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Overview

Hepatitis is inflammation of the liver. It is most commonly caused by a viral infection, but may be due to chemicals, alcohol or drugs and inherited diseases or autoimmune disease. The following information is concerned with those caused by viruses.

The liver performs many functions in the body, including processing the body’s nutrients, manufacturing bile to help digest fats and breaking down potentially toxic (harmful) substances into harmless ones that the body can use or excrete. When the liver is damaged, these functions are impaired to some extent and the potentially toxic substances accumulate. The hepatitis virus reaches the liver through the blood stream, multiplies in the liver cells and is released into the bloodstream, the bile duct, and faeces. In this way, it can be spread to other people. Screening donated blood for the presence of blood-borne hepatitis viruses and other communicable diseases has greatly reduced the transmission of infections in people receiving blood transfusions.

The table below summarises the three most common strains of hepatitis: Hepatitis A, Hepatitis B and Hepatitis C.
 

Virus Hepatitis A Hepatitis B Hepatitis C
Transmission route Faecal-oral Infected needle or blood, sexual contact Infected needle or blood, sexual contact
Incubation time (acute infection) 15-50 days 45-160 days 14-180 days
Onset Sudden Either sudden or slow, unnoticed Usually slow, unnoticed
Severity Mild Occasionally severe Usually slow-developing and symptoms not specific or strong
Chronic form? No Yes Yes
Associated with other diseases? None Liver cancer, cirrhosis Liver cancer, cirrhosis
Testing to diagnose acute infection HAV-Ab, IgM HBsAg, Anti-HBc, IgM, HBeAg HCV AG, Anti-HCV, HCV RNA (note - may have same results as in chronic hepatitis)
Testing to diagnose chronic infection or to monitor treatment N/A HBsAg, HBV DNA, Anti-HBe Anti-HCV (once), HCV RNA or viral load, HCV genotype (once)
Tests that detect previous infection HAV-Ab, IgG Anti-HBs, Anti-HBc total Anti-HCV
Vaccine available? Yes Yes No
Common treatment None Chronic form - entecavir, tenofovir, lamivudine, adefovir, pegylated interferon Chronic form - pegylated interferon and ribavirin, sofosbuvir, daclatasvir, sofosbuvir+ledipasvir


Abbreviations defined:

HAV-Ab = Hepatitis A Antibody 
Anti-HBs = Hepatitis B surface antibody 
HBsAg = Hepatitis B surface antigen 
HBeAg = Hepatitis B e-antigen 
Anti-HBe = Hepatitis B e-antibody 
Anti-HBc = Anti-hepatitis B core antigen 
HBV DNA = Hepatitis B Virus (test for virus genetic material) 
Anti-HCV = Hepatitis C Antibody 
HCV RNA = Hepatitis C Virus (test for virus genetic material) 
HCV Viral Load = A detection and/or count of the amount of virus in the blood 
HCV Genotype = Determines the type of Hepatitis C present (1 of 6 types)


Last Review Date: December 4, 2020


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