From the Guidelines
Hepatitis A, B, and C are distinct viral infections affecting the liver, but they differ in transmission, prevention, and long-term outcomes, with Hepatitis C being the most severe in terms of chronic infection and liver damage risk. The main differences between Hepatitis A, B, and C are:
- Transmission: Hepatitis A is typically transmitted through contaminated food or water, Hepatitis B through blood, semen, and other body fluids, and Hepatitis C primarily through blood contact.
- Chronic infection risk: Hepatitis A does not become chronic, Hepatitis B has a 5-10% chronic infection risk in adults, and Hepatitis C has a 75-85% chronic infection risk.
- Prevention: Vaccines exist for Hepatitis A and B, but not for Hepatitis C.
- Treatment: Hepatitis A typically requires supportive care, chronic Hepatitis B may be treated with antiviral medications like entecavir or tenofovir, and Hepatitis C is highly curable with direct-acting antivirals such as sofosbuvir/velpatasvir (Epclusa) or glecaprevir/pibrentasvir (Mavyret) 1. Some key statistics and recommendations include:
- Hepatitis B affects an estimated 257 million people worldwide and resulted in 887,000 deaths in 2015 alone 1.
- Hepatitis C infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide 1.
- The use of HBV vaccines has resulted in a reduction of chronically infected children under the age of five from 4.7% in the prevaccination era to 1.3% 1.
- Antiviral treatment for chronic Hepatitis B may be recommended for patients with serum HBV DNA level > 20,000 IU/mL and serum ALT level > 2 ULN 1.
- Direct-acting antivirals for Hepatitis C have achieved cure rates above 95% 1. In terms of management, it is crucial to prioritize the treatment of chronic Hepatitis C due to its high risk of liver damage and cancer, and to consider antiviral treatment for chronic Hepatitis B based on serum HBV DNA and ALT levels.
From the Research
Hepatitis A, B, and C: Key Differences
- Hepatitis A, B, and C are viral infections that affect the liver, but they have distinct differences in terms of transmission, symptoms, and treatment options.
- Hepatitis A is typically spread through contaminated food or water, while hepatitis B and C are usually transmitted through blood or bodily fluids 2.
- Hepatitis B and C can lead to chronic infections, which increase the risk of liver cirrhosis and hepatocellular carcinoma (HCC) 3, 4, 5.
Risk of Hepatocellular Carcinoma (HCC)
- The risk of HCC is significantly higher in individuals with chronic hepatitis B and C infections, particularly those with HBV-HCV coinfection 3.
- The pooled analysis of 63 studies showed that the risk of HCC was significantly higher in individuals positive for HBsAg, HBV DNA or HBeAg, and HBV and HCV coinfection 3.
- Hepatitis B virus infection can promote HCC development without prior end-stage liver disease 4.
Treatment and Prevention
- Effective prevention and management strategies for HBV infection are crucial in reducing liver-related complications, including HCC 6.
- New diagnostics and highly effective, pangenotypic direct-acting antivirals provide opportunities to cure and eradicate chronic hepatitis C virus infection 2.
- Understanding the role of hepatitis B and C viral infections in HCC development is essential for the future design of treatments and therapies for this cancer 4.