Hepatitis viruses A to E: the comparison table
- Topic
Five unrelated viruses inflame the liver; A and E spread through food and water, B, C and D through blood and sex.
What it is
Five hepatotropic viruses cause most viral hepatitis. They differ in genome, route, chronicity and cancer risk, and the comparison is a classic exam table. Hepatitis A and E are faecal-oral and usually self-limited; hepatitis B, C and D are parenteral or sexual and can become chronic, leading to cirrhosis and hepatocellular carcinoma. Other viruses (EBV, CMV, HSV, yellow fever) can inflame the liver as part of systemic infection.
Key facts
- Acute viral hepatitis follows a similar sequence for all viruses: incubation, a prodrome with malaise and nausea, an icteric phase, and recovery.
- HEV genotype 3, the zoonotic form, has been documented in Colombia.
The five hepatitis viruses compared
| Virus | Genome and family | Route | Chronic infection | Key points |
|---|---|---|---|---|
| Hepatitis A | RNA, picornavirus | Faecal-oral (water, food, shellfish) | Never | Acute, often silent in children; vaccine exists |
| Hepatitis B | Partly double-stranded DNA, hepadnavirus | Blood, sex, mother to child | Most perinatal infections; few adult infections | Integrates in host DNA; cirrhosis and HCC; immune-complex disease; vaccine exists |
| Hepatitis C | RNA, flavivirus | Blood (transfusion before screening, shared needles), less often sex | Most infections | Genotypes; cryoglobulinemia; direct-acting antivirals cure most |
| Hepatitis D | Circular defective RNA, deltavirus | Blood, with HBV | Common after superinfection of an HBV carrier | Needs HBsAg; worsens HBV disease |
| Hepatitis E | RNA, hepevirus | Faecal-oral (water); zoonotic from pork | Only in immunosuppressed people | Severe in pregnancy; outbreaks after floods |
Clinical notes
- Serology identifies the virus: IgM anti-HAV, HBsAg and IgM anti-HBc, anti-HCV with HCV RNA, anti-HDV, IgM anti-HEV.
- Vaccines exist for hepatitis A and B; vaccination against B also prevents D.
Test yourself
Think of the answer, then tap the question to see it.
Which hepatitis virus has a DNA genome?
Hepatitis B virus, a partly double-stranded DNA hepadnavirus that replicates through reverse transcription.
Which hepatitis virus most often becomes chronic after infection in adults?
Hepatitis C virus: most infected people do not clear it.
Why can hepatitis D not infect a person without hepatitis B?
HDV is a defective RNA virus that uses HBsAg as its envelope, so it needs HBV to assemble and infect.
In which group of patients is hepatitis E especially dangerous?
Pregnant women, in whom it can cause fulminant hepatitis with high mortality; also immunosuppressed people, in whom it can become chronic.
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Viral Hepatitis (StatPearls (NCBI Bookshelf), 2024); Hepatitis E (World Health Organization, 2026); Hepatitis A (World Health Organization, 2026).
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Representative model, for educational purposes only.