The ABCs of Hepatitis

Hepatitis refers to inflammation of the liver, commonly caused by a viral infection but can also be caused by alcohol abuse, toxins and drugs.  There are five (5) main Hepatitis viruses, referred to as types A, B, C, D and E.

Hepatitis A

This is a viral disease caused by the Hepatitis A virus.

The disease is closely associated with contaminated drinking water and food, inadequate sanitation and poor personal hygiene.


The Hepatitis A virus is transmitted primarily by the faecal-oral route. This is when a healthy person (not infected by the virus) ingests food or water that has been contaminated with the faeces from an infected person. The virus can also be transmitted by contaminated hands put in the mouth as commonly experienced in children.


There is no specific treatment for Hepatitis A. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.


Improved sanitation, food safety and immunization are the most effective ways to combat Hepatitis A.

Hepatitis B

Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B virus. It is a major global health problem and the most serious type of viral Hepatitis. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver with possibilities of liver cancer.


Hepatitis B virus is transmitted to people by direct blood contact, semen and vaginal fluid of an infected person. Modes of transmission are the same as those for the human immunodeficiency virus (HIV), but the Hepatitis B virus is 50 to 100 times more infectious.

Common modes of transmission are: 

  • Birth (spread from an infected mother to her baby during birth)
  • Unprotected sex with an infected partner.
  • Sharing needles, syringes, or other drug-injection equipment.
  • Sharing items such as razors or toothbrushes with an infected person.
  • Direct contact with the blood or open sores of an infected person.
  • Exposure to blood from needle sticks or other sharp instruments.


There is no specific treatment for acute Hepatitis B. Care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.


The Hepatitis B vaccine is the main mode of Hepatitis B prevention. The vaccine can be given as either three or four separate doses, as part of existing routine immunization schedules. Protection lasts at least 20 years and is possibly lifelong. People in high-risk groups should also be vaccinated.

People in high-risk groups include: 

  • People with high-risk sexual behaviour
  • Partners and household contacts of infected people
  • Injecting drug abusers
  • People who frequently require blood or blood products
  • Recipients of solid organ transplantation
  • People at occupational risk of Hepatitis B virus infection, including health workers
  • Travellers to countries with high rates of Hepatitis B.

To Note: The vaccine has an outstanding record of safety and effectiveness.

Hepatitis C

Hepatitis C is a contagious liver disease that results from infection with the Hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness.


The Hepatitis C virus is most commonly transmitted through exposure to infectious blood.

This can occur through: 

  • Receipt of contaminated blood transfusions, blood products and organ transplants
  • Injections given with contaminated syringes and needle pricks in health-care settings
  • Injection drug use.
  • Being born to a Hepatitis C-infected mother.
  • Hepatitis C may be transmitted through sex with an infected person.


Hepatitis C does not always require treatment. Combination antiviral therapy has been the mainstay of Hepatitis C treatment.


There is no vaccine for Hepatitis C.

The risk of infection can be reduced by avoiding: 

  • Unnecessary and unsafe injections
  • Unsafe sharps waste collection and disposal
  • Use of illicit drugs and sharing of injection equipment
  • Unprotected sex with Hepatitis C-infected people
  • Sharing of sharp personal items that may be contaminated with infected blood
  • Tattoos, piercings and acupuncture performed with contaminated equipment.

For people infected with the Hepatitis C virus, the below recommends are approved by the world health organization (WHO):

Education and counselling on options for care and treatment

  • Immunization with the Hepatitis A and B vaccines to prevent co-infection from these Hepatitis viruses to protect their liver.
  • Regular monitoring for early diagnosis of chronic liver disease.

Hepatitis D

Hepatitis D virus (HDV) is found ONLY in people who carry the Hepatitis B virus. HDV may follow a recent (acute) Hepatitis B infection or an existing long-term (chronic) Hepatitis B liver disease worse. It can cause symptoms in people who carry the Hepatitis B virus but who never had symptoms.

Risk factors include: 

  • Abusing intravenous (IV) or injection drugs.
  • Being infected while pregnant (the mother can pass the virus to the baby)
  • Carrying the Hepatitis B virus.
  • Intercourse through anal penetration.
  • Receiving many blood transfusions.


Many of the medicines used to treat Hepatitis B are not helpful for treating Hepatitis D. A liver transplant for end-stage chronic Hepatitis B may be effective.


Use the same guidelines as for Hepatitis B; only a person who is infected with Hepatitis B can become infected with Hepatitis D. There is no vaccine for Hepatitis D, but it can be prevented in persons who are not already HBV-infected by Hepatitis B vaccination.

Hepatitis E

Hepatitis E is a liver disease caused by the Hepatitis E virus. The Hepatitis E virus is transmitted mainly through contaminated drinking water. It is usually a self-limiting infection and resolves within 4–6 weeks. Occasionally, a severe form of Hepatitis develops (acute liver failure), which can lead to death.


The Hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. The risk factors for Hepatitis E are related to poor sanitation.

Other transmission routes have been identified, which include: 

  • Foodborne transmission from ingestion of products derived from infected animals
  • Transfusion of infected blood products;
  • Vertical transmission from a pregnant woman to her fetus.
  • The ingestion of raw or uncooked shellfish has also been identified as the source of sporadic cases in endemic areas.


  • Jaundice (yellow discolouration of the skin and sclera of the eyes, dark urine and pale stools) • Loss of appetite
  • An enlarged, tender liver
  • Abdominal pain and tenderness;
  • Nausea and vomiting
  • Fever.


There is no available treatment capable of altering the course of acute Hepatitis. As Hepatitis E is usually self-limiting, hospitalization is generally not required. However, hospitalization is required for people with fulminant Hepatitis and should also be considered for infected pregnant women.


  • Maintaining hygienic practices such as handwashing with safe water, particularly before handling food
  • Avoiding drinking water and/or ice of unknown purity
  • Avoiding eating uncooked shellfish, and uncooked vegetables or fruits that are not peeled or properly washed.