Yes — you can sexually transmit hepatitis A, mainly through oral-anal contact, which is why it shows up in outbreaks among men who have sex with men. Hepatitis B is the more classic blood-borne and sexually transmitted hepatitis. Both inflame the liver. A always clears on its own; B can become a lifelong infection.
Hepatitis A virus
Hepatitis B virus
| Item | Value |
|---|---|
| Hepatitis A | curable — Hepatitis A virus |
| Hepatitis B | managed — Hepatitis B virus |
What each one is
Hepatitis A
Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV). It spreads fecal-orally — through contaminated food or water, but also through close personal and sexual contact, especially oral-anal (rimming) contact, where the virus passes from one person's stool to another's mouth. It does not become chronic. Unlike hepatitis B and C, people who get hepatitis A recover completely once their immune system clears the virus CDC, About Hepatitis A. Reported acute cases collapsed from nearly 10,000 in 2020 to about 1,600 in 2023 as the large person-to-person outbreaks waned CDC AtlasPlus, 2023.
Hepatitis B
Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV). It's mainly blood-borne and sexually transmitted, carried in blood, semen, and vaginal fluids. Doctors split it in two: acute hepatitis B is the short-term illness in the first six months after exposure, while chronic hepatitis B is infection that lasts beyond six months and can be lifelong CDC, About Hepatitis B. Acute reports have held roughly steady at about 2,200 a year from 2020 through 2023, but hundreds of thousands more Americans live with undiagnosed chronic infection that quietly scars the liver over decades.
Symptoms compared
Neither infection reliably announces itself. With hepatitis A, not everyone develops symptoms — adults are more likely to than children, and young kids are often contagious with no signs at all. When symptoms do appear, they include fatigue, nausea, abdominal pain, jaundice (a yellowing of the skin or whites of the eyes that signals the liver is struggling to process bilirubin), dark urine, and clay-colored stools. For a deeper breakdown, see our guide to hepatitis a symptoms and how long they last.
Hepatitis B overlaps heavily. Many people have none. Acute symptoms can include fatigue, fever, poor appetite, nausea, abdominal pain, dark urine, clay-colored stools, joint pain, and jaundice. Most people with chronic HBV feel completely fine for years while the virus persists, so screening finds it where symptoms can't. Our full rundown of hepatitis b symptoms covers both the acute and chronic pictures.
How to tell them apart
You usually can't tell them apart by how you feel. The jaundice, nausea, dark urine, and fatigue look essentially identical from the patient's chair, and a blood test settles it. A clinician weighs a few discriminating clues:
- Exposure history: recent oral-anal contact, travel, or a foodborne outbreak points toward hepatitis A; a new sexual partner, blood exposure, or birth to an HBV-positive parent points toward hepatitis B.
- Course over time: hepatitis A illness resolves and the person recovers fully, while hepatitis B may linger past six months and turn chronic.
- Only hepatitis B carries the risk of becoming a lifelong infection, so a clinician who suspects B will look beyond the acute episode.
Hepatitis A vs. hepatitis B at a glance
| Hepatitis A | Hepatitis B | |
|---|---|---|
| Virus | HAV | HBV |
| Main spread | Fecal-oral; oral-anal sexual contact, food/water | Blood-borne and sexual (blood, semen, vaginal fluids) |
| Becomes chronic? | No — always clears, full recovery | Yes — can be lifelong |
| Vaccine? | Yes | Yes |
| Typical treatment | Supportive care only | Acute: supportive; chronic: lifelong antivirals |
| Confirmed by | Blood test | Triple serologic blood panel |
Testing
Hepatitis A is confirmed with a blood test that detects the body's response to the virus. Hepatitis B uses a triple serologic panel: HBsAg flags active infection, anti-HBs shows immunity or recovery, and total anti-HBc marks past or current infection CDC, Hepatitis B testing. Reading all three together tells a clinician whether you're infected now, protected, or were exposed in the past. The CDC now recommends screening every adult aged 18 and older for hepatitis B at least once in their lifetime, and pregnant people during each pregnancy CDC, Universal HBV screening, 2023.
Getting checked is straightforward. Depending on what's suspected, you may give a urine sample, a self-collected swab, or have a quick exam, and hepatitis panels are free or low-cost at health departments, Planned Parenthood, and Title X clinics. You can get tested alongside a broader STI panel, since the same visit can cover several infections at once. Timing matters too: it takes a window after exposure before a test turns positive, so check when to test after exposure before you book.
Treatment compared
Hepatitis A has no specific antiviral treatment, so care is supportive: rest, fluids, and good nutrition while your immune system clears the virus on its own, usually over weeks. Alcohol and liver-stressing medications are best avoided during recovery.
Acute hepatitis B usually needs only supportive care as well. Chronic HBV is different: there's no cure, but FDA-approved antivirals — tenofovir or entecavir — suppress the virus and lower the risk of liver cancer, and this care is managed by a specialist CDC, Hepatitis B treatment. Most people take these medicines for life, and viral clearance happens in only about 2 to 5 percent even after a decade of treatment AASLD, 2018. Age at infection drives the outcome — caught in adulthood, hepatitis B becomes chronic in under 5 percent of people, but caught in infancy it becomes lifelong in about 90 percent, which is why the birth-dose vaccine carries so much weight.
Can you have more than one at once?
Yes. Hepatitis A and hepatitis B are separate viruses with separate routes, and being infected with one offers no protection against the other. Someone with chronic hepatitis B who then catches hepatitis A can develop a more severe acute illness because the liver is already under strain, one reason clinicians often recommend the hepatitis A vaccine for people living with hepatitis B. Co-infection with HIV or hepatitis C is also possible and changes how each is managed, so a positive result for one is a good prompt to screen for the others.
When to see a clinician
Get evaluated if you develop jaundice, dark urine, clay-colored stools, persistent nausea, or unexplained fatigue and abdominal pain — especially after a possible exposure. Anyone aged 18 or older who has never been screened for hepatitis B should ask for the panel at a routine visit, and pregnant people should be tested each pregnancy. If you've had a recent exposure to either virus, see a clinician promptly: post-exposure vaccination or immune globulin can sometimes prevent infection if given quickly. Seek urgent care for severe vomiting, confusion, or deepening jaundice, which can signal serious liver injury.