From the Guidelines
Hepatitis A and E cannot become chronic infections, as they are typically cleared by the body's immune system within a few weeks to months without causing long-term liver damage in most people. These two types of hepatitis are acute viral infections that resolve completely without leading to persistent infection, unlike hepatitis B, C, and D, which can develop into chronic conditions when the immune system fails to eliminate the virus within six months of infection 1. The reason hepatitis A and E remain acute is related to their viral replication strategies, which do not involve integrating into the host's DNA or developing mechanisms to effectively evade immune clearance long-term. Most patients with hepatitis A or E experience complete recovery with supportive care alone, though rare cases of fulminant hepatitis can occur, particularly with hepatitis E in pregnant women 1. After recovery from hepatitis A or E, patients develop lifelong immunity against reinfection with the same virus. It's worth noting that while hepatitis E is typically self-limiting, there have been cases of chronic hepatitis E described in immunocompromised individuals 1. However, based on the most recent and highest quality study, hepatitis A and E are not considered chronic infections in the general population 1.
Some key points to consider:
- Hepatitis A and E are acute viral infections that typically resolve on their own without leading to chronic infection.
- Hepatitis B, C, and D can develop into chronic conditions if the immune system fails to eliminate the virus within six months of infection.
- The viral replication strategies of hepatitis A and E do not involve integrating into the host's DNA or evading immune clearance long-term.
- Most patients with hepatitis A or E recover completely with supportive care alone, but rare cases of fulminant hepatitis can occur.
- Patients who recover from hepatitis A or E develop lifelong immunity against reinfection with the same virus.
From the Research
Hepatitis Types
Characteristics of Hepatitis A
- Hepatitis A virus is transmitted through fecal-oral contamination and does not usually result in chronic infection or chronic liver disease 2, 3.
- The disease is usually self-limited, and supportive care is often sufficient for treatment 2, 3.
Comparison with Other Hepatitis Types
- In contrast, hepatitis B and hepatitis C are associated with a significant number of chronic infections, and most deaths from viral hepatitis are due to these two types 5.
- Hepatitis C, in particular, has chronic infection treatment options, such as sofosbuvir, which was approved for the treatment of chronic hepatitis C virus infection 6.