Hepatitis.Care & specialists in India

The main types are viral hepatitis A, B, C, D, and E, plus non-viral causes including autoimmune hepatitis, alcoholic hepatitis, drug-induced hepatitis, and metabolic dysfunction-associated steatohepatitis (MASH). Each type has distinct transmission, course, treatment, and prevention strategies. Hepatitis A and E are typically acute; B, C, and D can become chronic.

Hepatitis A and E spread through contaminated food and water. Hepatitis B and C spread through blood and body fluids — injection drug use, unprotected sex, unsafe medical injections, and mother-to-child transmission. Hepatitis D only infects people already infected with hepatitis B. Non-viral hepatitis is not contagious.

Common symptoms include fatigue, nausea, loss of appetite, abdominal discomfort, dark urine, pale stools, and yellowing of the skin and eyes (jaundice). Many people with chronic hepatitis B or C are asymptomatic for years until advanced liver damage develops. Routine screening is recommended because of this silent course.

Hepatitis C is curable in over 95% of patients with 8-12 weeks of direct-acting antiviral therapy. Hepatitis A and E are self-limiting and recover fully. Hepatitis B is rarely cured but can be suppressed indefinitely with oral antivirals. Hepatitis D has limited options but bulevirtide is newly approved in Europe. Autoimmune hepatitis is controlled long-term but typically not cured.

Hepatitis A is spread by fecal-oral route, is acute and self-limited, and is vaccine-preventable. Hepatitis B is spread by blood and sex, can be acute or chronic, and is vaccine-preventable but rarely cured. Hepatitis C is spread mostly by blood, becomes chronic in 75% of adults, and is curable in over 95% with direct-acting antivirals — though no vaccine exists.

Yes, for hepatitis A and B. Both are part of routine childhood vaccination in most countries and recommended for all adults. There is no vaccine for hepatitis C, D (other than via HBV vaccination), or E (a vaccine exists in China but is not widely available). Hepatitis B vaccination protects against hepatitis D since HDV requires HBV to replicate.

Diagnosis starts with blood tests showing elevated liver enzymes (ALT, AST) and bilirubin. Specific testing follows: hepatitis A IgM, hepatitis B surface antigen and antibodies, hepatitis C antibody and RNA, autoantibodies for autoimmune hepatitis, and history for alcoholic and drug-induced hepatitis. Imaging and sometimes liver biopsy stage the severity.

Mild acute hepatitis A or E without dehydration or signs of liver failure can often be managed at home with rest, fluids, antiemetics, avoidance of alcohol and hepatotoxic drugs, and close clinician follow-up. Chronic hepatitis B and C require specialist evaluation and treatment. Any signs of confusion, vomiting blood, or progressive jaundice require immediate hospital care.

Acute hepatitis A lasts 4-8 weeks with full recovery in over 95% of cases. Acute hepatitis B in adults usually resolves over 8-16 weeks; only 5-10% become chronic. Hepatitis C becomes chronic in 75% of infected adults and is lifelong without treatment. With current direct-acting antivirals, HCV is cured in 8-12 weeks in over 95% of treated patients.

Yes. Chronic hepatitis B and C are leading global causes of hepatocellular carcinoma. Risk rises substantially once cirrhosis develops but also occurs in non-cirrhotic HBV carriers. Six-monthly ultrasound surveillance with or without alpha-fetoprotein is recommended in patients with cirrhosis or high-risk HBV. Antiviral therapy reduces but does not eliminate cancer risk.

No. Alcoholic hepatitis is acute liver inflammation from sustained heavy drinking that can occur with or without underlying cirrhosis. Cirrhosis is the end-stage scarring of the liver after years of chronic injury — sometimes precipitated by repeated alcoholic hepatitis. Severe alcoholic hepatitis carries 28-day mortality of 20-40%; abstinence is the single most effective intervention.

Yes. Hepatitis B is the most common: without intervention, 70-90% of infants born to HBeAg-positive mothers develop chronic hepatitis B. Universal birth-dose HBV vaccine and HBIG for high-risk infants prevent over 95% of transmissions. Hepatitis C transmission to infants is approximately 5-6%, higher in HIV co-infection. Hepatitis E in pregnancy can be severe.

Not all chronic hepatitis B patients require immediate treatment. Treatment is recommended for those with active hepatitis (elevated ALT plus high HBV DNA), evidence of fibrosis, cirrhosis, or extrahepatic manifestations. Patients in the inactive carrier phase are monitored every 6-12 months. EASL 2017 and AASLD 2018 guidelines define eligibility criteria.

Direct-acting antivirals (DAAs) block specific steps in HCV replication — NS3/4A protease, NS5A, and NS5B polymerase. Pangenotypic combinations like sofosbuvir-velpatasvir and glecaprevir-pibrentasvir achieve sustained virologic response in 95-99% across all genotypes, including in cirrhotic patients. Treatment duration is typically 8-12 weeks.

Hepatitis B is efficiently transmitted by sexual contact and is considered a sexually transmitted infection. Hepatitis C transmission by sex is uncommon between monogamous heterosexual partners but more common in men who have sex with men, particularly in HIV co-infection. Hepatitis A can occasionally spread by oral-anal sexual practices. Condom use and vaccination reduce risk.

Hepatitis C is associated with cryoglobulinemic vasculitis, glomerulonephritis, and B-cell lymphoma. Chronic hepatitis B is associated with polyarteritis nodosa and membranous nephropathy. Autoimmune hepatitis itself is an autoimmune disease causing liver inflammation. The relationship between infection, autoimmunity, and hepatitis is complex and frequently bidirectional.

Hepatitis E is acute viral hepatitis caused by hepatitis E virus, spread by contaminated water (genotypes 1 and 2 in Asia and Africa) and undercooked pork or game meat (genotypes 3 and 4 in Europe and North America). Most cases recover fully but mortality reaches 30% in third-trimester pregnant women. Chronic infection occurs in immunosuppressed patients.

Yes. The CDC and US Preventive Services Task Force now recommend universal one-time screening for hepatitis B and C in all adults 18 and older, in addition to risk-based and pregnancy screening. Most chronic hepatitis B and C is asymptomatic for years, and early diagnosis allows effective treatment that prevents cirrhosis and liver cancer.

Avoid alcohol completely, limit acetaminophen to under 2 g daily, and avoid herbal supplements and unprescribed medications that can cause additional liver injury. Avoid raw shellfish, which can transmit hepatitis A and cause severe infection in cirrhotic patients. Disclose your hepatitis status to all healthcare providers so they can prescribe safely.

Yes. Hepatitis A is common in children where sanitation is limited and is often mild or asymptomatic. Hepatitis B can be acquired at birth from infected mothers and becomes chronic in 90% of perinatally exposed infants. Universal HBV birth-dose vaccination prevents this. Hepatitis C in children is uncommon but occurs through vertical transmission.