Compare the routes of transmission of hepatitis viruses A-E.

A and E spread faeco-orally (contaminated food/water); B, C, and D spread by blood/blood products. B also spreads vertically and sexually; C rarely vertically; D only co-occurs with B.

Clinical relevance. The transmission route determines which preventive measures (sanitation vs blood/needle precautions and vaccination) apply.

More Detail

Transmission of viral hepatitis

The route of spread separates the enteric viruses (A, E) from the parenterally/blood-borne viruses (B, C, D), which has direct implications for prevention.

Comparison

Route	A	B	C	D	E
Faeco-oral	Yes	No	No	No	Yes
Blood/products	Rare	Yes	Yes	Yes	No
Vertical	No	Yes	Rare	Occasional	No
Sexual	Rare	Yes	Rare	Rare	No

Key points

• A and E: faeco-oral, linked to poor sanitation and contaminated water/shellfish.
• B, C, D: blood-borne (transfusion, shared needles, contaminated equipment).
• B is the most transmissible, including vertical (mother-to-child) and sexual routes; D requires HBV to be present.