Hepatitis - Hepatitis B and D

Prognosis

Hepatitis A

Hepatitis A is the least serious of the common hepatitis viruses. It only has an acute (short term) form that can last from several weeks to up to 6 months. It does not have a chronic form. Most people who have hepatitis A recover completely. Once people recover, they are immune to the hepatitis A virus.

In very rare cases, hepatitis A can cause liver failure (fulminant hepatic failure) but this usually occurs in people who already have other chronic liver diseases, such as hepatitis B or C.

Hepatitis B

Hepatitis B can have an acute or chronic form. The vast majority (95%) of people who are infected with hepatitis B recover within 6 months and develop immunity to the virus. People who develop immunity are not infectious and cannot pass the virus on to others. Still, blood banks will not accept donations from people who test positive for the presence of HBV antibodies.

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About 5% of people develop a chronic form of hepatitis B. People who have chronic hepatitis B remain infectious and are considered carriers of the disease, even if they do not have any symptoms.

Chronic hepatitis B infection significantly increases the risk for liver damage, including cirrhosis and liver cancer. In fact, hepatitis B is the leading cause of liver cancer worldwide. Liver disease, especially liver cancer, is the main cause of death in people with chronic hepatitis B.

Patients with hepatitis B who are co-infected with hepatitis D may develop a more severe form of acute infection than those who have only hepatitis B. Co-infection with hepatitis B and D increases the risk of developing acute liver failure. Patients with chronic hepatitis B who develop chronic hepatitis D also face high risk for cirrhosis. Hepatitis D occurs only in people who are already infected with hepatitis B.

Hepatitis C

Hepatitis C has an acute and chronic form but most people (75 - 85%) who are infected with the virus develop chronic hepatitis C. Chronic hepatitis C poses a risk for cirrhosis, liver cancer, or both.

• About 60 - 70% of patients with chronic hepatitis C eventually develop chronic liver disease.
• About 5 - 20% of patients with chronic hepatitis C develop cirrhosis over a period of 20 - 30 years. The longer the patient has had the infection, the greater the risk. Patients who have had hepatitis C for more than 60 years have a 70% chance of developing cirrhosis.
• Of these patients, about 4% eventually develop liver cancer. (Liver cancer rarely develops without cirrhosis first being present.)
• About 1 - 5% of people with chronic hepatitis C eventually die from cirrhosis or liver cancer.