Viruses that cause hepatitis: Is hepatitis curable?


Viruses that Cause Hepatitis: An Overview

Hepatitis, characterized by the inflammation of the liver, can result from various causes, including toxic substances like alcohol, certain medications, and autoimmune diseases. However, viruses are the most common culprits behind this condition. Several distinct viruses, specifically termed hepatitis viruses, are primarily responsible for the inflammation and damage to the liver. This article delves into the different viruses that cause hepatitis, their modes of transmission, symptoms, and preventive measures.

Hepatitis A Virus (HAV)

Hepatitis A is highly contagious and spreads primarily through the ingestion of contaminated food or water, or direct contact with an infectious person. The symptoms, including jaundice, fatigue, and abdominal pain, are usually mild and resolve within two months. Vaccination can prevent HAV infection, and maintaining good hygiene practices, like regular handwashing, can significantly reduce the risk of transmission.

Hepatitis B Virus (HBV)

HBV spreads through contact with infected bodily fluids, such as blood, semen, and vaginal secretions, or from mother to child during childbirth. It can cause both acute and chronic hepatitis. Chronic HBV infection can lead to severe liver damage, cirrhosis, and liver cancer. Vaccination is the most effective way to prevent HBV infection. Additionally, practicing safe sex and avoiding sharing needles or other items that might be contaminated with blood can also prevent transmission.

Hepatitis C Virus (HCV)

HCV is primarily transmitted through exposure to infected blood, often through needle sharing among drug users, improperly sterilized medical equipment, and transfusions. Unlike hepatitis A and B, there is no vaccine for hepatitis C. However, antiviral medications can cure most cases of HCV infection. Preventive measures include avoiding sharing needles and ensuring the use of sterile medical equipment.

Hepatitis D Virus (HDV)

HDV occurs only in those infected with HBV, as it requires the hepatitis B virus to replicate. Transmission routes are similar to HBV, and it can lead to more severe forms of hepatitis. Vaccination against hepatitis B can also prevent HDV infection. Individuals already infected with HBV should avoid behaviors that increase the risk of co-infection with HDV.

Hepatitis E Virus (HEV)

HEV, like HAV, spreads through the consumption of contaminated water or food. HEV is particularly common in areas with poor sanitation. It usually results in a mild form of hepatitis and resolves on its own without the need for treatment. There is currently no vaccine for HEV available worldwide, but maintaining proper hygiene and sanitation practices can help prevent infection.

Hepatitis G Virus (HGV)

Also known as GB virus C (GBV-C), HGV was discovered in the late 1990s. Its pathogenicity remains somewhat ambiguous, with some studies suggesting it might not cause significant liver disease on its own. However, it shares transmission routes with HCV, primarily through exposure to infected blood. The clinical significance of HGV in causing hepatitis is less clear compared to the other hepatitis viruses, and it often coexists with HCV infections.

TTV (Torque Teno Virus)

TTV is a DNA virus identified in the late ’90s that exhibits ubiquitous transmission. It has been detected in the blood of healthy individuals as well as those with liver disease, leading to debates about its role in hepatitis. While initially linked to post-transfusion hepatitis, subsequent research has shown that TTV’s pathogenicity concerning liver disease is minimal or non-contributory. However, its high prevalence in the general population makes it a virus of interest for researchers studying viral hepatitis and liver function.

SEN Virus

The SEN virus is another DNA virus that was discovered in the early 2000s in patients with non-A-E hepatitis. Its role in liver disease is not entirely understood, and like TTV, it appears to have a minimal impact on liver health in most individuals. However, certain genotypes of the SEN virus have been associated with more significant liver damage, particularly in immunocompromised individuals or those with pre-existing liver conditions.

Other Herpesviruses

Certain members of the herpesvirus family, such as Cytomegalovirus (CMV) and Epstein-Barr Virus (EBV), can occasionally cause hepatitis, particularly in immunocompromised individuals. These infections usually present with liver inflammation as part of a systemic infection and can be severe, requiring antiviral treatment.

Yellow Fever Virus

This mosquito-borne virus can cause a severe form of hepatitis known as yellow fever, characterized by jaundice, liver failure, and bleeding. Vaccination is highly effective in preventing yellow fever and is recommended for people living in or traveling to endemic areas.

Dengue Virus

Another mosquito-borne virus that can sometimes cause liver inflammation and elevated liver enzymes, typically alongside classic dengue fever symptoms like high fever, headache, and rash. Severe cases can lead to dengue hemorrhagic fever, which can include liver damage.


While primarily associated with respiratory illnesses, certain adenovirus types can lead to hepatitis, particularly in children and immunocompromised adults. These infections are usually self-limiting but can be severe in vulnerable populations.

Preventive measures

Vaccinations are available for hepatitis A and B, significantly reducing the incidence of these infections worldwide. For hepatitis C, while no vaccine is available, curative treatments have been developed in recent years. General preventive measures for hepatitis include practicing good hygiene, avoiding the sharing of needles or items that might come into contact with blood, practicing safe sex, and ensuring that any medical procedures are performed with sterile equipment.

For viruses without a vaccine, such as TTV and SEN virus, general preventive measures focusing on reducing exposure to infectious blood and body fluids are crucial. For vaccine-preventable viral hepatitis and mosquito-borne viruses like yellow fever and dengue, vaccination remains the cornerstone of prevention.

Is hepatitis curable?

The curability of hepatitis depends on the type of virus causing the infection:

Hepatitis A

Hepatitis A (HAV) infection typically resolves on its own without the need for treatment. Patients usually recover completely with supportive care, ensuring adequate hydration and rest. There is no chronic form of HAV.

Hepatitis B

Chronic hepatitis B (HBV) can be managed but not always cured. Antiviral medications can significantly reduce the viral load, limit disease progression, and decrease the risk of liver cancer. A small proportion of individuals may achieve a functional cure, where the virus becomes undetectable and liver enzymes normalize; however, the virus can remain dormant in the liver. Acute HBV infections tend to resolve on their own in adults.

Hepatitis C

Hepatitis C (HCV) is curable in most cases with antiviral therapy. Direct-acting antiviral (DAA) medications can cure over 95% of HCV infections, making it the most curable form among the hepatitis viruses. Treatment duration can be as short as 8-12 weeks, depending on the virus genotype and patient factors.

Hepatitis D

Hepatitis D (HDV) occurs only in those already infected with HBV. Managing HDV usually focuses on controlling HBV because HDV depends on HBV to replicate. There is no cure for HDV, but it can be managed with medications to control hepatitis B, potentially limiting the impact of HDV.

Hepatitis E

Hepatitis E (HEV) is typically acute and resolves on its own without the need for specific treatment. There is no chronic form of hepatitis E in healthy individuals, though it can become chronic in immunocompromised patients, such as those with a solid organ transplant. Supportive treatment is usually sufficient for recovery.


  • Hepatitis A and E are not chronic conditions and do not require curative treatment, as the body clears the virus naturally.
  • Hepatitis B can be managed effectively, and a small percentage may achieve a functional cure, but the virus often remains in the body.
  • Hepatitis C is curable in the majority of cases with the use of direct-acting antivirals.
  • Hepatitis D management focuses on controlling hepatitis B to limit HDV’s impact, with no cure specifically for HDV.

It’s important for individuals diagnosed with hepatitis to receive care from healthcare providers experienced in treating viral hepatitis to determine the most appropriate treatment strategy.

Last update: 16 April 2024, 13:40


Gastroenterologist - Hepatologist, Thessaloniki

PhD at Medical School, Aristotle University of Thessaloniki, Greece

PGDip at Universitair Medisch Centrum Utrecht, The Netherlands

Ex President, Hellenic H. pylori & Microbiota Study Group