Hepatitis A, B, C
Key facts at a glance
- In viral liver inflammation, a distinction is made between chronic and acute infections. Hepatitis A never becomes chronic, hepatitis B in about 5-10% of the cases in adults, and hepatitis C in about three-quarters of the cases.
- An acute hepatitis infection often goes unnoticed. If symptoms do occur, they typically include lack of appetite, aversion to fatty foods and alcohol, exhaustion, headache, nausea, vomiting, upper abdominal pain, and flu-like symptoms. Only in a few cases does icterus (“jaundice”) develop, involving yellowing of the eyes and the skin as well as dark urine and pale stool.
- Chronic hepatitis can take a mild course – causing mild inflammation of the liver and symptoms such as fatigue, exhaustion, upper abdominal pain, or itching.
- In severe cases, the liver cells are gradually destroyed and replaced by connective tissue (fibrosis); the liver tissue hardens. In the further course of the disease, liver cirrhosis (= scarring and shrinking of the liver causing loss of liver function) and in a small number of those cases, liver cancer may also develop after many years. Other organs, muscles, and joints may be affected as well.
- Hepatitis A is mainly transmitted through contaminated food/water (“travel-related hepatitis”), hepatitis B and C through blood: hepatitis B mainly during sex and injecting drug use, hepatitis C mainly during injecting drug use, in rare cases also during sex.
- A person who has had hepatitis A or B cannot be reinfected. By contrast, reinfection with hepatitis C is also possible after recovery or successful treatment.
- The best protection from hepatitis A and B is vaccination. There is no vaccination against hepatitis C.
- Protection from hepatitis is also offered by disinfection or the use of sterile equipment and disposable material (e.g. at hospitals and medical practices, but also when tattooing and piercing), protective measures for unborn and newborn children as well as the testing of blood and blood products. Hygiene measures, safer use practices, and the use of condoms or internal condoms also reduce the risk of infection.
- Today, direct-acting antivirals allow chronic hepatitis C to be cured in nearly all cases, usually within eight to twelve weeks. If chronic hepatitis B requires treatment, the therapy is often lengthy and – if interferons are used – involves many side effects.
- In people with HIV and hepatitis B or hepatitis C coinfection, there are special factors to be considered in the treatment, such as interactions between medications. The therapy should therefore be performed by experienced specialists.