Know the Difference: Hepatitis A vs. Hepatitis C

Hepatitis is inflammation of the liver. It has many possible causes, but it commonly occurs due to a virus. Viral hepatitis is a leading cause of liver disease around the world. At least five distinct viruses can cause hepatitis:

• hepatitis A virus (HAV)
• hepatitis B virus
• hepatitis C virus (HCV)
• hepatitis D virus
• hepatitis E virus

They have similar symptoms, but some forms can become chronic and lead to life-threatening complications. Others resolve spontaneously without any specific treatment.

Two of the more common types are HAV and HCV. According to the National Institutes of Health, HAV is the most common form of acute viral hepatitis, with about 1.5 million people contracting HAV globally each year. About 130 to 150 million people around the world are living with chronic HCV.

These two types of hepatitis have some things in common, but they also have important differences.

HAV has an incubation period of 15 to 50 days. Most of the time, the symptoms begin around the 28th day. HCV has an incubation period of 14 to 80 days, but the symptoms become noticeable in about 45 days on average.

The symptoms of hepatitis A and C are the same. They include:

• nausea
• vomiting
• abdominal pain
• fever
• fatigue
• loss of appetite
• gray-colored stools
• joint pain
• yellowing of the skin and eyes, or jaundice

HAV causes an acute infection. The symptoms last a few weeks to a few months, but HAV never becomes chronic.

HCV can also be an acute infection. When it lasts more than six months, doctors consider it to be a chronic condition that can cause serious complications. Over a span of 20 to 30 years, chronic HCV can cause scarring of the liver, or cirrhosis. This makes it hard for your liver to do its job. HCV increases your risk of developing liver cancer or liver failure. The symptoms are generally worse for people who also have HIV.

Transmission of HAV

HAV is found in fecal matter. It's transmitted when you consume contaminated food or water. It can also be spread from sexual contact with an infected person. You're at increased risk of HAV when traveling to areas that have poor sanitation and high rates of HAV. HAV is more common in regions of Africa, Asia, and Central and South America. Rates of infection are much lower in:

• North America
• Western Europe
• Australia
• Japan

Transmission of HCV

HCV can be spread through contact with the blood of an infected person, although the cause can't be identified in many cases. Intravenous (IV) drug users who share needles are at particular risk. According to the CDC, between 50 and 90 percent of HIV-infected IV drug users also have HCV. It can also be transmitted through sexual contact or from an infected mother to her baby during childbirth.

The risk of getting HCV through a blood transfusion or a donated organ has been low in the United States since screening methods were improved in 1992. HCV can't be transmitted through food, water, or breast milk, and you can't get it from casual contact with an infected person.

HAV

A blood test called a hepatitis viral panel can identify hepatitis antibodies in your blood. The test can tell you if you were recently infected with HAV, had an HAV infection in the past, or have immunity to HAV.

HCV

HCV antibodies can usually be identified between four and 10 weeks after becoming infected. If your test results are positive for HCV, your doctor will likely order a second test. This is because some people can clear the HCV infection without treatment but those who do still have antibodies in their blood. Additional testing may indicate a chronic infection and the need for treatment.

If you receive a diagnosis of chronic HCV, you'll need further testing to see if any damage to your liver has occurred.

Treatment for HAV

A targeted treatment for HAV doesn't exist. Treating your symptoms with rest and fluid intake is the best way to support your liver as it recovers from the virus. It's also important to stop drinking alcohol while your liver is infected with hepatitis. You should review the medications you're taking and discuss with your doctor whether they're safe to take while you have HAV. Most people fully recover within a few weeks to a few months.

Treatment for HCV

HCV should be carefully monitored, even in the acute stage, but it doesn't always require treatment. If HCV becomes chronic, routine monitoring of the liver is necessary. Antiviral therapy can also treat HCV. Complications of HCV, such as cirrhosis of the liver, can occur if you don't get treatment. Cirrhosis of the liver occurs when scar tissue has built up over most of the liver. When this happens, your liver may not be able to function and you might need to consider a liver transplant. Chronic hepatitis C also puts you at risk for liver cancer. Both liver cancer and cirrhosis are late complications of chronic hepatitis C and neither usually appears until the infection has been present and untreated for about 30 years.

Preventing HAV

You can prevent HAV by getting a vaccine. It's given in two doses six months apart, and people can start getting it at age 1. You should also consider getting the vaccine if:

• you plan to travel to an area with poor sanitation or a high rate of HAV
• you're a healthcare worker at risk of accidental needle sticks
• you have any type of chronic liver disease, including other forms of hepatitis

A combination vaccine that prevents both HAV and HBV is also available. It's administered in three doses over six months or three shots in one month with a booster after 12 months.

You shouldn't get vaccinated for hepatitis if you've ever had an allergic reaction to an earlier vaccine or you're currently sick.

You can also take these additional measures to avoid getting HAV:

• Wash your hands thoroughly before eating and drinking, and after using the restroom.
• Drink bottled water instead of the local water when you're in a developing country.
• Eat food from established restaurants instead of from street vendors.
• Don't eat raw fruits or vegetables from countries with poor sanitation standards.

Preventing HCV

No vaccine is currently available to protect you against HCV. It can be difficult to tell whether you have HCV based on symptoms alone so taking preventive measures is a good way to ensure that you don't develop the condition. Practicing safe sex and avoiding sharing needles are two ways to help prevent HCV. If you're getting a tattoo or piercing, make sure the needles are clean and sterile.

HAV

Most people fully recover from HAV. Few people have lasting side effects from it, and it's almost never fatal.

HCV

Fifteen to 25 percent of people infected with HCV fully recover from it. About 75 to 85 percent develop a chronic condition. According to the CDC:

• 60 to 70 percent of people infected with HCV develop chronic liver disease
• 5 to 20 percent develop cirrhosis of the liver within 20 to 30 years
• 1 to 5 percent die from cirrhosis of the liver or liver cancer

Acting early if you think you have HCV or HAV can help prevent possible liver damage. Contact your doctor if you think you may have contracted HCV or HAV.