Hepatitis is an inflammation of the liver that’s linked to a variety of causes, including heavy drinking or consumption of toxins, certain medications or one of three strains of the hepatitis virus, hepatitis A, hepatitis B or hepatitis C.

Among viral hepatitis, hep C is the most common, causing about 44,000 new infections per year. Nearly 2.5 million Americans are living with hep C. Hepatitis B is the second most common cause of viral hepatitis, being linked to about 22,000 new infections per year, while hep A causes nearly 7,000 viral hepatitis cases per year.

While each strain of viral hepatitis is similar, they vary in many important ways, including the primary transmission methods. It’s technically possible for each to spread sexually, but hep B is most closely tied with sexual transmission. Many people with viral hepatitis are unaware they are infected, but two strains of the virus — A and B — can be prevented with a vaccine.

Learn more about viral hepatitis, what it does to the body and how it can be prevented.

In This Section

h2 id="symptoms">Hepatitis Symptoms

Many people who contract hepatitis don’t show signs of the virus and so remain unaware of their status. For those whose bodies do show signals of viral hepatitis, symptoms can begin appearing in as little as two weeks or up to six months after exposure, and both hep B and hep C can become chronic conditions.

Several of the symptoms of acute viral hepatitis infection are similar across the three types, while others are generally unique to only one or two types of hepatitis, and symptoms generally are the same regardless of the sex of the infected person:

Hepatitis A

  • Dark urine
  • Jaundice (yellow skin or eyes)
  • Stool that’s pale or clay in color
  • Low-grade fever
  • Poor appetite
  • Fatigue
  • Nausea

Hepatitis B

  • Dark urine
  • Stomach discomfort and pain
  • Painful or aching joints
  • Jaundice (yellow skin or eyes)
  • Low-grade fever
  • Poor appetite
  • Fatigue
  • Nausea

Hepatitis C

  • Dark urine
  • Stomach discomfort and pain
  • Stool that’s pale or clay in color
  • Jaundice (yellow skin or eyes)
  • Low-grade fever
  • Poor appetite
  • Fatigue
  • Nausea

Hepatitis Transmission

All three types of viral hepatitis can be transmitted sexually, but hep B and, to a lesser degree, hep C are more closely associated with sexual transmission, while both hep B and hep C are commonly transmitted through the sharing of dirty needles. Hepatitis A is most often transmitted by ingesting tiny amounts of infected fecal matter in food or drinks. Hep B and hep C both are transmitted through blood or other bodily fluids enter the body of an uninfected person, so it may be possible to transmit either type of that virus through sharing razors or toothbrushes, assuming blood is present.

Hepatitis Prevalence

Hepatitis C is the most common type of viral hepatitis, with nearly 2.5 million Americans living with the virus. The majority of people who have either hepatitis B or hepatitis C are unaware they are infected.

All three types of viral hepatitis have seen infection rates rise in recent years, though all three have become less common over the past couple of decades. Hepatitis A has declined the most dramatically, falling by almost 80% between 2000 and 2017, the most recent year for which data is available.

Viral hepatitis infections per 100,000 people by year

Year Hepatitis A Hepatitis B* Hepatitis C*
2000 4.8 2.9 1.1
2001 3.7 2.8 0.7
2002 3.1 2.8 0.5
2003 2.6 2.6 0.3
2004 1.9 2.1 0.3
2005 1.5 1.8 0.2
2006 1.2 1.6 0.3
2007 1 1.5 0.3
2008 0.9 1.3 0.3
2009 0.6 1.1 0.3
2010 0.5 1.1 0.3
2011 0.4 0.9 0.4
2012 0.5 0.9 0.6
2013 0.6 1 0.7
2014 0.4 0.9 0.7
2015 0.4 1.1 0.8
2016 0.6 1 1
2017 1 1.1 1
* Acute infections

The two most common types of viral hepatitis, hep B and hep C, vary widely depending on the area of the country in question. For hep B infections, the type of viral hepatitis more closely connected to STDs, West Virginia leads the country in the infection rate at 11.7 per 100,000, more than double the next highest rate, Maine’s 5.8 per 100,000.

Acute hepatitis B infections per 100,000 people by state

West Virginia 11.7
Maine 5.8
Kentucky 5.3
Tennessee 3.2
Florida 2.8
Indiana 2.5
Ohio 2.4
North Carolina 1.8
Alabama 1.7
Louisiana 1.6
Arkansas 1.5
Mississippi 1.5
Alaska 1.2
Georgia 1
Nevada 1
Oklahoma 1
Delaware 0.9
Kansas 0.8
South Carolina 0.8
Massachusetts 0.7
Virginia 0.7
Colorado 0.6
Maryland 0.6
Michigan 0.6
New Jersey 0.6
Oregon 0.6
Utah 0.6
Washington 0.6
Missouri 0.5
Nebraska 0.5
Pennsylvania 0.5
Arizona 0.4
Iowa 0.4
Minnesota 0.4
New York 0.4
Texas 0.4
California 0.3
Connecticut 0.3
Idaho 0.3
Montana 0.3
Illinois 0.2
South Dakota 0.2
Vermont 0.2
Wisconsin 0.2
Hawaii 0
New Hampshire 0
New Mexico 0
North Dakota 0
District of Columbia NA
Rhode Island NA
Wyoming NA

Hepatitis C is also more common in West Virginia than any other state, though the numbers are not as dramatic as for hep B in that state. But West Virginia leads the nation with 5.6 hep C infections per 100,000 people, followed by Massachusetts with 4.8 per 100,000.

Acute hepatitis C infections per 100,000 people by state

West Virginia 5.6
Massachusetts 4.8
Indiana 2.9
Utah 2.6
South Dakota 2.2
Tennessee 2.1
Kentucky 1.9
Florida 1.7
Pennsylvania 1.7
Maine 1.6
Wisconsin 1.6
Michigan 1.5
Ohio 1.4
New Jersey 1.4
Vermont 1.4
Montana 1.3
Nevada 1.2
Oklahoma 1.2
North Carolina 1.1
Georgia 1
Minnesota 1
New York 0.9
Oregon 0.8
Missouri 0.8
New Mexico 0.8
Kansas 0.7
Virginia 0.7
Colorado 0.7
Washington 0.7
Maryland 0.5
Idaho 0.5
Delaware 0.4
Alabama 0.3
South Carolina 0.3
California 0.3
Connecticut 0.3
Illinois 0.3
Louisiana 0.1
Nebraska 0.1
Texas 0.1
North Dakota 0.1
Arkansas 0
District of Columbia NA
Rhode Island NA
Wyoming NA
Mississippi NA
Alaska NA
Arizona NA
Iowa NA
Hawaii NA
New Hampshire NA

At-Risk Groups

Several groups are at an elevated risk of contracting viral hepatitis depending on their age, lifestyle and other factors. This includes:

  • Asians/Pacific Islanders: About 50% of people with chronic hep B in the U.S. are of Asian or Pacific Islander descent. An estimated one-third of Asian-Americans with hep B have not been diagnosed.
  • Baby Boomers: About 3 in 4 people with hep C were born between 1945 and 1965, and every person born during those years should be tested at least once for hepatitis C virus.
  • Injection drug users: Widespread outbreaks of hep A are currently ongoing across the U.S., and these individuals also are at elevated risk of hep B and hep C.
  • Men who have sex with men: Gay and bisexual men are at elevated risk of both hep A and hep B, and there currently are widespread outbreaks of hep A that have been reported to affected men who have sex with men. Gay and bisexual men who are 55 or older, have HIV or engage in other risky behaviors may also be at elevated risk of hep C.
  • All people who have unprotected sex and/or many casual partners: Hep A can be spread through sexual activity even with the use of condoms, while hep B is easily transmitted through sexual activity, particularly among those who engage in risky behaviors, such as unprotected sex. Though it’s less common, hep C also canbe transmitted through sex, especially among those with multiple partners or who engage in rough sex.
  • People who work in healthcare settings: Multiple outbreaks of both hep B and hep C have occurred in healthcare settings, including hospitals, long-term-care facilities and outpatient settings, usually through lapses in infection control protocols.
  • Individuals who have HIV or AIDS: Hep B and hep C both are major concerns for people who have tested positive for HIV. HIV-positive people who contract hep B are at a higher risk of developing chronic hep B, and HIV-positive injection drug users are at a serious risk of having hep C virus in addition to HIV (as many as 80%).
  • Diabetics: Particularly for diabetics who live in assisted-living facilities or make frequent visits to outpatient facilities, the risk of hep B infection is elevated.

Hepatitis Complications

The long-term health effects of untreated viral hepatitis depend on the type of hepatitis as well as the individual’s health status. For instance, people who contract hep A are often sick for a few weeks but don’t usually suffer long-term complications. But as many as 85% of people who contract viral hep C develop a chronic case of the virus.

Short- and long-term effects and complications of each type of hepatitis include:

  • Hep A: Usually a short-term infection, but it can last for several months. Most infected people recover with no long-term liver damage, but in very rare cases, hep A can be fatal.
  • Hep B: Ranges from a mild illness that lasts only a few weeks to a chronic, lifelong illness. As many as 10% of adults who become infected develop a chronic hep B infection, while about 90% of unvaccinated infants who become infected develop a chronic case of the virus. Chronic hep B can lead to liver disease, including cirrhosis, cancer or liver failure.
  • Hep C: The majority of people infected with hep C develop a chronic infection of the virus, while others may experience a mild illness. As many as 85% of people who become infected by hep C develop a chronic case of the virus, and up to 20% of those people develop cirrhosis, while another 1%-5% will die as a result.

Hepatitis & Pregnancy

Hepatitis B and hepatitis C both can be spread from a pregnant woman to her child, whether in the womb, during labor or after birth, but the chances of that happening depend on the type of virus involved.

Hepatitis B

Hep B can spread to a baby during childbirth regardless of whether the woman has a C-section or vaginal delivery. Babies who are infected with hep B will usually develop a chronic infection, with about 90% of infants infected with hep B developing a chronic infection of the virus. Babies born to mothers with hep B should get two doses of the hep B vaccine shortly after they are born, and this can help prevent them from becoming infected. Hep B cannot be spread through breastmilk or physical contact that doesn’t not involve blood or other bodily fluids.

Hepatitis C

The chance of a pregnant woman passing hep C to her baby is estimated at about 7%, but there is currently no method of preventing the transmission of the virus during birth. Women who are at high risk of having hep C should be screened during pregnancy, but other women generally don’t need to be screened.

Hepatitis Testing

Routine testing for hepatitis A is not recommended because of the nature of how the virus is transmitted, but there are several population groups that should be aware of recommendations regarding testing for hep B and hep C. And anybody who suspects they’ve been exposed should consult with their healthcare professional.

Federal recommendations for hep B and hep C testing include:

  • Foreign-born populations: People who hail from countries with a hep B prevalence rate of 2% or higher should be screened for hep B. This generally includes Asian and African countries as well as some countries in South America.
  • Injection drug users: People who inject drugs should be tested for hep B and hep C, even if they no longer inject drugs.
  • Men who have sex with men: Gay and bisexual men should be tested for hep B, and gay and bisexual men who are in their mid-50s or older should get tested at least once for hep C.
  • HIV-positive individuals: People with HIV should be tested for both hep B and hep C.
  • Pregnant women: Most pregnant women should be screened for hep B, and women at a higher hep C risk should be screened for that virus as well.
  • Baby Boomers: Anybody born between 1945 and 1965 should be checked at least once for hep C.
  • Hemodialysis patients: Long-term and short-term hemodialysis patients, including those with end-stage renal disease, should be screened for hep B and hep C.
  • Others: People who received blood transfusions or organ transplants before 1992 should be tested for hep C, people who are on immunosuppressive treatment regimens should be screened for hep B, and people who get illegal tattoos should be checked for hep C.

The only way to know for sure whether you are infected with viral hepatitis is to get tested. Depending on the type of viral hepatitis, several testing options could be possible, including:

  • Doctor’s office
  • Pharmacy clinic
  • Planned Parenthood
  • Urgent care center
  • Campus health clinic
  • Community health clinics
  • At-home test kits

Hepatitis Treatment

Treatment possibilities vary depending on the type of viral hepatitis:

Hepatitis A

Most infections resolve on their own time, but medications can help lessen the symptoms.

Hepatitis B

No treatments are available to treat acute viral hep B, but for people who develop chronic hep B, regular doctor visits can keep tabs on possible liver damage, while other patients may be treated with antiviral medications.

Hepatitis C

No treatment is recommended for acute viral hepatitis C, and individuals should be considered for treatment only if they develop chronic hep C. At that point, as many as 90% of people can be cured of chronic hep C with a several-month course of pills.

Hepatitis Prevention

While some common-sense lifestyle practices can reduce the risk of contracting viral hepatitis, there are vaccinations available for both hep A and hep B, though no vaccine has yet been developed for hep C.

Federal recommendations for hep A and hep B vaccinations include:

Hep A

  • All children at 12 months of age
  • International travelers to sites where hep A is common
  • Gay and bisexual men
  • Drug users, including non-injection drug users
  • People who are in direct contact with hep A-infected people

Hep B

  • All infants, and children younger than 19 who weren’t previously vaccinated
  • HIV-positive individuals
  • Gay and bisexual men
  • Sexually active people who aren’t in established, mutually monogamous relationships
  • Injection drug users
  • Healthcare workers
  • Hemodialysis patients
  • People with diabetes


Considering the potential for long-term health consequences, which can include permanent liver damage, cancer and even death, anybody who is at risk of contracting viral hepatitis should consider getting vaccinated for hep A and/or hep B, and people who are at risk should be tested to find out their status.

Additional References


by AtHomeSTDKit

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