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Hepatitis (A, B & C)

Hepatitis means an inflamed liver, most often from a virus. Hepatitis A and B can be prevented with vaccines, hepatitis B can be treated, and hepatitis C can be cured with pills — but many people have no symptoms, so testing is the only way to know.

Call 911 or go to an emergency room for any of these:

  • Yellow skin or eyes together with confusion, trouble thinking, personality changes or unusual sleep problems, a swollen belly, vomiting blood, or black or bloody stools. These can be signs of a badly damaged or failing liver (NIDDK); NIDDK says anyone who vomits blood or has black or bloody stools should go to a hospital right away (NIDDK). Rarely, acute viral hepatitis causes sudden liver failure (NIDDK, NIDDK).
  • A possible exposure to hepatitis B — a needle-stick, shared injection equipment, or sex with someone who has hepatitis B — especially if you are not fully vaccinated. Depending on your vaccine history, you may need a hepatitis B vaccine dose and sometimes hepatitis B immune globulin (HBIG), as soon as possible and preferably within 24 hours (CDC, MedlinePlus). Ask about HIV prevention medicine too (see HIV & AIDS). There is no preventive medicine for hepatitis C, so ask about testing (CDC).
  • A possible overdose — very small pupils, slow or stopped breathing, choking or gurgling sounds, a limp body, pale, blue or cold skin, or purple lips. Call 911, give naloxone if you have it, and stay with the person (MedlinePlus, CDC). See our Drug Overdose guide.

What is hepatitis?

Hepatitis means inflammation of the liver. Heavy alcohol use, toxins, some medicines and certain medical conditions can cause it, but it is most often caused by a virus — in the U.S., usually hepatitis A, B or C — and viral hepatitis is a leading cause of liver cancer. The good news: vaccines prevent hepatitis A and B, and medicines can cure hepatitis C. The hard part is that many people feel fine, don’t know they are infected and can still pass the virus on, so testing is the only way to know (CDC).

How each virus spreads

  • Hepatitis A spreads when someone swallows the virus, even in tiny amounts — through close contact with an infected person or contaminated food or drink (CDC). People can pass it on up to 2 weeks before feeling sick (CDC).
  • Hepatitis B spreads through blood, semen and other body fluids: at birth, during sex, and by sharing needles, syringes or glucose monitors; less often through shared razors or toothbrushes. It is not spread by kissing, sharing utensils, hugging, coughing, breastfeeding, food or water (CDC).
  • Hepatitis C spreads through blood, even amounts too small to see — most often by sharing drug-injection equipment, and also through shared razors, nail clippers or toothbrushes, from parent to baby (about 6% of babies born to a parent with hepatitis C get it), unregulated tattoos or piercings, and, uncommonly, sex. It doesn’t spread through hugging, kissing, utensils, food, water or breastfeeding (CDC), so people with hepatitis C can go to work, school and childcare as usual (CDC).

Symptoms — often none

When symptoms happen they are similar for all three: dark urine or clay-colored stools, tiredness, fever, joint pain, poor appetite, nausea, stomach pain, vomiting and yellow skin or eyes (jaundice); diarrhea occurs with hepatitis A only (CDC). Hepatitis A symptoms are usually gone within 2 months (CDC). Most children under 5 with hepatitis B have no symptoms (CDC). Hepatitis C symptoms, if any, are usually mild, and serious signs of liver damage may not show up for 20 years or more (CDC).

Chronic infection, cirrhosis and liver cancer

  • Hepatitis A never becomes chronic; most people recover with no lasting liver damage (CDC).
  • Hepatitis B stays for life far more often the younger someone is infected: about 90% of infected infants and 30% of children infected at ages 1–5, but only about 5% of adults (CDC). Of people with chronic infection, 15%–25% develop cirrhosis, liver failure or liver cancer (CDC). Past hepatitis B can also “reactivate” during chemotherapy or other immune-weakening medicines (NIDDK).
  • Hepatitis C becomes chronic in more than half of people. Untreated, about 5%–25% develop cirrhosis (liver scarring) over 10–20 years, and people with cirrhosis have a 1%–4% chance each year of liver cancer (CDC). It is the leading cause of U.S. liver transplants (CDC). See our Cancer guide for cancer care and support.

How common is it?

CDC estimates about 3,300 new hepatitis A infections, 14,400 new hepatitis B infections and 69,000 new hepatitis C infections in 2023. About 640,000 adults were living with chronic hepatitis B (January 2017–March 2020), and more than 2.4 million — possibly as many as 4 million — people with hepatitis C (2017–2020) (CDC). About 1 in 2 people with hepatitis B (CDC) and one in three with hepatitis C (CDC) don’t know it. CDC counted 11,194 hepatitis C-related deaths in 2023, a conservative figure (CDC).

Hepatitis D and E, briefly

  • Hepatitis D only infects people who also have hepatitis B, spreads the same ways and causes complications sooner. The hepatitis B vaccine prevents both (NIDDK).
  • Hepatitis E usually spreads through water contaminated with stool, and in the U.S. through raw or undercooked pork, deer or wild boar. It usually clears on its own but can cause liver failure, more often in pregnancy and in people with other liver disease. There is no U.S. vaccine (NIDDK).

Hepatitis that isn’t caused by a virus

Alcohol-related hepatitis comes from heavy drinking; toxic hepatitis from certain poisons, chemicals, medicines or supplements (MedlinePlus); and autoimmune hepatitis from the immune system attacking the liver — it is more common in women and, untreated, can lead to cirrhosis (NIDDK). Mono (Epstein-Barr virus) can also swell the liver and cause abnormal liver tests (CDC); see our Epstein-Barr Virus guide. MBHA plans a separate Liver guide.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Vaccines for hepatitis A and B; 8–12 weeks of direct-acting antiviral pills for hepatitis C; antivirals such as tenofovir or entecavir and regular liver checks for some people with chronic hepatitis B; liver cancer checks; no alcohol; steroids and immune-calming medicines for autoimmune hepatitis; liver transplant for liver failure. Hepatitis B vaccine and hepatitis B and C screening: $0 under Medicare Part B for people who qualify, if the provider accepts assignment; Marketplace plans cover recommended screening and vaccines without a copay in-network. Medicine prices: cost estimate being researched. Hepatitis C treatment cures more than 95% of people, usually without side effects. Hepatitis B medicines can prevent severe liver disease for some people but are not a cure. Hepatitis A usually clears on its own.
Chiropractic No role in preventing or treating hepatitis. Not applicable. We found little research on chiropractic for hepatitis. Keep up with testing, vaccines and medical care.
Acupuncture No role in treating viral hepatitis. If you use acupuncture for other reasons, insist on sterile, single-use needles. Not applicable. A Cochrane review found the effects of acupuncture on chronic hepatitis B are unknown. Unsterile needles can spread hepatitis B and C.
Herbal medicine No herb or supplement cures or treats hepatitis, and none should replace antiviral medicine. Milk thistle is the most-used supplement for hepatitis C. Cost estimate being researched. NCCIH says no supplement has been shown to work for hepatitis C. Some products injure the liver, and St. John’s wort can weaken hepatitis C medicines.
Massage therapy No role in treating hepatitis; relaxation only. Not applicable. May help you relax. Hepatitis B and C don’t spread through touch. Tell your therapist if you bruise easily.
MBHA Wellness Coach Getting tested and vaccinated, not sharing needles, razors or toothbrushes, safer sex, cutting out alcohol, a healthy weight, a medicine and supplement review, links to syringe services programs, and help with stigma. Cost estimate being researched. Everyday habits protect your liver and the people around you. A coach supports — never replaces — testing, vaccines and treatment.

Approach 1 of 6

Conventional medicine (AMA)

Treatment depends on the type of hepatitis and whether it is short-term (acute) or long-term (chronic) (CDC). Vaccines prevent hepatitis A and B — see Testing and vaccines below.

Hepatitis A

There is no specific medicine; doctors usually recommend rest, a balanced diet and fluids (CDC). If you were exposed, call your doctor: a vaccine dose or immune globulin within 2 weeks can prevent illness (CDC).

Hepatitis B

Hepatitis C — a cure

Hepatitis C can be cured. Pills called direct-acting antivirals (DAAs) have very few side effects and cure more than 95% of people in 8–12 weeks. Early treatment prevents liver scarring, liver cancer and death, yet few people start within a year of diagnosis (CDC). Experts recommend treatment for nearly everyone, except during pregnancy and in children under 3 (CDC).

Hepatitis D and E

No medicine is approved for hepatitis D in the U.S.; people with it may need hepatitis B treatment (NIDDK). Hepatitis E usually needs only rest, fluids and healthy food, and no alcohol until you have recovered (NIDDK).

Alcohol-related, autoimmune and drug-induced hepatitis

  • Alcohol-related: stopping alcohol completely, with alcohol treatment if needed (NIDDK). For severe cases, doctors may add corticosteroids, and a liver transplant is an option for some who don’t respond (Ramkissoon & Shah, 2022).
  • Autoimmune: corticosteroids and immunosuppressants can relieve symptoms and prevent or reverse liver damage in many people; stopping them without your doctor can be very dangerous (NIDDK).
  • Drug- or herb-induced: usually stopping the product responsible — but talk with your doctor before stopping any medicine (NIDDK). Taking too much acetaminophen, often from several products at once, can cause severe liver damage (FDA).

Liver cancer checks, alcohol and transplant

For chronic hepatitis B, CDC notes that antiviral treatment, monitoring and liver cancer surveillance reduce illness and death (CDC). People with cirrhosis may be checked for liver cancer with blood tests and imaging every 6 months (NIDDK). Avoid alcohol, which adds liver damage (NIDDK). If hepatitis leads to liver failure or liver cancer, a transplant may be needed (NIDDK) and can be life-saving (NIDDK).

What it costs

  • Medicare Part B pays in full (if your provider accepts assignment) for hepatitis B vaccines for people who qualify (Medicare.gov), hepatitis B screening for people at high risk and in pregnancy (Medicare.gov), and hepatitis C screening for people born 1945–1965, people with past or ongoing injection drug use, or a transfusion before 1992 (Medicare.gov). These rules are narrower than CDC’s advice to screen all adults, so ask what will be covered.
  • Marketplace and many other plans must cover hepatitis C screening for adults 18–79, hepatitis B screening for people at high risk, and hepatitis A and B vaccines without a copay in-network; $0 isn’t guaranteed (HealthCare.gov).
  • Hepatitis C medicines can be costly, but most drug plans give some coverage, and drug companies, nonprofits and some states run programs that help pay (NIDDK). Prices for medicines, tests and visits: cost estimate being researched.

How well it works — what to expect

People with hepatitis B can live normal, healthy lives with good care (CDC), and most people with hepatitis C can be cured with timely treatment (CDC). Cirrhosis can’t be reversed, but treating its cause can slow the damage (NIDDK).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic has no role in preventing or treating hepatitis. It is mostly used for pain in the muscles, bones and joints (NCCIH), and we found little research on chiropractic for hepatitis. If you see a chiropractor for back or neck pain, tell them about your liver condition, and check any supplement they suggest with your doctor first — some can damage the liver (NIDDK).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture has no role in treating viral hepatitis. A Cochrane review of eight small trials, all at high risk of bias, concluded that its effects on chronic hepatitis B are unknown (Kong et al., Cochrane review, 2019). Never use it in place of testing, vaccines or antiviral medicine.

Sterile, single-use needles only. Hepatitis B and C spread through blood, and CDC lists acupuncture with unsterile needles among the ways hepatitis C can spread (CDC). FDA requires acupuncture needles to be sterile and labeled for single use, and complications have come from nonsterile needles (NCCIH). In one Canadian outbreak, two people caught hepatitis B at a clinic that re-used disposable needles (Rempel et al., 2016). Choose a licensed practitioner and watch each needle come out of a sealed package.

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Read this first. No herb or supplement cures or treats hepatitis. NCCIH says no dietary supplement has been shown to work for hepatitis C, and no complementary approach should replace conventional treatment or delay a visit to your provider (NCCIH). Hepatitis C is curable with antiviral pills (CDC) — please don’t let a supplement stand in the way.

Milk thistle (silymarin)

Milk thistle is the supplement most often used for hepatitis C, but studies haven’t shown a benefit: it did not improve liver function or lower the amount of virus, and an NIH-funded trial found it no better than a placebo (NCCIH). Results for hepatitis B are conflicting or too limited, and some products don’t match their labels or are contaminated (NCCIH).

Products that can harm the liver

“Natural” doesn’t always mean safe. Sudden liver damage from supplements is still rare but reported more often, and it can be severe enough to need an emergency liver transplant (NCCIH). Examples:

Interactions with hepatitis medicines

Show the label of any herb, vitamin or supplement to your liver doctor or pharmacist before you take it. We don’t list doses here.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage doesn’t treat hepatitis, but a gentle massage may simply help you relax during a stressful diagnosis or treatment. Hepatitis B and C don’t spread through hugging or everyday touch (CDC, CDC), so there is no reason to skip a massage. The risk of harm appears low; rare serious problems have mostly involved vigorous methods such as deep tissue massage (NCCIH). Cirrhosis can make you bruise or bleed easily (MedlinePlus), so tell your therapist and ask for gentle pressure.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach helps with the everyday steps that protect your liver and the people you love — alongside your medical care, never instead of it.

Get tested and vaccinated

Find free or low-cost testing and vaccines with CDC’s GetTested; your coach can help you finish every shot in the series (CDC).

Don’t share blood-contact items

Never share needles, syringes or other drug equipment, or razors, nail clippers, toothbrushes or glucose monitors (CDC). Wear gloves if you must touch someone else’s blood or open sores, and choose tattoo artists and piercers who use sterile tools (NIDDK). Washing hands after the bathroom or diaper changes and before handling food helps stop hepatitis A (CDC).

Safer sex

Latex or polyurethane condoms lower the risk of hepatitis B and C (NIDDK, NIDDK). If you have hepatitis B, your sex partners should be tested and, if not infected, vaccinated (NIDDK).

Alcohol, weight and your medicine cabinet

NIDDK advises people with hepatitis B or C to avoid alcohol, which can cause more liver damage (NIDDK, NIDDK). Obesity raises the chance of fatty liver disease, which can add to the damage in hepatitis B (NIDDK); fatty liver is common and linked with obesity and type 2 diabetes (NIDDK). Check with a doctor before taking any medicine or supplement (CDC); your coach can help you list everything you take, and support eating well, moving more and drinking less.

Support for people who use drugs

  • Syringe services programs (SSPs) offer sterile syringes and safe disposal, testing, vaccination and links to treatment. They are linked with about a 50% drop in new HIV and hepatitis C infections and don’t increase drug use or crime (CDC). Many also give out naloxone (CDC).
  • Medicines for opioid use disorder lower overdose deaths and behaviors that spread HIV and hepatitis C (NIDA). See our Drug Overdose guide.
  • CDC recommends the hepatitis A vaccine for everyone who uses illegal drugs (CDC) and hepatitis C testing for anyone who has ever injected, even once or long ago (CDC).

Living with hepatitis, without stigma

Hepatitis is a medical condition, not a moral failing. CDC says anyone who asks for a hepatitis B test should get one without having to explain why, because many people are reluctant to share risks that carry stigma (CDC). Stigma can keep people from seeking treatment, and the words we use matter (NIDA). Your coach offers a judgment-free place to talk it through.

Another approach

Hepatitis A, B and C at a glance

The three most common hepatitis viruses in the U.S.
FeatureHepatitis AHepatitis BHepatitis C
Main spreadSwallowing the virus: close contact, contaminated food or drinkBlood, semen and other body fluids: birth, sex, shared needlesBlood: mostly shared drug-injection equipment
Becomes chronic?NeverAbout 90% of infected infants; about 5% of infected adultsMore than half of people infected
Vaccine?YesYes (also prevents hepatitis D)No
TreatmentRest, fluids, good foodAntivirals for some people with chronic infection; not a cure8–12 weeks of pills cure more than 95%
CDC screeningNot routine; blood test if exposed and sickAll adults at least once (2023)All adults at least once (2020)

Sources: CDC, CDC, CDC, CDC, NIDDK. Many people with any of the three feel well, so only a blood test can tell you whether you have one.

Another approach

Testing and vaccines

Hepatitis C testing

CDC’s 2020 recommendations call for hepatitis C screening at least once in a lifetime for all adults aged 18 and older, and for all pregnant women during each pregnancy, except in settings where hepatitis C is very rare (under 0.1%) (CDC, MMWR 2020). People with ongoing risk need regular testing. An antibody test shows whether you have ever had hepatitis C; if positive, the lab automatically checks for the virus itself to see whether the infection is current (CDC).

Hepatitis B testing

CDC’s 2023 recommendations call for hepatitis B screening at least once in a lifetime for all adults aged 18 and older using a three-part blood test (the “triple panel”), and for all pregnant people during each pregnancy, preferably in the first trimester. Anyone who asks should be tested (CDC, MMWR 2023), and people still at risk need periodic testing (CDC). The triple panel shows whether you have hepatitis B now, had it before, are protected by a vaccine, or still need one (CDC).

Hepatitis A vaccine

CDC recommends it for all children aged 12–23 months, unvaccinated children and teens aged 2–18, people at higher risk (such as travelers, people who use drugs and people experiencing homelessness), people with chronic liver disease or HIV, and anyone who asks (CDC). It is two shots at least 6 months apart, or three shots over 6 months as a combined hepatitis A and B vaccine for adults 18 and older (CDC).

Hepatitis B vaccine

CDC recommends it for all infants, children and teens under 19 who haven’t had it, all adults aged 19–59, and adults 60 and older with risk factors. It is two or three shots depending on the brand, is safe in pregnancy, and most healthy people don’t need a booster (CDC). CDC’s vaccine advisers reviewed the timing of the newborn “birth dose” in September 2025 (CDC), so ask your baby’s clinician about the current schedule. A baby whose parent has hepatitis B should get the vaccine and HBIG right after birth (NIDDK); MBHA plans a separate Pregnancy guide. There is no vaccine for hepatitis C (CDC).

Another approach

Protecting your liver

If you have cirrhosis, NIDDK advises no alcohol or illegal drugs; checking with your doctor before any prescription or over-the-counter medicine (including NSAID pain relievers, acetaminophen and sleep aids) or herbal supplement; vaccines for hepatitis A and B, flu, pneumococcal pneumonia and shingles; and healthy food and weight (NIDDK).

Hepatitis and HIV

People with HIV plus hepatitis B or C are more likely to develop cirrhosis, so CDC advises HIV testing after a hepatitis B or C diagnosis (CDC). See our HIV & AIDS guide.

Related guides

Pain in the upper right belly can also come from the gallbladder — see Gallbladder. Mono can inflame the liver for a while (Epstein-Barr Virus), and viral hepatitis is a leading cause of liver cancer (CDC; see Cancer). MBHA plans separate Liver and Pregnancy guides.

Member stories

Living with Hepatitis (A, B & C)? Share your experience

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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