The liver is essential for cleaning the blood and storing energy. Although it can repair itself, repeated or long‑term injury can lead to chronic liver disease. As the disease worsens, the liver cannot perform its vital functions, which can become life‑threatening. In severe cases, chronic liver disease leads to liver failure, which may cause yellowing of the skin and eyes, and swelling in the abdomen and legs. It also increases the risk of liver cancer. Chronic liver disease is a leading cause of death in both Orange County and the United States.
Common causes of liver damage include frequent alcohol use, excess body weight, and viral infections known as hepatitis. Hepatitis A, B and C are the most common viruses affecting the liver. These infections may cause sudden liver failure or progress silently for years, eventually leading to chronic liver disease.
Hepatitis A Virus
Hepatitis A spreads through the fecal–oral route, which means the virus leaves the body in the stool of an infected person and then gets into another person’s mouth. This usually happens through contaminated food or water or through close personal contact. Poor handwashing can easily spread the virus.
Before the hepatitis A vaccine was introduced in 1996, outbreaks were common among young children - especially in childcare centers. Since then, infections have dropped significantly. Most current cases occur in unvaccinated adults, often after traveling to countries where hepatitis A is common. In the US, outbreaks have also been linked to fresh produce handled by infected workers or exposed to contaminated water.
Hepatitis A usually causes acute, short‑term illness. Most people recover on their own without lasting liver damage, but the infection can still cause significant symptoms and may require medical care.
Vaccination is the best way to prevent hepatitis A. The vaccine is recommended for all children starting at one year of age, and unvaccinated older children and adults can receive it at any time. Anyone traveling outside the United States who has not been vaccinated is strongly encouraged to talk with a health care provider about getting the hepatitis A vaccine.
Hepatitis B Virus
Hepatitis B spreads through infected blood and bodily fluids. People can become infected through shared household items with traces of blood such as toothbrushes, razors, nail clippers, or sharing needles or blood-sugar testing equipment. It can be spread through direct contact with infected bodily fluid – direct contact with skin wounds or through sexual contact. Pregnant people with hepatitis B can pass the virus to their baby during childbirth.
Hepatitis B can cause either acute (short-term) or chronic (long-term) infection. Infants and young children often show no symptoms at first, but are much more likely to develop lifelong infection, raising the risk of chronic liver disease, liver failure, and liver cancer.
A safe and effective vaccine has been available for decades to prevent hepatitis B. Beginning in the early 1990s, newborns began receiving the hepatitis B vaccine at birth, which has been highly effective at preventing infection in infants. Antiviral medications can manage chronic hepatitis B but do not cure it, so ongoing monitoring is essential.
Current Recommendations to Protect Against Hepatitis B Include:
• Screening all pregnant people for hepatitis B during every pregnancy
• Vaccinating all newborns at birth
• Ensuring all children and adults complete the hepatitis B vaccine series
• Testing all adults at least once to learn if they are infected or if they still need vaccination
Knowing one’s hepatitis B status helps prevent transmission and supports early liver‑health monitoring.
Hepatitis C Virus
Identified in 1989, hepatitis C was once commonly spread through blood transfusions. This risk dropped sharply after donor screening began in 1992. Today, transmission occurs mostly through sharing needles or other equipment used for injected drugs.
Many newly infected individuals have no symptoms, but most develop chronic infection, which can cause serious long‑term liver damage.
Unlike hepatitis A and hepatitis B, there is no vaccine to prevent hepatitis C. However, since 2013, new antiviral treatments have become available that cure over 90% of infections, allowing most people with hepatitis C to be successfully treated.
Because early infection is often silent, all adults should be tested at least once in their lifetime. People with ongoing risk—such as those who inject drugs—should be tested more regularly. Treatment for hepatitis C is widely available.
Protecting Your Liver
Hepatitis A, B, and C all affect the liver differently:
- Hepatitis A: spreads through contaminated food, water or close contact; usually causes short-term illness; preventable with vaccination
- Hepatitis B: spreads through blood and bodily fluids; can be acute or chronic; preventable with vaccination
- Hepatitis C: spreads through blood-to-blood contact; often becomes chronic; highly curable with treatment
No matter the type, taking proactive steps can protect both your health and the health of those around you.
Simple Steps to Keep Your Liver Healthy
• Maintain a healthy weight
• Limit or avoid alcohol
• Get tested for hepatitis B and C
• Follow treatment and monitoring if infected
• Make sure you and your family are vaccinated against hepatitis A and B
Hepatitis A and B vaccines work very well. Countries that use the hepatitis A vaccine widely have seen big drops in the number of people getting sick over the past 30 years. Giving the hepatitis B vaccine at birth has almost completely stopped childhood hepatitis B in the United States. High vaccination rates help keep families and communities safe.
There is no vaccine for hepatitis C yet, but there are treatments that can cure most people. These treatments help prevent liver damage and reduce new infections.
Getting vaccinated for hepatitis A and B—and getting tested for hepatitis C so treatment can start early if needed—are important steps to help reduce hepatitis in the United States.
Resources:
California Department of Public Health – Hepatitis A
California Department of Public Health – Hepatitis B
California Department of Public Health – Hepatitis C
Centers for Disease Control – Hepatitis Basics
Schedule Vaccine Appointment for Hepatitis A or B via My Turn CA
About Dr. Christopher Zimmerman
Dr. Christopher Zimmerman is board certified in both Internal Medicine and Pediatrics. He has more than a decade of experience as a primary care physician taking care of both adults and children. Dr. Zimmerman also trained as an Epidemic Intelligence Service Officer with the Centers for Disease Control (CDC), and holds a Master’s in Public Health from the Harvard School of Public Health. He has extensive experience on vaccination and vaccine preventable diseases from the CDC, the New York City Department of Public Health as well as working on the Global Polio Eradication Initiative with the World Health Organization.
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