The ABCs of Hepatitis for Health Professionals

Overview

This document provides a detailed overview of Hepatitis A, B, and C, including their causes, transmission routes, symptoms, chronic infection potential, testing, treatment, and vaccination recommendations.

Hepatitis A

• Cause: Hepatitis A virus (HAV)
• Transmission: Fecal-oral route; close contact, sexual contact with an infected person, ingestion of contaminated food or water.
• Incubation Period: 15-50 days (average: 28 days)
• Symptoms: Jaundice, fever, fatigue, nausea, vomiting, abdominal pain, diarrhea (HAV only).
• Chronic Infection: None.
• Severity: Most recover without lasting liver damage; death is rare but more common in older adults.
• Serologic Tests: IgM anti-HAV for acute infection.
• Vaccination: Recommended for children and people at increased risk (travelers, men who have sex with men, drug users, etc.).

Hepatitis B

• Cause: Hepatitis B virus (HBV)
• Transmission: Bloodborne; birth to infected mother, sexual contact, sharing needles, etc.
• Incubation Period: 60-150 days (average: 90 days)
• Symptoms: Similar to HAV, though nonspecific symptoms might be present in some people.
• Chronic Infection: Develops in 90% of infants, 25-50% of children, and 5% of adults who are newly infected.
• Severity: Most recover without liver damage; 15-25% of chronic cases develop serious liver disease.
• Serologic Tests: HBsAg, IgM anti-HBc for acute; HBsAg, anti-HBs, total anti-HBc for chronic.
• Vaccination: Recommended for all infants, unvaccinated children, and others at risk (e.g., healthcare workers, travelers, people with liver disease).

Hepatitis C

• Cause: Hepatitis C virus (HCV)
• Transmission: Bloodborne primarily through sharing needles; less common through birth, sexual contact, etc.
• Incubation Period: 14-182 days (average range: 14-84 days)
• Symptoms: May include jaundice, fever, fatigue, and others; nonspecific symptoms in 10-20% of cases.
• Chronic Infection: Develops in over 50% of new infections.
• Severity: 5-25% with chronic hepatitis C develop cirrhosis over 10-20 years; risk of liver cancer.
• Serologic Tests: Anti-HCV, NAT for HCV RNA.
• Treatment: Acute treatment recommended; chronic cases can be cured with oral therapy.
• Vaccination: No vaccine available.

Key Testing Recommendations

• Hepatitis B: All pregnant women, people born in regions with high HBV, household contacts of infected persons, and others.
• Hepatitis C: All adults, pregnant women during pregnancy, people who inject drugs, those with HIV, and specific medical conditions.

Vaccination Details

• Hepatitis A: Single-antigen vaccine: 2 doses; combo vaccine: 3 doses.
• Hepatitis B: Infants: 3-4 doses; Adults: 2 or 3 doses depending on manufacturer.
• Hepatitis C: No vaccine available.

Conclusion

• Hepatitis A, B, and C have distinct modes of transmission, symptoms, and management strategies.
• Vaccinations are available for Hepatitis A and B, but not for Hepatitis C.
• Regular monitoring and testing are essential for managing chronic infections and preventing transmission.