[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Liver and gallbladder](https://durgical.com/en/general-pathology/areas/liver/) › Hepatitis viruses A to E: the comparison table # 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. Updated Nov 12, 2026 ## Key points - Only HBV is a DNA virus; A, C, D and E are RNA viruses. - Faecal-oral: A and E (vowels at the 'bowel' end); parenteral or sexual: B, C, D. - Chronicity: HCV most often in adults; HBV mostly when acquired at birth or in infancy; HAV never chronic; HEV chronic only in immunosuppressed people. - HDV is defective: it needs HBsAg from HBV to infect, as coinfection or superinfection. - HEV can be severe in pregnancy, with high maternal mortality in some genotypes. - HBV and HCV are the main viral causes of hepatocellular carcinoma. ## 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. ## Memory aid The vowels hit the bowels: A and E go by mouth; B, C and D go by blood, and D cannot travel without B. ## 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. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/general-pathology/hepatitis-viruses-a-to-e-the-comparison-table/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Connections ## Related 5 - [Hepatitis B and D](https://durgical.com/en/general-pathology/hepatitis-b-and-d/) - [Hepatitis C: why it becomes chronic, and its extrahepatic disease](https://durgical.com/en/general-pathology/hepatitis-c-why-it-becomes-chronic-and-its-extrahepatic-disease/) - [Viral hepatitis on biopsy: acute and chronic](https://durgical.com/en/general-pathology/viral-hepatitis-on-biopsy-acute-and-chronic/) - [Liver failure: acute, chronic and acute-on-chronic](https://durgical.com/en/general-pathology/liver-failure-acute-chronic-and-acute-on-chronic/) - [Oncogenic viruses and H. pylori: the table to know](https://durgical.com/en/general-pathology/oncogenic-viruses-and-h-pylori-the-table-to-know/) ## Related conditions 4 - [Viral hepatitis](https://durgical.com/en/conditions/viral-hepatitis/) - [Acute liver failure](https://durgical.com/en/conditions/acute-liver-failure/) - [Hepatocellular carcinoma](https://durgical.com/en/conditions/hepatocellular-carcinoma/) - [Cirrhosis](https://durgical.com/en/conditions/cirrhosis/) ## Microorganisms 5 - [Hepatitis A virus](https://durgical.com/en/microbiology/hepatitis-a-virus/) - [Hepatitis B virus](https://durgical.com/en/microbiology/hepatitis-b-virus/) - [Hepatitis C virus](https://durgical.com/en/microbiology/hepatitis-c-virus/) - [Hepatitis D virus](https://durgical.com/en/microbiology/hepatitis-d-virus/) - [Hepatitis E virus](https://durgical.com/en/microbiology/hepatitis-e-virus/) [← All of general pathology](https://durgical.com/en/general-pathology/) 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](https://www.ncbi.nlm.nih.gov/books/NBK554549/) (StatPearls (NCBI Bookshelf), 2024); [Hepatitis E](https://www.who.int/news-room/fact-sheets/detail/hepatitis-e) (World Health Organization, 2026); [Hepatitis A](https://www.who.int/news-room/fact-sheets/detail/hepatitis-a) (World Health Organization, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/hepatitis-viruses-a-to-e-the-comparison-table/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/hepatitis-viruses-a-to-e-the-comparison-table/