multi class comparison

Hepatitis Types: A vs B vs C — Transmission, Chronicity, Prevention

Picking the wrong transmission precaution or telling a Hep A patient they need lifelong monitoring wastes resources and spikes anxiety. The NCLEX expects you to match each hepatitis type to its route, chronicity risk, and prevention strategy.

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Comparison

Side-by-side3 compared
Comparevs
Dimension
Hepatitis A
Hepatitis B
Hepatitis C
Transmission & risk
  • ★Fecal-oral: contaminated food/water, shellfish
  • Incubation 15–50 days (avg 28)
  • Blood, body fluids, sexual, perinatal
  • Incubation 45–180 days (avg 120)
  • Blood-to-blood: needles, pre-1992 transfusion
  • Incubation 14–180 days (avg 45)
Chronicity & course
  • ★Never becomes chronic
  • self-limiting
  • Acute: fatigue, jaundice, RUQ pain
  • Chronic in ~5–10% of adults
  • Chronic in ~90% of neonates
  • ★Chronic in ~75–85% — highest of three
  • Often silent until liver damage
Serology markers
  • Acute: IgM anti-HAV
  • Immunity: IgG anti-HAV
  • Acute: HBsAg + IgM anti-HBc
  • Immunity: anti-HBs ≥10 mIU/mL
  • Anti-HCV antibody + HCV RNA
  • No immunity marker — reinfection possible
Isolation & precautions
  • Contact precautions
  • enteric focus
  • Strict hand hygiene after toileting
  • Standard precautions
  • Blood/body-fluid exposure protocol
  • Standard precautions
  • Blood/body-fluid exposure protocol
Treatment
  • Acute: supportive care
  • Self-limiting
  • no chronic state
  • Acute: supportive care
  • Chronic: antivirals (entecavir, tenofovir)
  • Direct-acting antivirals (sofosbuvir)
  • >95% cure rate
Teaching & prevention
  • Hand hygiene
  • vaccine 2-dose series
  • Exposed: immune globulin within 2 wks
  • No sharing razors
  • condoms
  • vaccine 3-dose
  • Exposed: HBIG + vaccine within 24 hr
  • ★No vaccine — avoid bloodborne exposure
  • No needle sharing
  • abstain alcohol
  • LFT monitor
Red flags — escalate
  • Fulminant failure rare
  • watch confusion, ↑INR
  • Highest acute liver-failure risk
  • Encephalopathy, asterixis, ↑INR then ICU
  • Acute failure rare
  • chronic damage is risk
Complications
  • Rare fulminant hepatitis
  • full recovery typical
  • Cirrhosis, hepatocellular carcinoma
  • Cirrhosis, hepatocellular carcinoma
Transmission & risk

Hepatitis A

  • ★Fecal-oral: contaminated food/water, shellfish
  • Incubation 15–50 days (avg 28)

Hepatitis B

  • Blood, body fluids, sexual, perinatal
  • Incubation 45–180 days (avg 120)
Chronicity & course

Hepatitis A

  • ★Never becomes chronic
  • self-limiting
  • Acute: fatigue, jaundice, RUQ pain

Hepatitis B

  • Chronic in ~5–10% of adults
  • Chronic in ~90% of neonates
Serology markers

Hepatitis A

  • Acute: IgM anti-HAV
  • Immunity: IgG anti-HAV

Hepatitis B

  • Acute: HBsAg + IgM anti-HBc
  • Immunity: anti-HBs ≥10 mIU/mL
Isolation & precautions

Hepatitis A

  • Contact precautions
  • enteric focus
  • Strict hand hygiene after toileting

Hepatitis B

  • Standard precautions
  • Blood/body-fluid exposure protocol
Treatment

Hepatitis A

  • Acute: supportive care
  • Self-limiting
  • no chronic state

Hepatitis B

  • Acute: supportive care
  • Chronic: antivirals (entecavir, tenofovir)
Teaching & prevention

Hepatitis A

  • Hand hygiene
  • vaccine 2-dose series
  • Exposed: immune globulin within 2 wks

Hepatitis B

  • No sharing razors
  • condoms
  • vaccine 3-dose
  • Exposed: HBIG + vaccine within 24 hr
Red flags — escalate

Hepatitis A

  • Fulminant failure rare
  • watch confusion, ↑INR

Hepatitis B

  • Highest acute liver-failure risk
  • Encephalopathy, asterixis, ↑INR then ICU
Complications

Hepatitis A

  • Rare fulminant hepatitis
  • full recovery typical

Hepatitis B

  • Cirrhosis, hepatocellular carcinoma

★ marks the fact that sets a column apart.

Clinical Pearl

A = Ass (fecal-oral, never chronic). B = Blood + Baby + vaccine. C = Chronic + Curable, no vaccine.

Component Topics

Hepatitis

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