Differences between Hepatitis A, B, C, D and E

Here is the comparative chart of Hepatitis A, B, C, D and E.

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differences-between-hepatitis-a-b-c-d-and-e

Hepatitis is an inflammation of the liver caused by the virus. There are different strains of hepatitis and the most common ones are A, B, C, D, and E. Hepatitis is a self-limiting condition but can progress to more severe conditions like fibrosis, liver cirrhosis, and liver cancer.

Keep in mind that although hepatitis is mainly caused by viruses, other factors can also lead to hepatitis such as toxic substances like drugs and alcohol and autoimmune response.

There are five types of hepatitis and the table below shows the differences between the different types of hepatitis.

Point of ComparisonHepatitis AHepatitis BHepatitis CHepatitis DHepatitis E
How it is spreadContaminated food and water/fecal-oral routeDirect contact with infected body fluid including bloodUse of an intravenous drug that is not sterilized/bloodContact with infected blood/unsafe injections or transfusionsBlood-to-blood contact/childbirth/unprotected sex with infected person/fecal-oral route
Viral genome RNADNARNARNARNA (1, 2, and 3)
ClassificationHepatovirusHepadnavirusHepacivirusLooks like viroids and plant satellite virusesHepevirus
Virus particles expressed in nm and morphology27 nm /icosahedral non-enveloped42 nm/double-shelled virion spherical

27 nm/nucleocapsid core

22 nm/spherical and filamentous, has excess virus coat material (2, 5, and 7)

About 50 to 80 nm/enveloped35 to 37 nm/enveloped, a hybrid particle with a coating of HBsAg and HDV core.32 to 34 nm/non-enveloped icosahedral. (4, 5, and 6)
Incubation period14 to 28 days30 to 180 days14 days to 6 monthsIt needs hepatitis virus B to replicate14 to 70 days
Nature of infectionNot ChronicChronicChronicChronicChronic
Availability of vaccine YesYesNoNoYes
AntigenHAV(42 nm – HBsAg, HBcAg, HBeAg), (27 nm – HbcAg, HBeAg), (22 nm – HBsAg)HCV core antigenHCV core antigenHEV antigen
Antibodies Anti-HAV(42 nm – Anti-HBs, Anti-HBc), (Anti-HBe, 27 nm – Anti-HBc), (Anti-HBe, 22 nm – Anti-HBs) (1, 5, and 9)Anti-HCVAnti-HBs, Anti-HDVAnti-HEV
Symptoms/Clinical manifestationsFever, headache, general body weakness, and yellowing of the skin (jaundice).Upon checking on the liver, there’s severe damage along with other chronic diseases.The symptoms are the same as hepatitis B, but more severe and chronic.The liver is severely damaged and has a high mortality rate.Symptoms are mostly evident in pregnant women and have a high mortality rate. (7, 8, and 9)
Prevention
  • Observe proper hygiene
  • Vaccination
  • Observe proper hygiene
  • Blood screening
  • Vaccination
  • Proper blood screening
  • Ensuring that sterile needle is used when giving drugs via injection
  • Sanitary healthcare practices
  • Proper blood screening
  • Ensuring that sterile needle is used when giving drugs through injection
  • Observe proper hygiene
  • Safe sex should be practiced at all times.
  • Ensure food sanitation (3, 7, and 10)
TreatmentThere is no available treatmentNucleotide analogs pegylated interferonDirect-acting antiviral agentInterferonRibavirin
Complications The complication is rare but can be extremely fatal. It could lead to cholestasis. (4, 7, 9, and 10)There is a possibility of death due to fulminant hepatitis. The patient will also be at risk for liverIt could lead to liver cirrhosis, liver cancer, and death.It could lead to serious morbidity and mortality.The complications are the same as hepatitis A.
Post-exposure management Two weeks post-exposure; immune globulin should be given to the patient.  It is 80% to 90% effective when given early during the incubation period.If the patient is not yet immunized, a hepatitis B vaccine must be given including high titer immune globulin to somehow reduce the risk of hepatitis B infection. (3, 5, and 6)Immune globulin can be given, but its effectiveness is unclear.The primary focus is to make sure that the condition will not lead to hepatitis B.The available immune globulin does not likely have protective antibodies.
Age preference Commonly affects children and young adultsCommon in young adults, especially those sexually active and percutaneous. It could affect babies and toddlers too. (3, 5, 9, and 10)It could affect people of all ages, but more common in adults.It could affect people of all ages.For epidemic cases, the ones affected are young and adults, particularly people in their 20s to 40s. For sporadic cases, the ones severely affected are older adults, specifically, 60 years old and above.
Onset Acute/SuddenAcute/InsidiousAcute/InsidiousAcute/InsidiousAcute
SeverityMildCan be severeModerateCan be severeMild
TherapyNo available therapy
  • Interferon
  • Adefovir
  • Lamivudine
  • Entecavir
  • Pegylated interferon
  • Tenofovir
    • Telbivudine
  • Pegylated interferon
  • Telaprevir
  • Ribavirin
  • paritraprevir
Pegylated interferonNone
Prognosis Generally good. With treatment and timely management, the patient will have a full recovery.Generally good. The patient will recover fully but will be a chronic carrier.There is a high rate of chronic carriers, but the majority recovers fully.The infection is acute and short-lived but can become chronic too. If a patient is a chronic hepatitis B carrier and experienced sudden exacerbation, then a hepatitis D is suspected.Generally good. The patient fully recovers with no chronic carrier. (5, 7, and 9)

 

What to keep in mind?

  • The outcome is determined by many factors such as the type of hepatitis a person has, the clinical manifestations, especially how soon the symptoms developed and noticed, and timely treatment.
  • Some people don’t even know they have hepatitis until dreadful symptoms start to appear such as liver failure.
  • Hepatitis A usually resolved within 2 months and no long-term effects can be experienced. In fact, the patient will have a lifelong immunity after recovering from it.
  • With hepatitis B, the majority of adults recover within the 90-day period and they have lifelong immunity too.
  • The problem is with infants and older children as most of them develop chronic infections leading to severe complications like liver cirrhosis and liver cancer.
  • More so, the majority of hepatitis C leads to a chronic condition, with at least 5% of people who have it will experience life-threatening complications.

 

References

  1. https://www.southernnevadahealthdistrict.org/Health-Topics/the-five-types-of-hepatitis/
  2. https://www.medicinenet.com/viral_hepatitis/article.htm
  3. https://www.cdc.gov/hepatitis/resources/professionals/pdfs/abctable.pdf
  4. https://www.verywellhealth.com/what-are-the-different-types-of-hepatitis-63211
  5. https://my.clevelandclinic.org/health/diseases/4245-hepatitis-viral-hepatitis-a-b–c
  6. https://www.health.com/condition/hepatitis-c/types-of-hepatitis
  7. https://www.hepmag.com/blog/different-types-hepatitis
  8. https://www.usatoday.com/story/news/nation-now/2018/05/29/types-hepatitis-virus-liver-diseases/653765002/
  9. https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/infectious+diseases/hepatitis/hepatitis+a+b+c+d+and+e+summary
  10. https://www.everydayhealth.com/sexual-health/hepatitis.aspx

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2 Responses to Differences between Hepatitis A, B, C, D and E

  1. mariappan November 27, 2015 at 2:52 pm #

    Nice info

  2. ramchandra neupane November 22, 2016 at 9:55 am #

    dami xa

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