clean hands often, especially after using the bathroom.
• Avoid preparing food, if possible, while you are sick.
• Talk to those listed below about having hepatitis A so they can get more information to protect themselves:
  • Household contacts
  • Sexual contacts
  • Playmates/attendees at childcare centers
  • Persons sharing illegal drugs
  • Persons sharing food or drink
  • Coworkers and/or restaurant patrons where there is an infected food worker

If you have hepatitis A, avoid drinking alcohol.

How can you avoid hepatitis A?

The best way to prevent hepatitis A is to be vaccinated. People with certain risk factors and health problems need this vaccine. Ask your doctor if the vaccine is right for you. You cannot get hepatitis A from the vaccine. Hepatitis A vaccination is recommended for:

• All children at age 1 year
• People who use injection and non-injection illegal drugs
• People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C
• People with bleeding problems who take clotting factors
• People whose work has a risk for hepatitis A infection
• People who live in areas with high rates of hepatitis A infection
• Travelers to countries that have high rates of hepatitis A. These include:
  • Africa
  • Asia
  • Latin America
  • South America
  • Eastern Europe

Getting vaccinated is the best way to prevent hepatitis A.

Other ways to avoid hepatitis A:

• Boil water or drink bottled water in places where the water may not be clean.
• Eat cooked foods and fruits that you can peel. Avoid eating uncooked vegetables or fruits that could have been washed with dirty water, such as lettuce.
• Avoid eating raw or steamed shellfish such as oysters. Shellfish may live in dirty water.
• Use condoms correctly and every time you have sex.
• Clean hands often.

What about pregnancy?

Hepatitis A vaccine does not contain live virus, so the risk to the baby is expected to be low. However, the safety of hepatitis A vaccination during pregnancy is not known. The risk of the vaccination should be weighed against the risk for hepatitis A in pregnant women. Ask your health care provider if the vaccine is right for you.

Hepatitis B is a disease of the liver caused by hepatitis B virus. Most adults who have hepatitis B will recover on their own. However, children and some adults can develop chronic (lifelong) hepatitis B.

How is it spread?

Hepatitis B virus is spread by contact with body fluids that carry the virus, such as:

• Blood
• Semen
• Vaginal fluids
• Other body fluids

Hepatitis B is spread by contact with infected body fluids, mostly by:

• Sexual contact: (This is the most common way it is spread in the U.S.)
  • Vaginal and anal sex
  • Sharing unclean sex toys
  • Body fluids with hepatitis B can enter tiny breaks or rips in the linings of the vagina, vulva, rectum,or mouth. Rips and tears in these areas can be common and often unnoticed.
• Needle sharing:
  • Used or unclean needles
  • During illegal drug or drug equipment use
• Contact with blood:
  • Open sores of an infected person
  • Sharing items such as razors or toothbrushes with an infected person
  • Being tattooed or pierced with tools that were not properly cleaned
• Pregnancy and birth:
  • Hepatitis B can spread to babies during pregnancy and birth.

Infected mothers can pass hepatitis B to their babies during childbirth.

Hepatitis B is rarely spread from a blood transfusion because:

• Hepatitis B tests are done on all donated blood.
• Blood and blood products that test positive for hepatitis B are safely destroyed. None are used for transfusions.
• There is no risk of getting hepatitis B when donating or giving blood.

Who is at risk of hepatitis B?

Anyone can get hepatitis B if not vaccinated. However, in the U.S., you may be at a higher risk if you:

• Have sex partners that have hepatitis B
• Have HIV or another STD
• Inject drugs or share needles, syringes, or other drug-injection equipment
• Live with someone who has hepatitis B
• Are undergoing dialysis
• Have diabetes
• Travel to areas that have moderate to high rates of hepatitis B
• Work in health care or public safety and are exposed to blood or body fluids on the job
• Are an infant born to an infected mother

What are signs of hepatitis B?

When you first get hepatitis B, it is called acute hepatitis B. Most adults who have hepatitis B will recover on their own. However, children and some adults can develop chronic (lifelong) hepatitis B.

Acute hepatitis B: Signs of acute hepatitis B can appear within 3 months after you get the virus. These signs may last from several weeks to 6 months. Up to 50% of adults have signs of acute hepatitis B virus infection. Many young children do not show any signs. Signs include:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine
• Joint pain

Chronic hepatitis B: Hepatitis B is chronic when the body can't get rid of the virus. Children, mostly infants, are more likely to get chronic hepatitis B than adults. People with chronic hepatitis B may have no signs for as long as 20 or 30 years. Signs may be the same as acute hepatitis B. There may also be signs of liver damage and cirrhosis such as:

• Weakness
• Weight loss
• Small, red, spider-like blood vessels on the skin
• Confusion or problems thinking
• Loss of interest in sex
• Swollen stomach or ankles
• A longer than normal amount of time for bleeding to stop

How do you know if you have hepatitis B?

The only way to know if you have hepatitis B is by a medical exam. There are several blood tests your health care provider can use to diagnose hepatitis B. These tests can tell you:

• If it is an acute or a chronic infection
• If you have recovered from infection
• If you are immune to hepatitis B
• If you could benefit from vaccination

How is it treated?

Acute hepatitis B: There are no drugs to treat acute hepatitis B. Doctors usually suggest rest, good nutrition, and fluids. Some people may need to be in the hospital.

Chronic hepatitis B: People with chronic hepatitis B virus infection should receive care from a provider who has experience treating hepatitis B. These providers can be:

• Some internists or family medicine providers
• Infection specialists
• Gastroenterologists (digestive system specialists)
• Hepatologists (liver specialists)

If you have chronic hepatitis B, get checked regularly for signs of liver disease. Discuss treatment with your health care provider. Not every person with chronic hepatitis B needs treatment. If you show no signs of liver damage, your provider will continue to check you for liver disease.

What can happen if chronic hepatitis B is not treated?

Chronic hepatitis B is a serious disease that can result in long-term health problems. Up to 1 in 4 people with chronic hepatitis B develop serious liver problems. These include:

• Liver damage and scarring (cirrhosis)
• Liver failure
• Liver cancer
• Death

If you have hepatitis B

• See your health care provider regularly.
• Tell current and recent sex partners that you have hepatitis B.
• Get plenty of rest.
• Eat healthy foods.
• Drink plenty of fluids.
• Avoid drinking any alcohol.
• Check with your health care provider before taking:
  • Prescription medicines
  • Supplements or herbal medicines
  • Over-the-counter drugs
• Avoid spreading hepatitis B to others by:
  • Having safer sex and using condoms during all sexual contact.
  • Not sharing used or unclean needles and sex toys.
  • Not donating blood, blood products, or organs.
  • Cleaning all blood spills – even those that have already dried. Use a mixture of bleach and water (one part household bleach to 10 parts water). Even dried blood is a risk to others.
  • Not sharing personal care items like razors, toothbrushes, nail clippers or earrings.
  • Not sharing glucose-monitoring equipment.
  • Asking sexual partner(s) and people living in close contact with you to be tested and vaccinated.

How can you avoid hepatitis B?

Getting the vaccine for hepatitis B is the best way to prevent hepatitis B. The hepatitis B vaccine is safe and effective. It is usually given as 3-4 shots over a 6-month period. You will not get hepatitis B from the vaccine. Ask your health care provider if you should get this vaccine. It is recommended for:

• All infants, starting with the first dose of hepatitis B vaccine at birth
• Everyone under the age of 19 who has not been vaccinated
• People whose sex partners have hepatitis B
• Sexually active people who are not in a long-term, faithful relationship
• People with a sexually transmitted disease
• People who share needles, syringes, or other drug-injection equipment
• People who have close household contact with someone infected with the hepatitis B virus
• Health care and public safety workers at risk for exposure to blood or body fluids on the job
• People with kidney disease. This includes all those on dialysis and those being considered for dialysis.
• Adults with diabetes
• Residents and staff of facilities for disabled persons
• People with chronic liver disease
• People with HIV infection
• Travelers to regions with moderate or high rates of hepatitis B

Travelers at increased risk for infection include:

• Adventure travelers
• Peace Corps volunteers
• Missionaries
• Military personnel

Certain events may increase the risk for hepatitis B for travelers:

• An injury or illness that requires certain types of treatment. These include anything that breaks the skin such as shots, fluids in the vein, transfusion, stitches, and surgery.
• Dental treatment
• Unprotected sexual contact
• Sharing drug injection equipment
• Tattooing, ear piercing, acupuncture and other practices that break the skin
• Practices with risk for breaking the skin such as manicures and pedicures
• Sharing certain items such as earrings, razors, toothbrushes and nail clippers

The hepatitis B vaccine is the best way to prevent hepatitis B.

Other ways to avoid hepatitis B:

• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting hepatitis B. Each time you have sex use a condom (male or female type):
    • Before vaginal sex
    • Before anal sex
    • Before oral sex
  • Have sex with only one partner who does not have sex with others and does not have hepatitis B.
• Know that other forms of birth control do not protect against hepatitis B.
• Not using or injecting drugs.
• Not reusing or sharing syringes, or drug equipment (works).
• Wear gloves if you have to touch another person's blood.
• Do not use another person's toothbrush, razor, nail clippers or any other item that might have even a tiny bit of blood on it.
• Make sure any tattoos or body piercings are done under good conditions, using:
  • Sterile tools
  • Clean hands and gloves
  • Disinfected work surfaces

What about pregnancy?

If you have hepatitis B, your baby has a very high chance of getting it. Pregnant women should be checked for hepatitis B by a health care provider. If you are at risk for hepatitis B, ask your provider about getting vaccinated. The hepatitis B vaccine is safe for pregnant women and their baby. The vaccine can help your baby if:

• It is given to the baby within 12 hours of birth.
• The baby finishes the vaccine series. Note: babies should be tested after the last vaccine shot to make sure they are protected from the disease.

Don't breastfeed until you have discussed it with your health care provider. Avoid breastfeeding if your nipples are cracking or bleeding until the sores heal. Until they heal, you can pump your milk to keep up your milk supply. Do not feed this milk to your baby. Throw it away.

Hepatitis B is a very serious disease for babies. 9 out of 10 babies infected develop chronic hepatitis B.

Hepatitis C is a disease of the liver caused by hepatitis C virus. Hepatitis C infection can lead to chronic viral hepatitis, including liver damage, cirrhosis (scarring of the liver), and liver cancer.

How is it spread?

Hepatitis C virus is mostly spread by blood from an infected person when:

• Sharing needles or other equipment to inject drugs. This is the most common way people get hepatitis C in the U.S.
• Getting a needle stick with a needle that was used on an infected person
• Sharing items that may have come in contact with another person's blood, such as razors, nail clippers, pierced earrings, toothbrushes
• Being tattooed or pierced with tools that were used on an infected person
• Having sexual contact with a person infected with the hepatitis C virus. The risk of getting hepatitis C from sexual contact is thought to be low.

Hepatitis C is rarely spread from a blood transfusion because:

• Hepatitis C tests are done on all donated blood.
• Blood and blood products that test positive for hepatitis C are safely destroyed. None are used for transfusions.
• There is no risk of getting hepatitis C when donating or giving blood.

Hepatitis C is not spread by kissing,hugging, coughing, or sharing food and eating utensils.

Who is at risk of hepatitis C?

Anyone can get hepatitis C. It is important for people at high risk of infection to be tested and treated for hepatitis C. In the U.S., you are at a higher risk if you:

• Have ever used a needle to inject drugs, even if once and long ago
• Had a blood transfusion or organ transplant before 1992
• Are a health care worker who had blood exposure to mucous membranes or to non-intact skin, or a needlestick injury
• Have ever been on kidney dialysis
• Were born of a mother who had hepatitis C at the time
• Are a Vietnam-era Veteran
• Had contact with hepatitis-C-positive blood to nonintact skin or to mucous membranes
• Received tattoos or body piercings in non-regulated settings
• Have ever snorted drugs or shared drug equipment
• Have liver disease
• Have abnormal liver tests
• Have a history of alcohol abuse
• Have hemophilia and received clotting factor before 1987
• Have had a sexual partner with hepatitis C, now or in the past
• Have had 10 or more lifetime sexual partners
• Have HIV infection

The only way to know if you have Hepatitis C is to be tested. VA offers hepatitis C testing and treatment to enrolled Veterans.

What are signs of hepatitis C?

When you first get hepatitis C, it is called acute hepatitis C. About 15% of people who have acute hepatitis C infection clear the virus from their bodies. The other 85% of people develop a chronic (lifelong) hepatitis C infection. Of these, 50 to 80%, if treated, may be cured.

Acute hepatitis C: Most people with acute hepatitis C do not have any signs. If signs occur, the average time is 6-7 weeks after exposure, but can be less or more. Some people can have mild to severe signs including:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine

Chronic hepatitis C: 3-5 million persons in the United States have chronic hepatitis C infection. Most people do not know they are infected. They don't look or feel sick until the virus causes liver damage. This can take 10 years or more to happen. Signs may be the same as acute hepatitis C. There may also be signs of liver damage and cirrhosis such as:

• Weakness
• Weight loss
• Small, red, spider-like blood vessels on the skin
• Confusion or problems thinking
• Loss of interest in sex
• Swollen stomach or ankles
• A longer than normal amount of time for bleeding to stop

How do you know if you have hepatitis C?

The only way to know if you have hepatitis C is by a medical exam. There are several blood tests your health care provider can use to diagnose hepatitis C. These tests can tell you:

• If it is acute or chronic infection
• If you have recovered from infection
• If you could benefit from vaccination for hepatitis A and B

In some cases, your health care provider may suggest a liver biopsy. A liver biopsy is a test for liver damage. A needle is used to remove a tiny piece of liver, which is then sent for tests.

How is it treated?

If you have chronic hepatitis C infection, your health care provider will examine you for liver problems and may prescribe drugs to help control the disease. Hepatitis C drugs can help to:

• Clear the virus from the body
• Slow down or prevent liver damage
• Lower the chance of getting cirrhosis and liver cancer

Before starting treatment it is important to discuss your options with your health care provider. Treatment for hepatitis C may not be for everyone. Some patients might not need treatment. Other patients might not be able to be treated due to other medical problems.

What can happen if hepatitis C is not treated?

For every 100 people infected with hepatitis C:

• About 15 will clear the virus from their bodies.
• About 85 will develop chronic (long-term) infection. Of these 85 people:
  • 66 will get only minor liver damage
  • 17 will develop cirrhosis and may have symptoms of severe liver disease
  • 2 will develop liver cancer

Chronic hepatitis C infection is the leading cause of liver cancer and cirrhosis in the U.S. Cirrhosis is scarring of the liver which causes it to not work properly. Both liver cancer and cirrhosis can be fatal. A liver transplant may be necessary if chronic hepatitis C causes the liver to fail.

If you have hepatitis C

• See your health care provider regularly.
• Tell current and recent sex partners that you have hepatitis C.
• Get vaccinated against hepatitis A and hepatitis B.
• Get plenty of rest.
• Eat healthy foods.
• Drink plenty of fluids
• Avoid drinking any alcohol. Alcohol use speeds up the damage hepatitis C causes in your liver. Drinking alcohol before starting hepatitis C treatment makes treatment less likely to work. There are ways to help you stop drinking alcohol.
• Check with your health care provider before taking:
  • Prescription medicines
  • Supplements
  • Over-the-counter drugs
• Avoid spreading hepatitis C to others by:
  • Having safer sex and using condoms during all sexual contact.
  • Not sharing used or unclean needles and sex toys.
  • Not donating blood, blood products, or organs.
  • Cleaning all blood spills – even those that have already dried. Use a mixture of bleach and water (one part household bleach to 10 parts water). Even dried blood is a risk to others.
  • Not sharing personal care items like razors, toothbrushes, nail clippers or earrings.
  • Not sharing glucose-monitoring equipment.
  • Asking your sexual partner(s) to be tested for hepatitis C (and perhaps other infections).

If you have hepatitis C, you can prevent liver damage by not drinking alcohol and by getting vaccinated for hepatitis A and hepatitis B.

How can you avoid hepatitis C?

Right now there is no vaccination to protect you against hepatitis C. However, you can take steps to protect yourself from becoming infected:

• Don't use injectable drugs.
• If you use drugs, get vaccinated against hepatitis A and hepatitis B and enter a treatment program.
• Never share needles, syringes, water, or "works" for intravenous drug use, to inject steroids, or cosmetic substances.
• Handle needles and other sharp objects safely.
• Do not use personal items that may have come into contact with an infected person's blood.
• Do not get tattoos or body piercings from an unlicensed facility or in an informal setting.
• Wear gloves if you have to touch another person's blood. Always clean hands after removing gloves.
• Have safer sex. Each time you have sex use a condom.

What about pregnancy?

It is possible to get pregnant if you or your partner has hepatitis C. If you are a pregnant woman who already has hepatitis C (or gets hepatitis C during the pregnancy), the chance of passing the virus to your baby is 4 out of 100. The risk becomes greater if the mother has both hepatitis C and HIV. With good prenatal care, babies born to mothers or fathers with hepatitis C are usually quite healthy. The chance of your baby being infected with hepatitis C is the same whether your baby is born by vaginal delivery or C-section. Before breastfeeding, talk to your health care provider.

Viral hepatitis is common in the United States and affects women and men. Hepatitis B and C are more common than hepatitis A.

• In 2015, hepatitis A affected an estimated 2,500 Americans. The percentage of people with hepatitis A has gone down by 95% since the hepatitis A vaccine became available in 1995.

• Chronic hepatitis B may affect more than 1 million Americans. Asian-Americans and Pacific Islanders have the highest rates of hepatitis B infection. About 50% of the people living with Hepatitis B are Asian-Americans and Pacific Islanders.

  Within this high-risk group, hepatitis B is usually passed from a mother to her baby during pregnancy. Babies born with hepatitis B are likely to have it their entire lives and are at higher risk of liver damage and liver cancer.

• Hepatitis C is the most common type of viral hepatitis infection in the United States. An estimated 3.5 million Americans have chronic hepatitis C. The CDC recommends that everyone born between 1945 and 1965 (also called baby boomers) get tested at least once for hepatitis C because it is so common in this age group.

Hepatitis A

Hepatitis A is found in an infected person’s stool (poop).

Hepatitis A is spread through:

• Eating or drinking contaminated food or water
  • You can get hepatitis A by eating food prepared by a person with the virus who didn’t wash his or her hands after using the bathroom and then touched the food.
  • You can get hepatitis A by eating raw or undercooked shellfish that came from sewage-contaminated water.
• Vaginal, oral, or anal sex. Hepatitis A can be spread even if the infected person has no symptoms.
• Touching unclean diaper changing areas or toilets. If an infant or toddler had hepatitis A and soiled the changing area, others who come into contact with the stool could become infected.

You are more likely to get hepatitis A if you travel out of the country to a developing country with poor sanitation or without access to clean water and have not gotten vaccinated for hepatitis A. Ask your doctor if you need a hepatitis A vaccination.

Hepatitis B

Hepatitis B is found in an infected person’s blood and other body fluids, such as semen and vaginal fluid.

Hepatitis B is usually spread through:

• Vaginal, oral, or anal sex. This is the most common way hepatitis B is spread. Hepatitis B can be spread even if the infected person has no symptoms.
• Birth to a mother who has hepatitis B
• Sharing or reusing needles, syringes, and drug preparation equipment such as cookers and cotton when injecting drugs. Hands or drug preparation equipment that have even tiny amounts of blood on them can spread hepatitis B.
• Accidental needle stick or other sharp instrument injury (higher risk for health care workers)

A less common way to spread hepatitis B is through pre-chewed food to a baby from a mother who has hepatitis B. However, hepatitis B cannot be spread through breastfeeding.

Hepatitis C

Hepatitis C is found in an infected person’s blood and other body fluids.

Hepatitis C is usually spread through:

• Sharing or reusing needles, syringes, and drug preparation equipment such as cookers and cotton when injecting drugs. This is the most common way hepatitis C is spread in the United States. Hands or drug preparation equipment that have even tiny amounts of blood on them can also spread hepatitis C.
• Accidental needle stick or other sharp instrument injury (higher risk for health care workers)

Less common ways to spread hepatitis C:

• Vaginal, oral, or anal sex
• Birth to a mother who has hepatitis, though this is rare
• Sharing personal items like razors and toothbrushes
• Tattoos or body piercings
• Blood transfusions done in the United States before the 1990s (when hepatitis C testing began) or in other parts of the world where hepatitis C testing is less common

Hepatitis B and C can cause problems during pregnancy and can be passed to your baby. The risk of passing the virus to your baby is higher with hepatitis B than C.

Research shows that pregnant women with hepatitis B or C may have a higher risk for certain pregnancy complications:

• Gestational diabetes
• Low-birth-weight baby (less than 5 ½ pounds)
• Premature birth (also called preterm birth, or babies born before 37 weeks of pregnancy). Premature birth is the leading cause of infant death and raises the risk of health and developmental problems at birth and later in life.

Talk to your doctor if you think you may be pregnant or plan to become pregnant. Some antiviral medicines that treat hepatitis C, such as ribavirin, can cause serious birth defects if taken during pregnancy.

Maybe. Hepatitis B and C can be passed from a pregnant woman to her baby during childbirth.

• If you have hepatitis B, the risk of passing the infection to your baby is higher than if you have hepatitis C. Make sure your baby gets HBIG (hepatitis B immune globulin) and the first shot of hepatitis B vaccine within 12 hours of birth. Your baby will need two or three more shots of the vaccine over the next 1 to 15 months to help keep them from getting hepatitis B. The timing and total number of shots will depend on the type of vaccine and your baby’s age and weight. All babies should be vaccinated for hepatitis B. Talk to your doctor.

  The hepatitis B vaccine is very important. Babies who become infected with hepatitis B have a 90% chance of developing chronic (long-term) hepatitis B. One in four people infected at birth will die of hepatitis B-related causes such as liver cancer or liver failure. Your doctor will test your baby after the last shot to make sure he or she is protected from the disease.

• If you have hepatitis C, the risk of passing the virus to your baby is believed to be low, but it is still possible. The only way to know if your baby becomes infected is by doing a test. The CDC recommends testing a child after he or she turns 18 months old. Most infants infected with hepatitis C at birth have no symptoms and do well during childhood.

Yes, you can breastfeed your baby if you have viral hepatitis. You cannot pass viral hepatitis through breastmilk.

But, if you have hepatitis C and your nipple or the surrounding skin is cracked or bleeding, stop nursing your baby on that breast until the sores heal. You can pump or hand-express your milk from that breast until it heals. Throw any breastmilk from that breast away, because it might have been contaminated with hepatitis C from the cracked or bleeding skin.

Pumping the breast that is cracked or bleeding will help keep up your milk supply and prevent the breast from getting overly full and painful. You can feed your baby your milk from your healthy breast.

The symptoms of viral hepatitis are similar for all types of hepatitis. They include:

• Low-grade fever (a temperature between 99.5°F and 101°F)
• Fatigue (tiredness)
• Loss of appetite
• Upset stomach
• Vomiting
• Stomach pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice (JAWN-diss), which is when the skin and whites of the eyes turn yellow

People who are newly infected are most likely to have one or more of these symptoms, but some people with viral hepatitis do not have any symptoms. New hepatitis A infections usually cause symptoms, but as many as half the people with new hepatitis B and hepatitis C infections do not have symptoms.

Certain blood tests can show if you have hepatitis, even if you do not have symptoms. People with chronic hepatitis B or C often develop symptoms when their liver becomes damaged.

Hepatitis A

Maybe. If you have symptoms of viral hepatitis, talk to your doctor or nurse about getting tested for hepatitis A.

Hepatitis B

Maybe. All pregnant women need to be tested for hepatitis B during their first trimester of pregnancy. Also, about half the people with hepatitis B have symptoms after infection. This means you might have the infection without knowing it.

The U.S. Preventive Services Task Force recommends getting tested for hepatitis B if you are at high risk of infection:

• You were born in an area with medium or high rates of hepatitis B infection. Those areas are colored medium and dark blue on this map of hepatitis B around the world (PDF – 166 KB) from the CDC.
• Your parents were born in one of the high-risk areas, and you were not vaccinated against hepatitis B as a baby
• You live with, have sex with, or share needles with someone who has hepatitis B
• You have ever had sex with more than one partner and did not use a condom
• You inject drugs
• You receive dialysis
• You get medical treatments that weaken your immune system
• You have HIV

Hepatitis C

Maybe. Most people with hepatitis C don’t have any symptoms. This means you might have the infection without knowing it. The CDC recommends hepatitis C testing for some women without symptoms.

Ask your doctor about getting tested for hepatitis C if:

• You were born between 1945 and 1965
• You have ever injected drugs, even once
• You had a blood transfusion or organ transplant before 1992
• You received clotting factors made before 1987
• You have sex with or share needles with someone who has hepatitis C
• You have been on dialysis
• Your liver test results were not normal
• You have HIV

Why do all baby boomers need to be tested for viral hepatitis?

The CDC recommends that all Americans born between 1945 and 1965 (called baby boomers) get a one-time test for hepatitis C. This is because three in four adults with hepatitis C are baby boomers, and most baby boomers do not know they have it.

It’s likely that many baby boomers with hepatitis C were infected many years ago before the blood supply was tested for hepatitis C.

Talk to your doctor if you have symptoms of viral hepatitis. Your doctor will:

• Ask questions about your health history
• Do a physical exam
• Order blood tests that look for parts of the virus or antibodies that your body makes in response to the virus. Other tests may measure the amount of the virus in your blood.

Hepatitis A, B, and C all start out as an acute (short-term) infection. Some acute infections can develop into lifelong, chronic infections. Your doctor may do a blood test to see if the infection is acute or chronic.

• Hepatitis A causes acute infection only. Most people recover with no lasting health problems.
• Hepatitis B and C can cause both acute and chronic infections. Some people recover from the acute infection and cannot spread the infection to others. For other people, the infection develops into a chronic infection and can be spread to others.

Acute (Short-Term)

Acute viral hepatitis usually goes away on its own. Hepatitis A causes only acute infection, but hepatitis B and C often cause chronic or lifelong infection. If you have acute hepatitis A, B, or C, you may feel sick for a few months before you get better.

Your doctor may recommend rest and making sure you get enough fluids. Avoid alcohol and certain medicines, like the pain reliever acetaminophen, because they can damage the liver during this time. Some people with acute viral hepatitis need to be hospitalized to manage the symptoms.

If you think you have hepatitis, go to the doctor right away.

Chronic (Long-Term)

If you have chronic viral hepatitis, your treatment depends on the type of hepatitis you have:

• Hepatitis B. You will probably meet with your doctor regularly, every six to 12 months, to watch for signs of liver disease and liver cancer. If you plan to become pregnant in the future, talk to your doctor first. You may need antiviral medicines to treat hepatitis B, but many people do not need medicine. The Food and Drug Administration (FDA) has a list of approved medicines to treat hepatitis B.
• Hepatitis C. If you have hepatitis C, talk with your doctor about whether you need medicine. Recently approved antiviral medicines treat and may cure hepatitis C in adults. The FDA has a list of approved medicines to treat hepatitis C. If you have health insurance, ask about your copay or coinsurance and which medicines are covered under your plan.

Most people recover from hepatitis A with no treatment or long-lasting health problems.

Chronic hepatitis B and C can lead to serious health problems, such as:

• Cirrhosis, or scarring of the liver
• Liver cancer
• Liver failure

People with liver failure may need a liver transplant to survive. In the United States, cirrhosis caused by chronic hepatitis C is currently the most common reason for needing a liver transplant. Viral hepatitis is also the most common cause of liver cancer.

Call your doctor or your local or state health department if you think you may have been exposed.

• If you may have been exposed to hepatitis A or B, your doctor may recommend getting a vaccine (shot) to keep you from getting the infection.
• The CDC recommends that people who are exposed to hepatitis C, such as a health care worker after an accidental needle stick, get tested for hepatitis C infection. New antiviral medicines for hepatitis C cure most of the people who take them. If you have health insurance, ask about your copay and coinsurance and which medicines are covered under your plan.

You can lower your risk of getting viral hepatitis with the following steps. The steps work best when used together. No single step can protect you from every kind of viral hepatitis.

Steps to lower your risk of viral hepatitis:

• Get vaccinated. Getting vaccinated is the best way to prevent hepatitis A and B. There is no vaccine for hepatitis C. The hepatitis A and hepatitis B vaccines are recommended for anyone who wants protection from the viruses and for people with certain risk factors and health problems. Ask your doctor if you need the vaccines.
• Wash your hands after using the bathroom and changing diapers and before preparing or eating food.
• If you have sex, use condoms. Condoms lower your risk of getting or passing sexually transmitted infections (STIs), including viral hepatitis. Viral hepatitis can be passed through menstrual blood, vaginal fluid, and semen (cum). Make sure to put the condom on before the penis touches your vagina, mouth, or anus. Other methods of birth control like birth control pills, shots, implants, or diaphragms, will not protect you from viral hepatitis.
• Limit your number of sex partners. Your risk of getting viral hepatitis goes up with the number of lifetime sex partners you have.
• If you use needles or syringes for any reason, do not share them with others.
• Do not share personal items that could have blood on them, such as razors, nail clippers, toothbrushes, or glucose monitors.
• Do not get tattoos or body piercings from an unlicensed person or facility.
• Wear protective gloves if you have to touch another person’s blood.
• If you are a health care or public safety worker, get vaccinated for hepatitis A and B, and always follow recommended standard precautions and infection-control principles, including safe injection practices.

Do I need the viral hepatitis vaccines?

Maybe. The hepatitis A and B vaccines can protect you from getting infected. Talk to your doctor or nurse about getting the recommended vaccines.

There is no vaccine yet to prevent hepatitis C. But you can take other steps to lower your risk of getting hepatitis C.

Hepatitis A vaccine

The hepatitis A vaccine is given in two doses, six to 18 months apart. Two doses are needed for lasting protection.

The vaccine is recommended for:

• All children, starting at 1 year (12 to 23 months old)
• Men who have sex with men
• People who travel or work in a part of the world where hepatitis A is common, such as certain parts of Central or South America, Asia, Africa, and eastern Europe.
• People who use illegal drugs
• People who are treated with clotting factor concentrates, such as people with hemophilia (HEE-moh-FIL-ee-uh)
• People with chronic liver disease
• People who work with hepatitis A in a laboratory or with hepatitis A–infected primates
• Members of households planning to adopt a child, or care for a newly arriving adopted child, from a country where hepatitis A is common.

Hepatitis B vaccine

The hepatitis B vaccine is usually given in three doses over six months. The vaccine is recommended for:

• All children at birth
• All children and teens younger than 19 who have not been vaccinated
• Men who have sex with men
• People who live with or have sex with someone who is infected with hepatitis B
• People with more than one sex partner
• People who share equipment to inject drugs
• People with chronic liver or kidney disease
• People with HIV
• People younger than 60 with diabetes
• People whose jobs expose them to human blood or other body fluids
• Residents and staff of facilities for people with developmental disabilities
• People who travel to parts of the world where hepatitis B is common, such as Southeast Asia, sub-Saharan Africa, the Amazon Basin in South America, the Pacific Islands, parts of Eastern Europe, and parts of the Middle East. 

How long do the hepatitis A and B vaccines protect you?

During your lifetime, you need:

• One series of the hepatitis A vaccine (two shots given at least 6 months apart)
• One series of the hepatitis B vaccine (three or four shots given over a 6-month period)

Most people don’t need a booster dose of either vaccine. But if you have had dialysis, a medical procedure to clean your blood, or have a weakened immune system, your doctor might recommend additional doses of the hepatitis B vaccine.

How can I get free or low-cost hepatitis A and B vaccines?

The hepatitis A and hepatitis B vaccines are covered under most insurance plans.

• If you have insurance, check with your insurance provider to find out what’s included in your plan.
• Medicare Part B covers hepatitis B vaccines for people at risk.
• If you have Medicaid, the benefits covered are different in each state. Check with your state's program.

Find a clinic near you where you can get vaccines for hepatitis A and B.