ABCs of Hepatitis: Patients must Need to Know

ABCs of Hepatitis: Your liver, which is the largest solid internal organ in your body, aids in the digestion of food, energy storage, bile production, management of blood clotting, and toxin removal. However, a viral infection such as hepatitis can impair these key processes. And put your own health at risk.

“Hepatitis affects about 5 percent of the U.S. population,” says Dr. Beckie Port, an associate professor in the Division of Gastroenterology and Hepatology at Seattle Children’s Hospital and Regional Medical Center. “And the most common types are hepatitis A, B, C, D & E.”

What is Hepatitis?

Hepatitis is simply the inflammation of the liver. There are several types, which differ in severity and method of contagion. Some forms are more dangerous than others, but all require medical attention to prevent complications or even death. Those who ignore the symptoms do so at their own risk.

It can be transmitted through blood, feces, and other bodily fluids, as well as less common vectors such as contaminated food or water. Sexual contact is also a surprisingly important vector of contagion, though it usually only occurs between members of the same sex groups.

The virus is spread among gay men primarily by sexual contact, but there are other sources such as contaminated IV equipment and even via the fecal matter of a partner. Such infection is much more common in those who practice both receptive and insertive anal sex concurrently (known as “versatile”) than those who only punctate.

The inflammation caused by the hepatitis virus makes it difficult for your liver to operate, resulting in persistent problems if left untreated. Your liver is responsible for a variety of activities, including the removal of hazardous chemicals. A damaged liver can lead to liver cancer and other liver disorders.

Common ABCs Of Hepatitis

Hepatitis A (HAV)
Hepatitis B (HBV)
Hepatitis C (HCV)

What is Hepatitis A?

Hepatitis A is caused by the hepatitis A virus (HAV) that leads to inflammation of the liver. The infection usually leads to mild illness, but in some cases, it can lead to a serious, life-threatening disease. Hepatitis A is most often spread when people eat food or drink water contaminated by small amounts of fecal matter — even just tiny amounts that can’t be seen.

How is it spread?

The virus may also be passed indirectly through contact with objects, food, or drinks contaminated by the feces of an infected person.
Surfaces may become contaminated with the virus (and serve as a source of infection) through contact with a person who is infected with hepatitis A, or from a contaminated environment.
Food items prepared by someone who is infected with the virus may also contain traces of the virus.
A person may also become infected by eating uncooked food fertilized with untreated sewage-contaminated water.
Hepatitis A is spread by the fecal-oral route.
It can also be transmitted sexually or perinatally, but this is relatively rare.

It is the most common type of hepatitis in the United States — typically affecting some 80,000 Americans each year. Worldwide, hepatitis A affects approximately 1.4 million people annually.

According to the World Health Organization (WHO), hepatitis A occurs worldwide with some 3 million new infections each year. In developing countries, where malnutrition and poor sanitation are common, the incidence of hepatitis A is 10 to 100 times higher compared with developed countries having a low incidence of the disease.

What are the symptoms?

Symptoms of Hepatitis A begin 2 to 6 weeks after exposure. It is possible for some carriers to not have any symptoms:

Nausea
Vomiting
Abdominal pain,
Dark urine,
Fatigue,
Fever,
Loss of appetite and jaundice
Dark-colored urine (indicative of bilirubin in the blood)
Precautions
Make sure to wash your hands with soap and water after using the bathroom, changing diapers, or before preparing or eating food.
If you are traveling to countries where hepatitis A is common, talk with a doctor about whether you should receive the vaccine for hepatitis A.
Take only pasteurized milk and juice, and avoid raw or undercooked meat or shellfish.
If you have been in contact with someone who has hepatitis A, see your doctor to get tested for the disease.
Do not touch anyone’s blood or body fluids, such as saliva, sweat, urine, etc.
Avoid sharing items such as towels, razors, or toothbrushes.
Don’t swallow your own spit while you’re ill. If you do, rinse your mouth with water and brush your teeth.
Do not eat or drink street food.
Only drink bottled or boiled beverages, clean fresh fruits, and vegetables before eating them (such as peeling fruits like oranges), and cook food thoroughly before eating them.
Do not eat raw or undercooked meat or shellfish.
If you are cooking for other people, wash your hands before and after handling food.
Cook all meat to at least 160°F (71C) throughout.
Avoid untreated water from lakes, rivers, wells, ponds, streams, and springs.

What are the treatment options?

There is no specific treatment for hepatitis A. It must run its course and the symptoms can be treated as needed with over-the-counter medications. Talk with your doctor to determine if you are in the group that needs the vaccination to prevent this condition.

What is Hepatitis B?

Hepatitis B a virus (HAV) is an infection of the liver. There are several types of hepatitis, but hepatitis B is a viral infection that can cause both acute and chronic infections. The virus enters the body through contact with infected blood or other body fluids containing blood. It then attacks the liver, which breaks it down into smaller components to produce energy.

Acute infection is when a person has symptoms of hepatitis B but recovers within 6 months. Some people may go on to develop chronic liver disease and become carriers of the virus, which can lead to liver cancer or cirrhosis (scarring) of the liver. Chronic carrier status occurs in approximately 10% of people with acute infectious hepatitis B, and far less frequently with hepatitis D (the combination of the two viruses is more common than either of them alone).

Furthermore

The hepatitis B virus is usually spread through contact with the blood of an infected person. It can also be passed from an infected mother to her baby during birth, or by sexual contact. The risk of infection is high in people who are living with a family member that has hepatitis B, especially if they are sharing equipment used for injecting drugs.

How is it spread?

It can be spread through contact with the blood of an infected person.
It can also be passed from an infected mother to her baby during birth, or by sexual contact.
The risk of infection is high in people who are living with a family member that has hepatitis B, especially if they are sharing equipment used for injecting drugs.
The virus is not spread through air or water, or by casual contact, such as having a meal with an infected person.
People who have significant exposure to blood at their workplace can also be at risk – for example, health care workers.

The hepatitis B vaccine is recommended for all infants at birth, and children should also be vaccinated before attending childcare or school. Also protect yourself by avoiding unprotected sex and sharing needles or other equipment for drug use with others.

What are the symptoms?

There may not be any early signs of hepatitis B infection in some people, while others experience:

Loss of appetite
Fever and generally feeling unwell
Jaundice (yellowing of the skin or whites of the eyes)
Pain in muscles, joints, and stomach.
Dark urine and pale stools (pee and poop)

Symptoms usually last less than 2 months, but it may take several months to feel back to normal. If you have chronic hepatitis B or become a carrier of the virus, you can experience episodes of illness that reduce your energy levels.

If you have any signs, see your doctor as soon as possible because treatment is more effective if started early. Chronic infection is diagnosed by a blood test that detects antibodies to the hepatitis B virus.

If you’re diagnosed with chronic hepatitis B, your doctor will also do a blood test to determine if cirrhosis of the liver has developed. If it has, you may be referred to a gastroenterologist for further assessment and advice about treatment options.

Precautions

There are many precautions that should be taken to avoid getting Hepatitis B. The virus is spread through contact with the blood or other body fluids of an infected person. Some of the main ways to avoid getting the virus include:

Always practice safe sex by using a condom.
Avoid contact with blood or other body fluids, including saliva.
Do not share needles or any other drug paraphernalia.
Get vaccinated against hepatitis B.
Wash your hands thoroughly after coming into contact with any blood or body fluids, and on a regular basis at work.

What are the treatment options?

There’s no specific treatment for hepatitis B, but it can usually be cured with antiviral medication. The doctor will also recommend managing your condition so you can avoid liver damage, and minimize risk to others.

Preventing the spread of infection through counseling is important because there’s currently no cure for hepatitis B or C – this means people with hepatitis can continue to pass on the infection for their whole life.

Doctors will often recommend that infected people avoid donating blood, organs, or other tissue, and advise them not to breastfeed if they have hepatitis B.

The most effective way of preventing the spread of hepatitis is by having a vaccination before being exposed to the virus – see your doctor about getting vaccinated as soon as possible.

Is there a vaccine?

There are different types of vaccination available to help protect you from hepatitis B, and it’s important that you speak to your doctor at the earliest opportunity to discuss what vaccines may be suitable for you. Your doctor can provide advice on this subject, and it will depend on your age, lifestyle, and medical history.

Most people are vaccinated when they’re children. Those who aren’t fully vaccinated at this time should consider doing so as soon as possible to protect themselves from hepatitis B infection in the future.

What is hepatitis C?

Hepatitis C is caused by the hepatitis C virus (HCV). It infects the liver and causes inflammation, resulting in symptoms including tiredness, nausea, loss of appetite, fever, vomiting, abdominal pain, and jaundice. There are currently no vaccines for hepatitis C.

The infection is usually spread when blood from a person with hepatitis C enters the bloodstream of another person. This can happen when drug users share needles, but it can also be spread through sexual contact and from mother to baby during birth.

Sharing other equipment used to prepare drugs for injection, such as spoons or filters, can also transmit HCV. It is not spread by coughing, sneezing, or sharing forks and knives.

Hepatitis C is a growing public health concern in many countries worldwide. In 2014, around 71 million people were estimated to have chronic hepatitis C infection. This number is expected to increase to almost 90 million by 2030. Some of them will develop serious liver conditions such as cirrhosis (scarring of the liver) and liver cancer.

How Is it Spread?

Hepatitis C can be spread by sharing other drug-injection equipment, such as cookers, spoons, water, and tourniquets.
Hepatitis C virus (HCV) is transmitted primarily through the parenteral route.
It’s spread by blood-to-blood contact – if someone with the virus has bleeding gums, for instance, then touches their mouth, they can spread it to another person.
Patients with hepatitis C can also spread the virus through sexual contact if they are not using properly sterilized medical equipment between treatments or procedures.

What are the symptoms?

Fatigue
Joint pain
Mild Flu-
like symptoms
Muscle and joint aches and pains.
Nausea or vomiting, Loss of appetite
Swelling in the legs and/or abdomen
Vomiting blood (if you vomit up some blood, consult your doctor immediately)
Dark urine (tea color or darker)
Pale-colored stools. (Compare to the color of the stool in a toilet bowl.)
Stomach pain or tenderness, especially if you also have nausea and vomiting.
Jaundice (yellowing of the skin or whites of the eyes)

If you have any signs, see your doctor as soon as possible because treatment is more effective if started early.

Precautions

There are many precautions for Hepatitis C that one should take into account if they are at risk for the virus:

Avoid contact with blood and other body fluids from an infected person.
Avoiding any kind of sexual contact with someone who has the virus.
Using condoms when engaging in sexual activity.
Using sterilized medical equipment when receiving tattooing or piercing procedures that involve blood contact.
Avoiding sharing drug injection needles and equipment to prevent contracting the virus if you are currently using drugs.
Avoid drinking alcohol as this can damage the liver further.
Anyone who is diagnosed with hepatitis C should seek treatment as soon as possible in order to reduce the risk of transmission and further damage to the liver.

What are the treatment options?

There is no specific antidote for hepatitis C. However, treatment can stop or slow the progression of the disease in most people. It may also reduce your risk of getting complications such as cirrhosis and liver cancer. Treatment options for hepatitis C may include:

Direct-acting antiviral medications – includes sofosbuvir, velpatasvir, voxilaprevir, and daclatasvir.
interferon-free regimens – PEG-IFN + RBV
Protease inhibitor with RBV-based therapy – Boceprevir or telaprevir may be included in some regimens.

Patients who are treated for hepatitis C may always have the virus. Once successfully treated, they will no longer be infectious to others nor will they develop liver cancer or cirrhosis because of their infection. This is not a current cure but eventually, a doctor and their patient might decide there is no need to treat it anymore as the liver damage has been repaired.