Which Is Worse, Hepatitis B or C?

The scary thing about liver conditions like hepatitis is that you may be living with it and not even be aware. 

Less than half of the people living with hepatitis B or hepatitis C are diagnosed. If you are one of these people living with an undetected case of hepatitis, you may be at risk for developing liver failure or liver cancer and transmitting the illness to other people. 

What are the most common hepatitis infections? Is hepatitis B worse than hepatitis C? How is hepatitis detected and treated? Michael D. Cook, certified physician assistant at Gastroenterology Associates of Southwest Florida answers these questions and can help you understand the risks of hepatitis.

What Is Hepatitis?

Michael says, “Hepatitis just means inflammation of the liver. There are about five different viruses and they’ve named them A through E.” Hepatitis can be caused by a virus but also by heavy alcohol use, certain types of medications, or complications from other medical conditions. 

Because the liver plays such an important role in filtering the blood, fighting infection, and processing nutrition, when the liver is compromised, it can be serious. 

What Are the Types of Hepatitis?

The three most common types of hepatitis in the United States are A, B, and C, but there are five types in total. All of these forms of hepatitis target the liver’s ability to function. Here are the differences between them:

  • Hepatitis A is caused by the hepatitis A virus, which spreads through the blood and stool of people infected by the virus.
  • Hepatitis B is also caused by a virus spread through bodily fluids from an infected person; however, it can be prevented through the use of vaccines.
  • Hepatitis C is also a viral form of hepatitis. It can be short-term or long-term. As a chronic infection, it can cause life-threatening health issues like cirrhosis or liver cancer.
  • Hepatitis D, also known as “delta hepatitis,” only occurs concurrently within people who also have the hepatitis B virus.
  • Hepatitis E, though not particularly common in the United States, can spread from eating raw or undercooked pork, shellfish, or wild game.

Is Hepatitis B Worse Than Hepatitis C?

Michael says, “At the end of the day, it’s not which one’s worse—they’re both bad.” He points out that both can lead to liver cancer if left untreated.

Together, hepatitis B and C account for more than 80% of all liver cancers in the world. However, hepatitis B does seem to be more dangerous in some ways than hepatitis C for several reasons:

  • Hepatitis B is certainly more virulent and contagious than hepatitis C.
  • Hepatitis B is prevalent around the world and it causes more liver cancer than hepatitis C. 
  • People with hepatitis B are more likely to die from complications to their liver than people with any of the other hepatitis infections. 

When comparing hepatitis B and C, we should note that these viruses attack our cells in completely different ways. Hepatitis C operates in the standard virus way, by invading our cells and reproducing copy after copy of itself until it overwhelms the healthy cells. Hepatitis B, however, goes beyond cloning itself to reproduce and instead inserts itself into the healthy cells’ DNA. This is a more ominous process because it is much harder to destroy the hepatitis B cell when it takes root at the DNA level.

Additionally, hepatitis C typically causes cirrhosis, which is scarring of the liver that interferes with its function, leading to liver cancer. However, in some cases, hepatitis B can cause liver cancer without any signs of cirrhosis. That can make liver cancer itself difficult to diagnose.

It is even possible to become infected simultaneously with hepatitis B and C. While hepatitis C is usually more present during these illnesses, the B infection is still in the bloodstream. 

Ultimately, we know hepatitis C can be cured. The FDA approved a once-daily pill to combat hepatitis C and the medication can reduce the virologic response to the point where the hepatitis C virus is no longer detectable in the person’s blood.

However, as Michael points out, most people with hepatitis C “walk around and they don’t even know they have it. You could argue that’s a good sign but you could also argue that’s a terrible sign because we don’t know there’s a problem.” When this occurs, unfortunately, the person goes untreated, which is why receiving a diagnosis can be beneficial.

How Is Hepatitis Diagnosed?

The first step in diagnosing a hepatitis infection is to receive a medical exam from your doctor. The doctor will perform a physical to look for signs of the illness. All the varieties of hepatitis present with a very similar set of symptoms, which includes:

  • Abdominal pain
  • Fatigue
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea
  • Vomiting

You may also experience jaundice or a yellowing of the skin and eyes and bowel movements that appear gray. Michael says, “Fortunately, most patients are asymptomatic. If you have hepatitis B and it’s an active condition, meaning you’re sick from it, your skin and eyes are going to have a yellow tint.” 

The doctor will look for these telltale signs and then order blood work to spot the viral load for the type of hepatitis and whether the infection is dormant or active. If the virus is active, you are contagious. The blood test can also determine if the infection is acute (short-term) or chronic (long-term). 

If the blood test confirms hepatitis, the doctor may also order an ultrasound of the liver to see if it is inflamed. The ultrasound should also show if the liver is scarred with cirrhosis. You may also have a CT or MRI to look more closely at the liver or signs of liver cancer. This is especially important if you have a family history of the disease. 

Finally, in the unusual event that the imaging tests aren’t shedding light on the situation, the clinician may order a liver biopsy.

Can Hepatitis Be Treated?

Michael says, “Now we have more options which are better for the patient and more affordable.”

Each form of hepatitis has its method of treatment. Once you know what type of hepatitis you have, you can expect the following treatment process:

  • Hepatitis A is a short-term illness that responds well to bed rest, hydration, and nutrition.
  • Hepatitis B in its acute form doesn’t require treatment but the chronic form of the disease is treated with antiviral medications.
  • Hepatitis C is also treated with antiviral medication for both the acute and chronic forms of the disease.
  • Hepatitis D doesn’t have a very effective treatment regimen at this time; there is a medication available but it has low efficacy. 
  • Hepatitis E usually resolves on its own as a short-term illness.

For prevention, there is a vaccine available to target hepatitis A and hepatitis B. You can also prevent hepatitis D by getting the hepatitis B vaccine. If you believe you have symptoms of hepatitis please call Gastroenterology Associates of Southwest Florida, PA for an appointment at 239-275-8882.

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