What causes it?

Number of U.S. cases

• About 19,900 estimated infections in 2020

• About 14,000 estimated new infections in 2020
• Estimated 880,000 adults with chronic hepatitis B

• About 66,700 estimated new infections in 2020
• Estimated 2.2 million adults with hepatitis C

Key facts

• Effective vaccine available
• Outbreaks related to contaminated food or to person-to-person transmission still occur in the United States
• Common in many countries, especially those without modern sanitation

• Effective vaccine available
• About 2 in 3 people with hepatitis B do not know they are infected
• In 2020 the rate of newly reported cases was almost 12 times higher in Asian Pacific Islander persons than among non-Hispanic White persons.
• Hepatitis B is a leading cause of liver cancer

• Hepatitis C is curable in more than 95% of cases.
• Nearly 40% of people with hepatitis C do not know they are infected
• In 2020 the rates of hepatitis C- associated deaths were highest in American Indian/Alaska Native and non-Hispanic Black people.
• Hepatitis C is a leading cause of liver transplants and liver cancer

How long does it last?

• Hepatitis A can last from a few weeks to several months.

• Hepatitis B can range from a mild illness, lasting a few weeks, to a serious, life-long (chronic) condition.

• Hepatitis C can range from a mild illness, lasting a few weeks, to a serious, life-long (chronic) infection. Most people who get infected with the hepatitis C virus develop chronic hepatitis C.

How is it spread?

• Hepatitis A virus is spread when someone ingests the virus (even in microscopic amounts too small to see) through close, personal contact with an infected person, or through eating contaminated food or drink.

• Hepatitis B is primarily spread when blood, semen, or certain other body fluids – even in microscopic amounts – from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus can also be transmitted by:
• Birth to an infected pregnant person
• Sex with an infected person
• Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
• Sharing personal items such as toothbrushes or razors, but is less common
• Direct contact with the blood or open sores of a person who has hepatitis B
• Poor infection control in health care facilities
• Although the virus can be found in saliva, it is not spread through kissing or sharing utensils. Hepatitis B is not spread through sneezing, coughing, hugging, breastfeeding or through food or water.

• Hepatitis C is spread when blood from a person infected with the hepatitis C virus – even in microscopic amounts – enters the body of someone who is not infected. The hepatitis C virus can also be transmitted by:

• Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
• Poor infection control, which has resulted in outbreaks in health care facilities
• Unregulated tattoos or body piercings with contaminated instruments
• Receiving a blood transfusion or organ transplant before 1992 (when widespread screening eliminated hepatitis C from the blood supply)
• Birth to an infected pregnant person
• Sexual contact with an infected person
• Hepatitis C is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, sneezing or through food or water.

Who should be vaccinated?

• All children aged 12–23 months
• All children and adolescents 2–18 years of age who have not previously received hepatitis A vaccine

People at increased risk for hepatitis A

• International travelers
• Men who have sex with men
• People who use or inject drugs (all those who use illegal drugs)
• People with occupational risk for exposure
• People who anticipate close personal contact with an international adoptee
• People experiencing homelessness

People at increased risk for severe disease from hepatitis A infection

• People with chronic liver disease, including hepatitis B and hepatitis C
• People with HIV

Other people recommended for vaccination

• Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
• Anyone who requests vaccination

• All infants, children and adolescents younger than 19 years of age
• All adults aged 19 through 59 years
• Adults aged 60 years and older with risk factors for hepatitis B
• Adults 60 years and older without known risk factors for hepatitis B may also receive hepatitis B vaccines
• Anyone who requests vaccination
•  

• There is no vaccine available for hepatitis C

How serious is it?

• People can be sick for a few weeks to a few months
• Most recover with no lasting liver damage
• Although very rare, death can occur

• Acute hepatitis B is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis B virus. Some people with acute hepatitis B have no symptoms at all or only mild illness. For others, acute hepatitis B causes a more severe illness that requires hospitalization.
• Approximately 25% of people who become chronically infected during childhood and 15% of those who become chronically infected after childhood die prematurely from cirrhosis or liver cancer, and most remain asymptomatic until onset of cirrhosis or end-stage liver disease.

• About half of adults who get infected with the hepatitis C virus develop a chronic infection
• Approximately 5%-25% of people with chronic hepatitis C develop cirrhosis over 10–20 years

Who should be tested?

• Screening for prior hepatitis A is not routinely recommended.
• People should only be tested for hepatitis A if they have symptoms and think they might have been infected.

• All adults aged 18 years and older at least once in their lifetime
• All pregnant people early during each pregnancy
• Infants born to pregnant people with HBV infection
• Any person who requests hepatitis B testing should receive it.

Anyone with ongoing risk for exposure should be tested periodically, including

• People born in countries with 2% or higher HBV prevalence
• People not vaccinated as infants with parents born in countries with 8% or higher HBV prevalence
• People who inject or have used injection drugs
• People incarcerated in jail, prison, or detention setting
• Men who have sex with men
• People with HIV
• People with hepatitis C
• People with a sexually transmitted infection or multiple sex partners
• People who share needles or are sexual contacts of people with hepatitis B
• Household contacts of people with hepatitis B
• People requiring immunosuppressive therapy
• People on kidney dialysis
• People with elevated liver enzymes without knowing the cause
• People who donate blood, plasma, organs, tissues or semen

• All adults aged 18 years and older at least once in their lifetime
• All pregnant people early during each pregnancy

At least one time testing for:

• People with HIV
• People who ever injected drugs and shared needles, syringes, or other drug equipment, including those who injected once or a few times many years ago.
• People with persistently abnormal liver enzymes
• People who received clotting factor concentrates produced before 1987
• People who received an organ transplant or a transfusion of blood or blood components before July 1992
• People who were notified that they received blood from a donor who later tested positive for HCV infection
• Health care, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV‑positive blood
• Children born to people with HCV infection

Regular or routine testing for:

• People with ongoing risk factors including people who currently inject and share needles, syringes, or other drug equipment
• People with certain medical conditions including those who ever received maintenance hemodialysis
• Any person who requests hepatitis C testing

Treatment

• People who test positive for hepatitis A are usually treated through supportive care (rest, adequate nutrition, and fluids) to help relieve symptoms

• People who test positive for acute hepatitis B are usually treated through supportive care (rest, adequate nutrition, and fluids) to help relieve symptoms. There is no specific medication available.
• People with chronic hepatitis B can be treated with antiviral drugs and should be monitored regularly for signs of liver disease progression.

• People who test positive for hepatitis C should be treated with medication right away
• Treatment is typically taking pills for 8 – 1 2 weeks. The pills can cure more than 95% of people and side effects are minimal
• The sooner the treatment starts the better it will be at preventing liver damage and further spread. Experts recommend not waiting until a person already has liver damage.