Difference Between Hepatitis A B C and D

Main Difference – Hepatitis A B C vs D

Hepatitis refers to an inflammation of the liver which can proceed to fibrosis or scarring, liver cirrhosis or malignancy. As far as the etiology is concerned, Hepatitis viruses are known to be commonest causes for hepatitis but certain other primary infections, alcohol, medication and autoimmune diseases can also result in the condition. There are 5 main types of hepatitis viruses, identified as A, B, C, D and E and they have a significant potential of leading to outbreaks and epidemic spread. In fact, types B and C have a high risk of causing the chronic type of this liver disease, which is the commonest cause so far identified for the development of liver cirrhosis and cancer, later in life.

This article covers,

1. What is Hepatitis A? – Pathology, Clinical features, Signs and Symptoms, and Management

2. What is Hepatitis B? – Pathology, Clinical features, Signs and Symptoms, and Management

3. What is Hepatitis C? – Pathology, Clinical features, and Treatment

4. What is Hepatitis D? – Pathology, Clinical features, and Treatment

5. What is the  difference between Hepatitis A B C and D?Difference Between Hepatitis A B C and D - Comparison Summary

What is Hepatitis A

Hepatitis A viral infection is transmitted from one person to another faeco-orally (consuming food and water contaminated with feces containing this particular virus (HAV)). Moreover, certain unprotected sexual practices are also known to increase the spread of HAV in general.

A higher incidence can be seen in developing countries mainly with poor hygiene and sanitation measures. However, the World Health Organization has taken lots of measures to bring down this rate of affected individuals. Introducing various protocols and vaccines have proven to be effective in controlling the transmission of the virus.

The incubation period of hepatitis A is around 2–4 weeks. Patients will experience fever, malaise, loss of appetite, loose stools, nausea, abdominal discomfort, dark color urine, and jaundice.

Infections caused this way are usually mild to moderate in severity, and most affected individuals will reach a full recovery and acquire a lifelong immunity to further HAV infections. HAV infections can become severe rarely; it can be a life-threatening condition for patients who are immune-compromised.

It is important to know that infections caused by hepatitis A can not be easily distinguished clinically from other types of acute viral hepatitis. However, an accurate diagnosis is usually made by doing an antibody test which will show HAV-specific Immunoglobulin G (IgM) antibodies in the blood.

Furthermore, a reverse transcriptase polymerase chain reaction (RT-PCR) can be used to detect the hepatitis A virus RNA, but it requires advanced laboratory techniques.

While there is no specific treatment for hepatitis A, the infection will gradually resolve on its own. Patients should be kept on fluids to prevent episodes of dehydration.

People should be made aware of safe water supply, food safety, improved sanitation and proper hand washing techniques in order to prevent this infection.

Difference Between Hepatitis A B C and D - 1

feco oral route

What is Hepatitis B

This is caused by Hepatitis B virus which is mainly transmitted through infected blood, blood products, semen, body fluids. It can also be transmitted from infected mothers to infants at the time of birth or from an infected family member to an infant during the early childhood. Invasive medical procedures and blood transfusions are the main routes of introducing infected blood and body fluids to individuals.

Therefore, health care workers should be highly cautious about how to manage these procedures with care, without getting the virus inside their body especially by needle stick injuries.

Most affected individuals will not show any symptoms during the acute infection, whereas some may indicate signs of jaundice, dark urine, lethargy, fatigue, nausea, vomiting and abdominal pain.

A rare entity of patients with acute hepatitis might end up with acute liver failure, unfortunately resulting in death, if proper treatments are not done on time.

The hepatitis B virus can also cause a chronic liver infection in some people so that can later develop into cirrhosis of the liver or liver cancer.

Acute HBV infection is diagnosed by the presence of HBsAg and immunoglobulin M (IgM) antibody to the core antigen, HBcAg whereas the chronic type can be diagnosed with a persistent HBsAg level for at least 6 months duration.

Even though there are no specific treatments for acute hepatitis B, a proper management should be carried out to provide an adequate nutritional balance and fluid replacement. Oral antiviral drugs can be used for patients with chronic hepatitis B infection. This could reduce the progression of cirrhosis, incidence of liver cancer and improve the quality of life. Vaccines against Hepatitis B virus are currently available to prevent related infections.

Difference Between Hepatitis A B C and D - 2

Hepatitis B virus

Hepatitis C virus

This is usually transmitted by the exposure to blood and blood products contaminated with Hepatitis C virus. Similar to Hepatitis B virus, this can be transmitted by blood and blood products transfusions, contaminated injections during invasive medical procedures and also through unprotected sexual intercourse. intravenous drug users are at a higher risk, and so far there has not been any vaccine introduced against HCV.

Patients usually experience fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain and signs of jaundice.

Screening for anti-HCV antibodies with a serological test is helpful in identifying patients who have been infected previously with this infection. Chronic infection could only be diagnosed by a nucleic acid test for HCV ribonucleic acid (RNA).

Antiviral medicines are used in most affected patients. This is known to be effective in 90% of persons with hepatitis C infection.

Main Difference - Hepatitis A B C vs D

Hepatitis C virus

Hepatitis D virus

The most special feature of this infection is that it only occurs in patients who have already been infected by Hepatitis B Virus, which is known as Superinfection. In fact, this combined dual infection of HDV and HBV can give rise to a more serious disease with a high rate of morbidity.

Even though no effective antiviral treatment has been introduced to treat hepatitis D, so far (except for Pegylated interferon alpha which is not widely been used), a Hepatitis B vaccine is available with protection against Hepatitis D virus.

Difference Between Hepatitis A B C and D - 4

Hepatitis D virus

Difference Between Hepatitis A B C and D

Spread of the Disease

Hepatitis A virus characteristically spreads through the ingestion of contaminated food and water whereas Hepatitis B, C and D usually take place due to parenteral contact with contaminated body fluids like blood (blood and blood product transfusions, invasive medical procedures). Furthermore, Hepatitis B can get transmitted from an infected mother to baby at birth due to the possible mixing of blood and also by unprotected sexual intercourse.

Natural History

Hepatitis A virus usually results in an acute inflammation of the liver (hepatitis) which will resolve on its own whereas Hepatitis B virus (HBV) can either be acute (short-term illness) or chronic (ongoing illness) and Hepatitis C virus (HCV) only have a chronic natural history. Hepatitis D will usually infect people who have already got infected by Hepatitis B virus-Super infection.

Signs and Symptoms

Acute hepatitis will give rise to  jaundice, fever, nausea, vomiting, abdominal pain and fatigue whereas chronic hepatitis will present asymptomatic until it leads to cirrhosis of the liver, fibrosis and less functional after several years, which may be too late.


Hepatitis A infection rarely results in chronic liver diseases compared to hepatitis B and C which ends up in debilitating symptoms and fulminant hepatitis or acute liver failure which are often life threatening.

Image Courtesy: 

“F-diagram-01” By UNICEF Philippines and Luis Gatmaitan / 2014 / Gilbert F. Lavides (CC BY 2.0) via Commons Wikimedia

“Hepatitis B virus v2” By TimVickers at en.wikipedia – Transferred from en.wikipedia (Public Domain) via Commons Wikimedia 

“HCV structure” By GrahamColm at en.wikipedia (CC BY-SA 3.0) via Commons Wikimedia

“Hepatitis-d-virion-Pathogens-04-00046-g001-1024” By Rafael Aldabe, Lester Suárez-Amarán, Carla Usai and Gloria González-Aseguinolaza. – (CC BY 4.0) via Commons Wikimedia  

About the Author: Embogama

Embogama is a passionate freelance writer for several years. Her areas of interest include general medicine, clinical medicine, health and fitness, Ayurveda medicine, psychology, counseling and piano music