Reference — Med-Surg
Viral Hepatitis Reference (A–E)
Five viruses inflame the same organ, but they spread differently, behave differently, and need different prevention. The cleanest way to keep them straight: route of transmission predicts almost everything else.
Educational use only. Post-exposure prophylaxis, vaccination schedules, and treatment regimens follow current CDC and facility guidance. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
The memory hook: vowels hit the bowel — hepatitis A and E are fecal-oral (acute, self-limited). The consonants (B, C, D) are bloodborne and can go chronic. Vaccines exist for A and B; preventing B also prevents D.
The Five Hepatitis Viruses
| Type | Transmission | Course | Vaccine |
|---|---|---|---|
| Hepatitis A (HAV) | Fecal-oral — contaminated food/water, poor hand hygiene, travel | Acute only; self-limited, no chronic state | Yes — vaccine + post-exposure immune globulin |
| Hepatitis B (HBV) | Bloodborne — blood, sexual contact, perinatal (mother to baby) | Acute → can become chronic (higher chronicity in perinatal infection) | Yes — vaccine + hepatitis B immune globulin (HBIG) post-exposure |
| Hepatitis C (HCV) | Bloodborne — IV drug use is the leading route; less commonly sexual/perinatal | Most acute infections become chronic | No vaccine — but curable with direct-acting antivirals |
| Hepatitis D (HDV) | Bloodborne — but only infects people who already have hepatitis B (needs HBV to replicate) | Worsens HBV; can be acute or chronic | No separate vaccine — preventing HBV (vaccine) prevents HDV |
| Hepatitis E (HEV) | Fecal-oral — contaminated water, mostly outside the U.S. | Acute, self-limited — but dangerous in pregnancy | No widely available vaccine (limited use in some countries) |
Clinical Notes by Type
Hepatitis A (HAV)
Standard + good hand hygiene; the 'travel and shellfish' hepatitis; full recovery is the rule
Hepatitis B (HBV)
Chronic HBV risks cirrhosis and liver cancer; newborns of positive mothers get vaccine + HBIG at birth
Hepatitis C (HCV)
The most common chronic bloodborne infection and a top cause of cirrhosis/transplant; cure is now expected with treatment
Hepatitis D (HDV)
A 'parasite of a parasite' — no HBV, no HDV
Hepatitis E (HEV)
Like HAV in route; notable for high mortality in pregnant patients
Shared Care & Teaching
All acute hepatitis shares a presentation: fatigue, anorexia, nausea, right-upper-quadrant discomfort, then jaundice, dark urine, and clay-colored stools as bilirubin rises. Care is largely supportive — rest, nutrition, avoid hepatotoxins (alcohol and acetaminophen limits). Standard precautions protect against the bloodborne types in the healthcare setting; meticulous hand hygiene and sanitation interrupt the fecal-oral types. Teach prevention by route: vaccination for A and B, safe sex and no needle-sharing for B/C/D, and food/water safety and handwashing for A/E. Chronic B and C need monitoring for cirrhosis and hepatocellular carcinoma — and reassurance for C that cure is now the expected outcome.
NCLEX Pearls
- ✦Vowels (A, E) = fecal-oral, acute, self-limited. Consonants (B, C, D) = bloodborne, can become chronic.
- ✦Vaccines: A and B. No vaccine for C — but it's curable with direct-acting antivirals.
- ✦Hepatitis D needs B to exist — the hepatitis B vaccine prevents both.
- ✦Hepatitis E is especially dangerous in pregnancy.
- ✦Newborn of an HBV-positive mother: hepatitis B vaccine + HBIG at birth.
- ✦Chronic B and C are leading causes of cirrhosis and liver cancer — ongoing surveillance matters.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with Academy of Medical-Surgical Nurses (AMSN) · Current medical-surgical nursing standards. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →