Hepatitis A, B, C, D and E

Viral hepatitis is an inflammatory disease of the liver, caused by the hepatitis viruses: the hepatitis A, B, C, D and E virus. Infection can be acute or chronic (for hepatitis B and C). There is a vaccine against hepatitis A and B, and since a few years, an effective treatment against hepatitis C.

What is hepatitis?

Hepatitis is an inflammation of the liver, which can affect its function. The liver has functions that are of vital importance to the body: 

  • metabolism and storage of nutrients from digestion
  • detoxification of toxic substances (medicines, alcohol)
  • support of the immune system and blood coagulation
  • production of proteins and bile.

A distinction is made between acute and chronic hepatitis. Hepatitis is “acute” if it has begun recently or was limited in time (less than 6 months) and “chronic” if it persists for longer than 6 months.

There are different types of hepatitis. Some types can heal spontaneously or with the help of medication, but others may become chronic disease carry risk of complications.

What are the different types of hepatitis?

There are 2 categories of hepatitis:

  1. the viral forms of hepatitis (primarily hepatitis A, B, C, D, E)
  2. the non-viral forms of hepatitis (‘toxic’ hepatitis which is related to substances that are toxic to the liver such as alcohol or drugs; and auto-immune hepatitis which results from an inappropriate response of the individual’s own immune system). 

The viral forms of hepatitis vary according to the virus involved, especially in terms of the mode of transmission, the risk groups, the severity of symptoms, the evolution of the disease or the possibilities for prevention and control. There are 5 types of hepatitis viruses, of which the first 3 are the most common in Belgium:

  1. hepatitis A virus (HAV)
  2. hepatitis B virus (HBV)
  3. hepatitis C virus (HCV)
  4. hepatitis D virus (HDV)
  5. hepatitis E virus (HEV).

DID YOU KNOW? The hepatitis C virus was only discovered in 1989. Until this discovery, the forms of hepatitis C were called “non-A” and “non-B”.

A short overview of the forms of hepatitis


Hepatitis A (and E)

Hepatitis B (and D)

Hepatitis C


Mainly via the faecal-oral route:

  • Ingestion of contaminated food or water
  • Sexual relations (oral-anal contact) with an infected person

Mainly through percutaneous/mucosal contact with infected blood or body fluids (sperm, saliva, etc.)

  • Sexual relations with an infected person
  • Exposure to infected blood: needle prick, sharing drug-related injection materila, …
  • From mother to child

Mainly through percutaneous/mucosal contact with blood/blood products

  • Exposure to infected blood: needle prick, sharing drug-related injection material, transfusions prior to 1990 …
  • Sexual relations with an infected person during which there is contact with blood
  • From mother to child



  • Often asymptomatic, or fever, loss of appetite, abdominal pain, nausea, vomiting, jaundice
  • Often asymptomatic or tiredness, loss of appetite, abdominal pain, nausea, vomiting, jaundice
  • Often asymptomatic or tiredness, loss of appetite, abdominal pain, nausea, vomiting, jaundice


  • In rare cases fulminant hepatitis with acute liver failure
  • Cirrhosis
  • Liver cancer
  • Liver failure
  • Cirrhosis
  • Liver cancer
  • Liver failure


  • No specific treatment
  • Chronic hepatitis: treatment with medicines is possible, depending on the case
  • Medical treatment: cure in +- 90-95% of cases


  • As a general rule, spontaneous resolution: the virus eventually disappears
  • No chronic infections (in rare cases possible with hepatitis E)
  • Often spontaneous resolution
  • 5-10% of infected adults progress to chronic hepatitis (much higher percentage for children)
  • More than half of the cases progress to chronic hepatitis


  • Vaccine against hepatitis A (target groups); no vaccine against hepatitis E available
  • Hygiene measures
  • Vaccine against hepatitis B
  • Post exposure prevention
  • Prevention of mother to child transmission
  • Safety of transfusions
  • Reduction of risk behaviour (e.g. through condom use)
  • No vaccine
  • Reduction of risk behaviour (e.g. needle exchange programme)
  • Testing and treatment
  • Safety of transfusions


In collaboration with the Cliniques universitaires Saint-Luc, Sciensano houses the National reference centre for hepatitis A, B, C, D and E, which analyses strains of the hepatitis virus. Sciensano also performs epidemiological surveillance on viral forms of hepatitis in Belgium and controls the quality of the vaccines.

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