Hepatitis A and E vs Hepatitis B, C, and D
How to tell Hepatitis A and E and Hepatitis B, C, and D apart when a board question makes them look alike.
A/E are fecal-oral acute; B/C/D are bloodborne or sexual/perinatal with chronic/HCC risk; D needs B.
Side by side
HAV and HEV are fecal-oral acute hepatitis viruses; HAV is linked to contaminated food/water and daycare/travel, while HEV is severe in pregnancy and waterborne in endemic regions.
HBV, HCV, and HDV are blood/body-fluid hepatitis viruses; HBV has DNA polymerase/reverse transcriptase and vaccine, HCV often becomes chronic, and HDV requires HBV surface antigen.
HAV and HEV cause acute infection without chronic carriage in immunocompetent hosts, spreading through enteric exposure.
HBV and HCV can cause chronic hepatitis, cirrhosis, and hepatocellular carcinoma; HDV is defective and depends on HBV coinfection or superinfection.
Anti-HAV IgM supports acute HAV; anti-HEV IgM/RNA supports HEV; no chronic infection is typical for HAV/HEV in standard Step 1 framing.
HBsAg, anti-HBc IgM, HBeAg, HBV DNA, anti-HCV/HCV RNA, and HDV markers distinguish bloodborne chronic hepatitis patterns.
The trap
HDV cannot infect without HBV surface antigen, so hepatitis D requires HBV coinfection or superinfection.
The repair move
For viral hepatitis, first sort fecal-oral versus bloodborne, then apply chronicity and dependency rules.
Try a free question
CoreA traveler develops acute jaundice, dark urine, malaise, and very high aminotransferases after contaminated food exposure; anti-HAV IgM is positive. Which virus is most likely?
Show answer and explanation
Answer: A. Hepatitis A virus. Fecal-oral acute hepatitis with anti-HAV IgM supports hepatitis A.
Why the other choices are tempting
- B. HBV is blood/body-fluid transmitted and can become chronic.
- C. HCV is bloodborne and commonly chronic.
- D. HDV requires HBV surface antigen.
- E. Hepatitis G is not the classic Step 1 hepatitis pattern here.
Flashcards
Tap a card to flip it.
Which hepatitis viruses are fecal-oral?
Hepatitis A and E are fecal-oral.
Which hepatitis virus is severe in pregnancy?
Hepatitis E is classically severe in pregnancy.
Quick answers
What is the fastest way to tell Hepatitis A and E from Hepatitis B, C, and D?
A/E are fecal-oral acute; B/C/D are bloodborne or sexual/perinatal with chronic/HCC risk; D needs B.
What is the key clue for Hepatitis A and E?
HAV and HEV are fecal-oral acute hepatitis viruses; HAV is linked to contaminated food/water and daycare/travel, while HEV is severe in pregnancy and waterborne in endemic regions.
What is the key clue for Hepatitis B, C, and D?
HBV, HCV, and HDV are blood/body-fluid hepatitis viruses; HBV has DNA polymerase/reverse transcriptase and vaccine, HCV often becomes chronic, and HDV requires HBV surface antigen.
What is the common trap with Hepatitis A and E vs Hepatitis B, C, and D?
HDV cannot infect without HBV surface antigen, so hepatitis D requires HBV coinfection or superinfection.