HEPATITIS-E
What is hepatitis E (HEV)?
Hepatitis E, known as Enteric non-A, non-B, is a viral hepatitis that is most commonly found in geographical areas lacking clean water and sanitation.
How common is it?
It is not common or typical in countries or areas with clean drinking water and adequate environmental sanitation. Typically, people diagnosed with hepatitis E have become infected during travels to or stays in geographical areas lacking clean water or sanitation.
How is it transmitted?
Hepatitis E is transmitted through oral contact with feces. This is primarily through contaminated water sources and a lack of sanitation. Transmission from person to person appears to be uncommon.
Symptoms
Symptoms of hepatitis E resemble those of hepatitis A:
Low-grade fever
Malaise (feeling of ill-health)
Anorexia (lack of appetite)
Nausea
Abdominal discomfort
Dark colored urine
Jaundice
Hepatitis E is not known to cause chronic infection.
Testing/Diagnosis
There are no specific blood tests commercially available for detecting HEV antigen or antibodies. There are diagnostic tests available in research laboratories. Talk to your health care provider about testing.
Treatment
Most people with hepatitis E experience a self-limited illness (one that runs a defined, limited course) and go on to recover completely. There is no accepted therapy, nor restrictions on diet or activity.
In most cases, hospitalization should be considered for people who are severely ill for provision of supportive care.
What does it mean for my health?
Pregnant women who become infected with HEV are at greater risk of death. The fatality rate may reach 15 to 20% among women during pregnancy.
Reduce your risk
Outbreaks of hepatitis E have occurred in Asia, Africa and Mexico, as well as in other geographical areas lacking a clean water source and sanitation. If you think you may be infected with hepatitis E, talk to your health care provider about testing.
There is no vaccine to prevent hepatitis E, therefore the only way to protect yourself is to avoid contaminated food or water.
When traveling to geographical areas where the water supply is doubtful:
Avoid drinking the water unless it is sealed bottled water.
Avoid using local ice.
Avoid uncooked shellfish.
Avoid uncooked fruits or vegetables that are not peeled or prepared by the traveler
Should I talk to my partner about hepatitis E?
No. Hepatitis E is primarily transmitted by contaminated drinking water and is not thought to be sexually transmitted.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
Tuesday, March 10, 2009
HEPATITIS-D
HEPATITIS-D
What is hepatitis D (HDV)?
Hepatitis D (HDV) is a viral infection of the liver that can only be acquired if a person has active hepatitis B (HBV).
How common is it?
Hepatitis D is linked directly to hepatitis B, particularly to chronic HBV infection. There are particular pockets worldwide where chronic HBV infection is high, but HDV infection is low or uncommon, such as Southeast Asia and China.
How is it transmitted?
The modes of HDV transmission are similar to those for HBV. However, sexual transmission of HDV is less efficient than for HBV.
Hepatitis D can only infect people with active HBV infection.
HDV is passed most often through sharing IV drug needles with an infected person.
People receiving clotting factor concentrates may also be at a higher risk.
Transmission of HDV from mother to child during birth is rare
Symptoms
Many with both HBV and HDV may or may not develop symptoms. When present, symptoms are similar to those of HBV.
People with both HBV and HDV are more likely to have sudden, severe symptoms, called fulminant hepatitis.
Those who are infected with both HBV and HDV are at greater risk for developing serious complications associated with chronic liver disease.
People infected with HBV and HDV may become chronically infected and may be contagious from time to time for the rest of their lives.
Testing/Diagnosis
Your health care provider can test for hepatitis D through blood tests that identify HDV antigen or HDV antibodies.
Treatment
Most people with acute viral hepatitis experience a self-limited illness (one that runs a defined, limited course) and go on to recover completely. There is no accepted therapy, nor restrictions on diet or activity.
People with chronic hepatitis B and D can be treated with interferon. Your health care provider can help you make decisions about your care needs based upon your medical history and liver condition.
In most cases, hospitalization should be considered for patients who are severely ill for supportive care.
What does it mean for my health?
Hepatitis D, can cause a more severe acute disease than an HBV infection alone. The severity of the diseases together can result in death.
When hepatitis D is acquired and HBV infection already exists, chronic liver diseases with cirrhosis are more likely to occur than with an HBV infection alone.
People with chronic HBV and HDV have a greater chance of developing chronic liver disease and cirrhosis.
Reduce your risk
Get vaccinated against hepatitis B. This also provides protection against HDV since hepatitis B must be present in order for HDV infection to occur.
If you inject drugs and can't stop, avoid sharing your works--needles, syringes, cotton, water, spoons, pots (cookers)--or any other drug paraphernalia. If you choose to share your works, clean them with water and bleach to reduce your risk of getting hepatitis C, filling syringes for at least 30 seconds.
Use latex condoms the right way every time you have vaginal, anal or oral sex. Even though HDV is not commonly transmitted through sex, hepatitis B is, and having hepatitis B makes it possible to get HDV. Click here for more information about preventing HBV.
Talk to your partner
When you and your partner understand how hepatitis D is passed, you can both agree to protect your health. Remember:
Hepatitis D is very rarely sexually transmitted, but using latex condoms the right way every time for vaginal, oral and anal sex greatly reduces the risk of passing or getting an STD, like hepatitis B.
If your partner uses injecting drugs, talk to them about stopping.
If you inject drugs and can't stop, avoid sharing your works--needles, syringes, cotton, water, spoons, pots (cookers)--or any other drug paraphernalia. If you choose to share your works, clean them with water and bleach to reduce your risk of getting hepatitis C, filling syringes for at least 30 seconds.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
What is hepatitis D (HDV)?
Hepatitis D (HDV) is a viral infection of the liver that can only be acquired if a person has active hepatitis B (HBV).
How common is it?
Hepatitis D is linked directly to hepatitis B, particularly to chronic HBV infection. There are particular pockets worldwide where chronic HBV infection is high, but HDV infection is low or uncommon, such as Southeast Asia and China.
How is it transmitted?
The modes of HDV transmission are similar to those for HBV. However, sexual transmission of HDV is less efficient than for HBV.
Hepatitis D can only infect people with active HBV infection.
HDV is passed most often through sharing IV drug needles with an infected person.
People receiving clotting factor concentrates may also be at a higher risk.
Transmission of HDV from mother to child during birth is rare
Symptoms
Many with both HBV and HDV may or may not develop symptoms. When present, symptoms are similar to those of HBV.
People with both HBV and HDV are more likely to have sudden, severe symptoms, called fulminant hepatitis.
Those who are infected with both HBV and HDV are at greater risk for developing serious complications associated with chronic liver disease.
People infected with HBV and HDV may become chronically infected and may be contagious from time to time for the rest of their lives.
Testing/Diagnosis
Your health care provider can test for hepatitis D through blood tests that identify HDV antigen or HDV antibodies.
Treatment
Most people with acute viral hepatitis experience a self-limited illness (one that runs a defined, limited course) and go on to recover completely. There is no accepted therapy, nor restrictions on diet or activity.
People with chronic hepatitis B and D can be treated with interferon. Your health care provider can help you make decisions about your care needs based upon your medical history and liver condition.
In most cases, hospitalization should be considered for patients who are severely ill for supportive care.
What does it mean for my health?
Hepatitis D, can cause a more severe acute disease than an HBV infection alone. The severity of the diseases together can result in death.
When hepatitis D is acquired and HBV infection already exists, chronic liver diseases with cirrhosis are more likely to occur than with an HBV infection alone.
People with chronic HBV and HDV have a greater chance of developing chronic liver disease and cirrhosis.
Reduce your risk
Get vaccinated against hepatitis B. This also provides protection against HDV since hepatitis B must be present in order for HDV infection to occur.
If you inject drugs and can't stop, avoid sharing your works--needles, syringes, cotton, water, spoons, pots (cookers)--or any other drug paraphernalia. If you choose to share your works, clean them with water and bleach to reduce your risk of getting hepatitis C, filling syringes for at least 30 seconds.
Use latex condoms the right way every time you have vaginal, anal or oral sex. Even though HDV is not commonly transmitted through sex, hepatitis B is, and having hepatitis B makes it possible to get HDV. Click here for more information about preventing HBV.
Talk to your partner
When you and your partner understand how hepatitis D is passed, you can both agree to protect your health. Remember:
Hepatitis D is very rarely sexually transmitted, but using latex condoms the right way every time for vaginal, oral and anal sex greatly reduces the risk of passing or getting an STD, like hepatitis B.
If your partner uses injecting drugs, talk to them about stopping.
If you inject drugs and can't stop, avoid sharing your works--needles, syringes, cotton, water, spoons, pots (cookers)--or any other drug paraphernalia. If you choose to share your works, clean them with water and bleach to reduce your risk of getting hepatitis C, filling syringes for at least 30 seconds.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
HEPATITIS-C
HEPATITIS-C
What is hepatitis C (HCV)?
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). It is sometimes called non-A and non-B hepatitis. Hepatitis C is the most common chronic bloodborne infection in the United States.
15 to 45% of those infected with HCV are able to clear the virus from their blood within about 6 months from the time of infection.
However, 55 to 85% of people with acute hepatitis C do not get rid of the virus within 6 months and therefore have chronic (long-term) hepatitis C.
About 70% of chronically infected persons will develop chronic liver disease.
Between 1 and 5 % of chronically infected patients may die from chronic liver disease.
HCV is the leading indication for liver transplants.
How common is it?
It is estimated that around 4 million Americans have been infected with hepatitis C, of whom 2.7 million have chronic infections. Each year, it is estimated that there are 30,000 new infections in the United States, according to the Centers for Disease Control and Prevention (CDC). Of those new infections, only 20% of those infected will have symptoms. That means many people will become infected with hepatitis C and not know it right away.
How is it transmitted?
Hepatitis C is primarily transmitted by direct contact with blood. The most common ways are:
Contact with HCV-infected blood through sharing of needles or other injecting equipment during intravenous drug use that have not been properly cleaned between users. At present, injection drug use is the most common risk factor for contracting the disease.
Organ transplants and blood transfusions prior to 1992.
Hepatitis C can be spread by vaginal or anal sex, but this does not occur very often (see "Reduce Your Risk" section below). Factors found to be associated with sexual transmission of HCV are: sex with multiple partners, presence of other STDs, or sex with trauma (for example, rough sex, rape, or sexual abuse).
Transmission through oral sex has not been documented.
Hepatitis C may be passed from an infected mother to her baby. Neonatal transmission may occur at birth if the mother is infected. The rate of infection is the same regardless of method of delivery (Caesarean section or vaginal). There are no recommendations to avoid pregnancy or breast-feeding if infected with HCV, because transmission of HCV infection through breast milk has not been documented. However, if nipples are cracked or bleeding, hepatitis C-infected mothers may not want to breastfeed because of increased risk.
Symptoms
Most individuals with hepatitis C (about 80%) do not have signs or symptoms. Liver disease progresses so slowly that a person can have hepatitis C for years without having symptoms. Many individuals with chronic hepatitis C have mild to moderate liver damage but do not feel sick. The possible symptoms for an acute infection (newly acquired or short-term) and a chronic (long-term or persistent) infection are different.
Acute Infection (newly acquired)
Often, people with an acute HCV infection are asymptomatic (have no symptoms).
Some people with an acute HCV infection will have jaundice (a yellowing of the skin and eyes) or mild flu-like symptoms.
Chronic Infection (persistent)
Most people with chronic HCV will have only mild to moderate liver disease. Symptoms of this may include: jaundice, fatigue, loss of appetite, nausea, or malaise.
Most people with chronic infection have abnormalities in liver enzyme levels that can fluctuate widely.
If a person develops cirrhosis (scarring) of the liver, symptoms and signs may be more prominent. In addition to fatigue, symptoms may include muscle weakness, poor appetite, nausea, weight loss, itching, dark urine, jaundice, fluid retention, and abdominal swelling.
Testing/Diagnosis
There are several blood tests that can be done to determine if a person has HCV. If you think you've been exposed or infected with HCV, talk to your health care provider. They may order one test or a combination of tests. You and your health care provider can discuss whether your sex partner(s) need to be tested for hepatitis C.
The only FDA-approved tests are anti-HCV tests. These tests look for antibodies to HCV in the blood.
The average time it takes for a person infected with hepatitis C to develop antibodies to the virus is 8-9 weeks after exposure. Most people will develop the antibodies by 6 months, but it can take up to 12 months. If you believe you have been recently exposed to Hepatitis C and the test comes back negative, consider retesting at a later time.
RNA tests are able to detect the presence or absence and amount of HCV in the blood. These tests are not FDA-approved, although they are commonly used for research purposes. With these tests, it is possible to find HCV in the blood within 1 to 2 weeks after being infected with the virus.
People with HCV should be evaluated for the presence and severity of chronic liver disease and possible treatment. Talk to your health care providers for specific recommendations. The degree of liver damage may be determined by: Liver function tests, which tests to see if enzymes are higher than normal levels, which indicates damage to liver cells; ultrasound, which tests for signs of liver damage and cancer; or, liver biopsy, to detect signs of liver damage and cancer.
None of the available tests to detect hepatitis C virus or its antibody can tell the difference between acute or chronic infections.
People who clear the virus from their bodies may still have antibodies to HCV in the blood for many months.
Testing is recommended for:
People who ever injected illegal drugs (including those who injected once many years ago).
People who were notified that they received blood from a donor who later tested positive for the HCV infection.
People who received blood transfusions or organ transplants before July 1992.
Health care professionals if exposed to HCV-infected blood.
Children born to HCV-infected women.
People who used kidney dialysis (a process for people with kidney failure, in which excess water and waste from the blood are removed and purified).
Persons who received clotting factor concentrate produced before 1987.
Persons with signs or symptoms of liver disease (for example, abnormal liver enzyme tests).
Routine screening for hepatitis C is not recommended for:
Health care providers
Pregnant women
Household contacts of HCV carriers
The general population
Treatment
Treatment may differ depending on the stage of illness at the time treatment is sought. Your health care provider can help you make the best decisions about your treatment based upon your individual health needs.
Acute(newly acquired):
People with acute viral hepatitis experience a self-limited illness (one that runs a defined, short course) and go on to recover completely.
Relatively few people seek medical care for acute HCV, since most individuals are asymptomatic (have no symptoms) or have only mild, flu-like symptoms.
There is no accepted therapy or restrictions on diet or activity, although alcohol use may be restricted.
New studies indicate that treatment with interferon shortly after infection with HCV may be effective in reducing the risk of chronic infection and liver disease. Contact your health care provider for more information
Consult your health care provider before starting any new medications, including over-the-counter or herbal remedies.
Chronic (persistent):
Treatment options for people with chronic HCV and/or liver damage include:
Treatment with interferon alone:
alpha interferon or
a new, longer-lasting interferon called pegylated interferon.
Combination therapy with interferon and ribavarin.
In most cases, combination therapy is more effective than interferon alone.
Your health care professional may know of emerging therapies in the clinical trial stage for which you may be a candidate. Discuss these possibilities with your health care provider and let them help you make the best healthcare choices for you.
Drugs used to treat HCV are not licensed for persons under 18 years of age. Children with hepatitis C should contact a children's specialist in liver diseases.
What does it mean for my health?
The majority of people with hepatitis C have some sort of mild or moderate liver damage. Some have such damage that they have cirrhosis, liver failure, liver cancer, or need a liver transplant because of hepatitis C.
People infected with Hepatitis C are at risk for chronic liver disease or other HCV-related chronic diseases for at least 2 decades after infection
Complications from hepatitis C cause 8,000 to 10,000 deaths per year.
Reduce your risk
Non-Sexual:
If you inject drugs and can't stop, avoid sharing your works--needles, syringes, cotton, water, spoons, pots (cookers)--or any other drug paraphernalia. If you choose to share your works, clean them with water and bleach to reduce your risk of getting hepatitis C, filling syringes for at least 30 seconds. Also, consider getting vaccinated against hepatitis A and B.
Avoid sharing personal objects, such as toothbrushes, razors or other items that might have blood on them.
Health care workers should follow standard precautions when handling sharps and body fluids. They should also be vaccinated against hepatitis B.
If you know you have hepatitis C, you can protect others by:
not donating blood, body organs, tissue or semen.
Covering cuts or sores to prevent spreading infectious blood or secretions.
not sharing personal hygiene items such as razors or toothbrushes.
Sexual:
Abstinence and mutual monogamy between two uninfected partners are effective prevention methods.
If you are having sex, but not with one steady partner, you should use latex condoms correctly and every time you have sex. The efficacy of latex condoms in preventing infection with hepatitis C is unknown, but their proper use may reduce transmission, and it reduces the risk of transmitting or acquiring other infections.
According to the CDC, if you have hepatitis C and only have one long-term steady sex partner, there is a very low chance of spreading hepatitis C to that partner through sexual activity. If you want to lower the chance, you may decide to use barrier precautions such as latex condoms.
Get vaccinated against hepatitis A and B.
Immune Globulin (IG) or Interferon After Exposure to HCV:
Available data indicate that immune globulin injections are not effective after exposure to someone infected with HCV. However, new studies indicate that treatment with interferon shortly after infection with HCV may be effective in reducing the risk of chronic infection and liver disease. Contact your health care provider for more information.
Talk to your partner
Good partner communication is important in a relationship. While HCV is more likely to be spread through sharing drug needles and works with others, it can be transmitted through sexual contact. If you or your partner use street drugs or any illegal drug requiring shooting with a needle, you could be a risk of getting hepatitis C.
Should I talk to my health care provider?
Yes. Speak to your health care provider if you have:
shared a injection drug needle in the past, even once.
received a blood product or transfusion prior to 1992.
had unprotected sex with someone with HCV.
had kidney dialysis.
received notice that you received blood from a donor who later tested positive for HCV infection.
If you have hepatitis C you can protect your liver by:
not drinking alcohol, because it may cause further damage to the liver.
seeing your health care provider regularly
not beginning to take any new medicines, including over-the-counter or herbal ones, without talking to your health care provider.
getting vaccinated against hepatitis A and B.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
What is hepatitis C (HCV)?
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). It is sometimes called non-A and non-B hepatitis. Hepatitis C is the most common chronic bloodborne infection in the United States.
15 to 45% of those infected with HCV are able to clear the virus from their blood within about 6 months from the time of infection.
However, 55 to 85% of people with acute hepatitis C do not get rid of the virus within 6 months and therefore have chronic (long-term) hepatitis C.
About 70% of chronically infected persons will develop chronic liver disease.
Between 1 and 5 % of chronically infected patients may die from chronic liver disease.
HCV is the leading indication for liver transplants.
How common is it?
It is estimated that around 4 million Americans have been infected with hepatitis C, of whom 2.7 million have chronic infections. Each year, it is estimated that there are 30,000 new infections in the United States, according to the Centers for Disease Control and Prevention (CDC). Of those new infections, only 20% of those infected will have symptoms. That means many people will become infected with hepatitis C and not know it right away.
How is it transmitted?
Hepatitis C is primarily transmitted by direct contact with blood. The most common ways are:
Contact with HCV-infected blood through sharing of needles or other injecting equipment during intravenous drug use that have not been properly cleaned between users. At present, injection drug use is the most common risk factor for contracting the disease.
Organ transplants and blood transfusions prior to 1992.
Hepatitis C can be spread by vaginal or anal sex, but this does not occur very often (see "Reduce Your Risk" section below). Factors found to be associated with sexual transmission of HCV are: sex with multiple partners, presence of other STDs, or sex with trauma (for example, rough sex, rape, or sexual abuse).
Transmission through oral sex has not been documented.
Hepatitis C may be passed from an infected mother to her baby. Neonatal transmission may occur at birth if the mother is infected. The rate of infection is the same regardless of method of delivery (Caesarean section or vaginal). There are no recommendations to avoid pregnancy or breast-feeding if infected with HCV, because transmission of HCV infection through breast milk has not been documented. However, if nipples are cracked or bleeding, hepatitis C-infected mothers may not want to breastfeed because of increased risk.
Symptoms
Most individuals with hepatitis C (about 80%) do not have signs or symptoms. Liver disease progresses so slowly that a person can have hepatitis C for years without having symptoms. Many individuals with chronic hepatitis C have mild to moderate liver damage but do not feel sick. The possible symptoms for an acute infection (newly acquired or short-term) and a chronic (long-term or persistent) infection are different.
Acute Infection (newly acquired)
Often, people with an acute HCV infection are asymptomatic (have no symptoms).
Some people with an acute HCV infection will have jaundice (a yellowing of the skin and eyes) or mild flu-like symptoms.
Chronic Infection (persistent)
Most people with chronic HCV will have only mild to moderate liver disease. Symptoms of this may include: jaundice, fatigue, loss of appetite, nausea, or malaise.
Most people with chronic infection have abnormalities in liver enzyme levels that can fluctuate widely.
If a person develops cirrhosis (scarring) of the liver, symptoms and signs may be more prominent. In addition to fatigue, symptoms may include muscle weakness, poor appetite, nausea, weight loss, itching, dark urine, jaundice, fluid retention, and abdominal swelling.
Testing/Diagnosis
There are several blood tests that can be done to determine if a person has HCV. If you think you've been exposed or infected with HCV, talk to your health care provider. They may order one test or a combination of tests. You and your health care provider can discuss whether your sex partner(s) need to be tested for hepatitis C.
The only FDA-approved tests are anti-HCV tests. These tests look for antibodies to HCV in the blood.
The average time it takes for a person infected with hepatitis C to develop antibodies to the virus is 8-9 weeks after exposure. Most people will develop the antibodies by 6 months, but it can take up to 12 months. If you believe you have been recently exposed to Hepatitis C and the test comes back negative, consider retesting at a later time.
RNA tests are able to detect the presence or absence and amount of HCV in the blood. These tests are not FDA-approved, although they are commonly used for research purposes. With these tests, it is possible to find HCV in the blood within 1 to 2 weeks after being infected with the virus.
People with HCV should be evaluated for the presence and severity of chronic liver disease and possible treatment. Talk to your health care providers for specific recommendations. The degree of liver damage may be determined by: Liver function tests, which tests to see if enzymes are higher than normal levels, which indicates damage to liver cells; ultrasound, which tests for signs of liver damage and cancer; or, liver biopsy, to detect signs of liver damage and cancer.
None of the available tests to detect hepatitis C virus or its antibody can tell the difference between acute or chronic infections.
People who clear the virus from their bodies may still have antibodies to HCV in the blood for many months.
Testing is recommended for:
People who ever injected illegal drugs (including those who injected once many years ago).
People who were notified that they received blood from a donor who later tested positive for the HCV infection.
People who received blood transfusions or organ transplants before July 1992.
Health care professionals if exposed to HCV-infected blood.
Children born to HCV-infected women.
People who used kidney dialysis (a process for people with kidney failure, in which excess water and waste from the blood are removed and purified).
Persons who received clotting factor concentrate produced before 1987.
Persons with signs or symptoms of liver disease (for example, abnormal liver enzyme tests).
Routine screening for hepatitis C is not recommended for:
Health care providers
Pregnant women
Household contacts of HCV carriers
The general population
Treatment
Treatment may differ depending on the stage of illness at the time treatment is sought. Your health care provider can help you make the best decisions about your treatment based upon your individual health needs.
Acute(newly acquired):
People with acute viral hepatitis experience a self-limited illness (one that runs a defined, short course) and go on to recover completely.
Relatively few people seek medical care for acute HCV, since most individuals are asymptomatic (have no symptoms) or have only mild, flu-like symptoms.
There is no accepted therapy or restrictions on diet or activity, although alcohol use may be restricted.
New studies indicate that treatment with interferon shortly after infection with HCV may be effective in reducing the risk of chronic infection and liver disease. Contact your health care provider for more information
Consult your health care provider before starting any new medications, including over-the-counter or herbal remedies.
Chronic (persistent):
Treatment options for people with chronic HCV and/or liver damage include:
Treatment with interferon alone:
alpha interferon or
a new, longer-lasting interferon called pegylated interferon.
Combination therapy with interferon and ribavarin.
In most cases, combination therapy is more effective than interferon alone.
Your health care professional may know of emerging therapies in the clinical trial stage for which you may be a candidate. Discuss these possibilities with your health care provider and let them help you make the best healthcare choices for you.
Drugs used to treat HCV are not licensed for persons under 18 years of age. Children with hepatitis C should contact a children's specialist in liver diseases.
What does it mean for my health?
The majority of people with hepatitis C have some sort of mild or moderate liver damage. Some have such damage that they have cirrhosis, liver failure, liver cancer, or need a liver transplant because of hepatitis C.
People infected with Hepatitis C are at risk for chronic liver disease or other HCV-related chronic diseases for at least 2 decades after infection
Complications from hepatitis C cause 8,000 to 10,000 deaths per year.
Reduce your risk
Non-Sexual:
If you inject drugs and can't stop, avoid sharing your works--needles, syringes, cotton, water, spoons, pots (cookers)--or any other drug paraphernalia. If you choose to share your works, clean them with water and bleach to reduce your risk of getting hepatitis C, filling syringes for at least 30 seconds. Also, consider getting vaccinated against hepatitis A and B.
Avoid sharing personal objects, such as toothbrushes, razors or other items that might have blood on them.
Health care workers should follow standard precautions when handling sharps and body fluids. They should also be vaccinated against hepatitis B.
If you know you have hepatitis C, you can protect others by:
not donating blood, body organs, tissue or semen.
Covering cuts or sores to prevent spreading infectious blood or secretions.
not sharing personal hygiene items such as razors or toothbrushes.
Sexual:
Abstinence and mutual monogamy between two uninfected partners are effective prevention methods.
If you are having sex, but not with one steady partner, you should use latex condoms correctly and every time you have sex. The efficacy of latex condoms in preventing infection with hepatitis C is unknown, but their proper use may reduce transmission, and it reduces the risk of transmitting or acquiring other infections.
According to the CDC, if you have hepatitis C and only have one long-term steady sex partner, there is a very low chance of spreading hepatitis C to that partner through sexual activity. If you want to lower the chance, you may decide to use barrier precautions such as latex condoms.
Get vaccinated against hepatitis A and B.
Immune Globulin (IG) or Interferon After Exposure to HCV:
Available data indicate that immune globulin injections are not effective after exposure to someone infected with HCV. However, new studies indicate that treatment with interferon shortly after infection with HCV may be effective in reducing the risk of chronic infection and liver disease. Contact your health care provider for more information.
Talk to your partner
Good partner communication is important in a relationship. While HCV is more likely to be spread through sharing drug needles and works with others, it can be transmitted through sexual contact. If you or your partner use street drugs or any illegal drug requiring shooting with a needle, you could be a risk of getting hepatitis C.
Should I talk to my health care provider?
Yes. Speak to your health care provider if you have:
shared a injection drug needle in the past, even once.
received a blood product or transfusion prior to 1992.
had unprotected sex with someone with HCV.
had kidney dialysis.
received notice that you received blood from a donor who later tested positive for HCV infection.
If you have hepatitis C you can protect your liver by:
not drinking alcohol, because it may cause further damage to the liver.
seeing your health care provider regularly
not beginning to take any new medicines, including over-the-counter or herbal ones, without talking to your health care provider.
getting vaccinated against hepatitis A and B.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
HEPATITIS-B
What is hepatitis B (HBV)?
Hepatitis B is a virus that causes inflammation of the liver. Chronic (long-lasting) hepatitis B can cause liver cell damage, which can lead to cirrhosis (scarring of the liver) and cancer. It is estimated that 5,000 people die each year in the United States due to the complications of cirrhosis and liver cancer as a result of HBV.
How common is it?
According to Centers for Disease Control and Prevention (CDC), it is estimated that 1.25 million people in the United States have chronic HBV. There were an estimated 73,000 new HBV infections in the United States in 2003.
How is it transmitted?
HBV is transmitted through direct contact with blood, semen, or vaginal secretions.
Hepatitis B can be transmitted through unprotected vaginal, anal, or oral sex. In adolescents and adults, this is the most common mode of transmission.
HBV can also be transmitted by injecting drug users who share needles or other injecting equipment contaminated with HBV-infected blood.
Although tattoo, body piercing, and acupuncture needles may transmit HBV, these exposures account for only a small proportion of reported cases in the United States.
Mothers who have HBV can pass it on to their babies during birth.
Although rarely, transmission may occur in the following ways.
Saliva can be a means of transmission through bites. However, transmission has not been documented to occur as a result of other types of exposure to saliva, including kissing.
The risk of transmission from blood transfusion is currently low in the U.S. since blood banks screen all donated blood.
HBV is found in transmittable levels in body fluids including:
Semen
Vaginal secretions
Saliva
Blood
HBV has also been found in low concentrations in other body fluids, though these fluids have NOT been associated with transmission:
Tears
Urine
Feces
Breast milk
Cerebrospinal fluid
HBV is not spread through food or water or by casual contact.
Symptoms
Many adults have few or no symptoms. Symptoms may mimic the flu and can include:
Loss of appetite
Malaise (feeling of ill-health)
Fatigue (feeling tired all the time)
Nausea and vomiting
Abdominal pain
Dark urine
Jaundice (yellowing of the skin and eyes)
Rash or arthritis may occur prior to the onset of other symptoms (during the prodromal or early acute stage).
A few patients (1%) have a more severe course of illness and may experience sudden and severe liver failure within a short period of time after infection. These people may suddenly collapse with fatigue, have jaundice, and develop swelling in their abdomen. This can be fatal if not treated immediately.
Testing/Diagnosis
Your health care provider can confirm HBV by using a special blood test to detect HBV particles or antibodies in the blood. Blood tests can determine whether a person has acute or chronic hepatitis.
HBV is not usually included in routine blood tests, so patients may have to request the test from their health care provider. There are three standard blood tests for HBV:
HBsAg (looks for hepatitis B surface antigens): This test detects the presence and levels of virus in the blood. When this test is positive or reactive, it means that the person is infected with HBV at the present time and can pass the virus to others.
Anti-HBs (looks for antibody to the hepatitis B surface antigen): If this test is positive or reactive, it means that the person is immune, either as a result of having had the disease previously or from receiving the hepatitis B vaccine. This person cannot pass the virus to others.
Anti-HBc (antibody to hepatitis B core antigen): This is usually present in chronic carriers, who can pass the virus to others. However, if it is present with a positive anti-HBs test, then it is associated with recovery from a previous infection, and this person is not a carrier.
In many settings, a health care provider will run all 3 of the above tests and interpret the results based on the outcome of all 3.
HBV usually takes between 3 weeks to 2 months to show up in the blood. It may take up to two months after infection for a Hepatitis B test to be accurate.
If chronic HBV is suspected, other tests may be ordered. These test can help to decide treatment options and may include:
Ultrasound, which tests for signs of liver damage and cancer
Liver biopsy, to detect signs of liver damage and cancer
Liver function tests, which tests to see if enzymes are higher than normal levels, which indicates damage to liver cells.
E-antigen test, which detects e-antigen, a viral protein that is put out by HBV-infected cells. This test is often used to monitor the effectiveness of some HBV therapies.
After receiving the hepatitis B vaccine, the following people may benefit from antibody confirmatory testing in order to be sure the vaccine is working. The test should be performed within 2 months after completion of the series or it may not give accurate results.
A person whose sex partner has chronic hepatitis B.
A person whose immune system is compromised (for instance, if someone living with AIDS).
A person whose job exposes him or her to human blood.
A child who is born to an HBV-positive mother.
Babies born to infected mothers should get two anti-HBs tests at aged 9 to 15 months to be certain that they are making antibodies, a sign that the vaccine has worked well. (Babies of HBV-infected mothers are not tested at birth but are automatically given the HBIG and the first shot of the hepatitis B vaccine series.)
Treatment
Treatment considerations for HBV vary depending on whether the infection is acute or chronic. Always consult your health care provider for specific recommendations and treatment options.
Acute (newly acquired):
No specific treatment is available for acute HBV infection.
Most patients with acute viral hepatitis experience a self-limited illness (one that runs a defined, limited course), and go on to recover completely.
There is no accepted therapy and no restrictions on diet or activity.
In most cases, hospitalization should be avoided, to prevent spread of the virus to other patients. It should, however, be considered for patients who are severely ill.
Your health care provider can recommend the best options based on your individual needs for care.
Chronic (persistent):
Interferon is used to help stop the replication of HBV. It is called an antiviral agent. Interferon has been 40 percent effective in eliminating chronic HBV infection. Persons who became infected during adulthood were most likely to respond to this treatment. Long-term follow up of treated patients suggests that remission of chronic HBV from treatments with interferon is of long duration. Talk to your health care provider about the use of Interferon.
Lamivudine (Epivir) is now available to treat chronic HBV. It is the first medication specifically formulated to do so. Talk to your health care provider for more information about lamivudine and to learn if it is right for you.
Adefovir dipivoxil (Hepsera™), is the first nucleotide analog approved to treat chronic HBV. Adefovir dipivoxil slows the progression of chronic HBV by interfering with the virus' replication process within the body. Results show that adefovir dipivoxil can significantly reduce liver inflammation and scarring. It has been shown to work in people who have resistance to the drug lamivudine. Consult your health care provider for more information about adefovir dipivoxil and to learn it is right for you.
Entecavir (Baraclude™) slows the progression of chronic hepatitis B by interfering with viral reproduction. In clinical studies, patients treated with entecavir showed significant improvement in the liver inflammation caused by HBV and an improvement in the degree of liver fibrosis (scarring). It is important to stay under your doctor’s care while taking entecavir. Baraclude™ was approved by the Food & Drug Administration (FDA) in March 2005. Talk to your doctor to learn more about this treatment.
Peginterferon (Pegasys®) is the first and only pegylated interferon approved for the treatment of chronic hepatitis B, including both variations of the virus. Peginterferon has a dual mode of action; it slows replication of the hepatitis B virus and boosts the immune system. Pegasys® was approved by the FDA to treat chronic hepatitis B in May 2005. Talk to your doctor to learn more about peginterferon.
What does it mean for my health?
Hepatitis B can cause:
Chronic infection
Cirrhosis (scarring) of the liver
Liver cancer
Death
The good news is that hepatitis B is preventable through vaccination. A person can choose to be vaccinated and no longer have to worry about being infected with HBV.
Reduce your risk
Vaccination before exposure to HAV:
Hepatitis B is preventable through vaccination. Since hepatitis D can only coexist with hepatitis B, getting vaccinated against hepatitis B also protects you against hepatitis D.
The HBV vaccine is given in a series of three doses.
The first and second doses must be given at least one month apart.
The first and third doses must be given at least 4 months apart.
If a dose is missed, it should be given as soon as possible.
The series should not be restarted if a dose is missed.
Routine booster doses of the HBV vaccine are NOT currently recommended.
Consult your health care provider for more information about the HBV vaccine and if it is right for you.
HIV can impair the response to the hepatitis vaccine.
A new combination vaccine called Twinrix has been approved for protection from both HAV and HBV in persons 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three.
Hepatitis B vaccine has been recommended as a routine infant vaccination since 1991 and as a routine adolescent vaccination since 1995. It is recommended for everyone 18 years of age and younger and for adults over 18 who are at risk for HBV infection. (However, anyone seeking immunity from HBV may be vaccinated.) Vaccination against hepatitis B is recommended for those who are at high risk of infection, including:
Health care professionals
Clients/staff of institutions for the developmentally disabled
Sexually active men who have sex with men
Household/sexual contacts of chronic HBV carriers
Travelers to and immigrants from countries with high incidence of HBV
Sexually active heterosexual men and women, including: those in whom another STD was recently diagnosed (hepatitis B infection with an HIV infected individual is more likely to lead to chronic HBV); those who have had more than one sex partner in the preceding six months; those who have received treatment in an STD clinic; and, those who are sex workers or prostitutes
Injecting and non-injecting drug users
Hemodialysis patients
Recipients of certain blood products
Inmates of long-term correctional facilities.
Immune Globulin (IG) after exposure to HAV:
Post exposure treatment to prevent illness (Immune globulin and HBV vaccine); if a person is exposed to hepatitis B and has NOT been vaccinated before the exposure:
For unvaccinated individuals who have had recent exposure to someone with acute hepatitis B, a dose of hepatitis B immune globulin (HBIG) may prevent illness.
The hepatitis B vaccine given with HBIG is also recommended. (The hepatitis B vaccine in conjunction with HBIG is more effective than administering the hepatitis B vaccine alone.)
Both should be administered within 7 days after the exposure, as treatment is recommended even without testing.
Since 1985, all plasma units for preparation of immune globulin have been screened for HIV.
Sexual Prevention:
Abstinence and mutual monogamy between two uninfected partners also offer a high level of protection.
Latex condoms offer effective prevention during vaginal and anal sex by reducing contact with infected bodily fluids (semen, vaginal secretions and blood).
A non-lubricated latex condom can be used for mouth-to-penis contact. Household plastic wrap, dams or a latex condom cut lengthwise and opened flat can reduce the risk of transmission during mouth-to-vulva or oral-anal contact.
Non-Sexual Prevention:
Avoid contact with infected blood or other body fluids directly or on objects such as needles, razors, toothbrushes, etc.
Clean surfaces contaminated with blood or other body fluids with a solution of 1 part household bleach and 10 parts water.
Cover cuts, sores, and rashes with bandages.
Talk to your partner
If you have an acute or chronic hepatitis B infection, you should discuss it with your partner so that he or she can learn how to protect themselves from becoming infected with HBV.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunization Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
Share your story
Do you have an experience related to hepatitis B that you are willing to share with others? Triumphs? Challenges? Please send your story to mystory@ashastd.org.
ASHA sincerely appreciates every submission and each is confidential and anonymous. It is ASHA's intent to collect these comments for use in our patient advocacy work, including potential publication. All submissions are property of ASHA and can be edited for length and clarity. Due to the large volume of emails, we regret that we cannot provide a response to each submission.
Please note: This email service cannot answer questions about hepatitis B. For any questions, please contact your health care provider or call the CDC at (800) CDC-INFO.
Hepatitis B is a virus that causes inflammation of the liver. Chronic (long-lasting) hepatitis B can cause liver cell damage, which can lead to cirrhosis (scarring of the liver) and cancer. It is estimated that 5,000 people die each year in the United States due to the complications of cirrhosis and liver cancer as a result of HBV.
How common is it?
According to Centers for Disease Control and Prevention (CDC), it is estimated that 1.25 million people in the United States have chronic HBV. There were an estimated 73,000 new HBV infections in the United States in 2003.
How is it transmitted?
HBV is transmitted through direct contact with blood, semen, or vaginal secretions.
Hepatitis B can be transmitted through unprotected vaginal, anal, or oral sex. In adolescents and adults, this is the most common mode of transmission.
HBV can also be transmitted by injecting drug users who share needles or other injecting equipment contaminated with HBV-infected blood.
Although tattoo, body piercing, and acupuncture needles may transmit HBV, these exposures account for only a small proportion of reported cases in the United States.
Mothers who have HBV can pass it on to their babies during birth.
Although rarely, transmission may occur in the following ways.
Saliva can be a means of transmission through bites. However, transmission has not been documented to occur as a result of other types of exposure to saliva, including kissing.
The risk of transmission from blood transfusion is currently low in the U.S. since blood banks screen all donated blood.
HBV is found in transmittable levels in body fluids including:
Semen
Vaginal secretions
Saliva
Blood
HBV has also been found in low concentrations in other body fluids, though these fluids have NOT been associated with transmission:
Tears
Urine
Feces
Breast milk
Cerebrospinal fluid
HBV is not spread through food or water or by casual contact.
Symptoms
Many adults have few or no symptoms. Symptoms may mimic the flu and can include:
Loss of appetite
Malaise (feeling of ill-health)
Fatigue (feeling tired all the time)
Nausea and vomiting
Abdominal pain
Dark urine
Jaundice (yellowing of the skin and eyes)
Rash or arthritis may occur prior to the onset of other symptoms (during the prodromal or early acute stage).
A few patients (1%) have a more severe course of illness and may experience sudden and severe liver failure within a short period of time after infection. These people may suddenly collapse with fatigue, have jaundice, and develop swelling in their abdomen. This can be fatal if not treated immediately.
Testing/Diagnosis
Your health care provider can confirm HBV by using a special blood test to detect HBV particles or antibodies in the blood. Blood tests can determine whether a person has acute or chronic hepatitis.
HBV is not usually included in routine blood tests, so patients may have to request the test from their health care provider. There are three standard blood tests for HBV:
HBsAg (looks for hepatitis B surface antigens): This test detects the presence and levels of virus in the blood. When this test is positive or reactive, it means that the person is infected with HBV at the present time and can pass the virus to others.
Anti-HBs (looks for antibody to the hepatitis B surface antigen): If this test is positive or reactive, it means that the person is immune, either as a result of having had the disease previously or from receiving the hepatitis B vaccine. This person cannot pass the virus to others.
Anti-HBc (antibody to hepatitis B core antigen): This is usually present in chronic carriers, who can pass the virus to others. However, if it is present with a positive anti-HBs test, then it is associated with recovery from a previous infection, and this person is not a carrier.
In many settings, a health care provider will run all 3 of the above tests and interpret the results based on the outcome of all 3.
HBV usually takes between 3 weeks to 2 months to show up in the blood. It may take up to two months after infection for a Hepatitis B test to be accurate.
If chronic HBV is suspected, other tests may be ordered. These test can help to decide treatment options and may include:
Ultrasound, which tests for signs of liver damage and cancer
Liver biopsy, to detect signs of liver damage and cancer
Liver function tests, which tests to see if enzymes are higher than normal levels, which indicates damage to liver cells.
E-antigen test, which detects e-antigen, a viral protein that is put out by HBV-infected cells. This test is often used to monitor the effectiveness of some HBV therapies.
After receiving the hepatitis B vaccine, the following people may benefit from antibody confirmatory testing in order to be sure the vaccine is working. The test should be performed within 2 months after completion of the series or it may not give accurate results.
A person whose sex partner has chronic hepatitis B.
A person whose immune system is compromised (for instance, if someone living with AIDS).
A person whose job exposes him or her to human blood.
A child who is born to an HBV-positive mother.
Babies born to infected mothers should get two anti-HBs tests at aged 9 to 15 months to be certain that they are making antibodies, a sign that the vaccine has worked well. (Babies of HBV-infected mothers are not tested at birth but are automatically given the HBIG and the first shot of the hepatitis B vaccine series.)
Treatment
Treatment considerations for HBV vary depending on whether the infection is acute or chronic. Always consult your health care provider for specific recommendations and treatment options.
Acute (newly acquired):
No specific treatment is available for acute HBV infection.
Most patients with acute viral hepatitis experience a self-limited illness (one that runs a defined, limited course), and go on to recover completely.
There is no accepted therapy and no restrictions on diet or activity.
In most cases, hospitalization should be avoided, to prevent spread of the virus to other patients. It should, however, be considered for patients who are severely ill.
Your health care provider can recommend the best options based on your individual needs for care.
Chronic (persistent):
Interferon is used to help stop the replication of HBV. It is called an antiviral agent. Interferon has been 40 percent effective in eliminating chronic HBV infection. Persons who became infected during adulthood were most likely to respond to this treatment. Long-term follow up of treated patients suggests that remission of chronic HBV from treatments with interferon is of long duration. Talk to your health care provider about the use of Interferon.
Lamivudine (Epivir) is now available to treat chronic HBV. It is the first medication specifically formulated to do so. Talk to your health care provider for more information about lamivudine and to learn if it is right for you.
Adefovir dipivoxil (Hepsera™), is the first nucleotide analog approved to treat chronic HBV. Adefovir dipivoxil slows the progression of chronic HBV by interfering with the virus' replication process within the body. Results show that adefovir dipivoxil can significantly reduce liver inflammation and scarring. It has been shown to work in people who have resistance to the drug lamivudine. Consult your health care provider for more information about adefovir dipivoxil and to learn it is right for you.
Entecavir (Baraclude™) slows the progression of chronic hepatitis B by interfering with viral reproduction. In clinical studies, patients treated with entecavir showed significant improvement in the liver inflammation caused by HBV and an improvement in the degree of liver fibrosis (scarring). It is important to stay under your doctor’s care while taking entecavir. Baraclude™ was approved by the Food & Drug Administration (FDA) in March 2005. Talk to your doctor to learn more about this treatment.
Peginterferon (Pegasys®) is the first and only pegylated interferon approved for the treatment of chronic hepatitis B, including both variations of the virus. Peginterferon has a dual mode of action; it slows replication of the hepatitis B virus and boosts the immune system. Pegasys® was approved by the FDA to treat chronic hepatitis B in May 2005. Talk to your doctor to learn more about peginterferon.
What does it mean for my health?
Hepatitis B can cause:
Chronic infection
Cirrhosis (scarring) of the liver
Liver cancer
Death
The good news is that hepatitis B is preventable through vaccination. A person can choose to be vaccinated and no longer have to worry about being infected with HBV.
Reduce your risk
Vaccination before exposure to HAV:
Hepatitis B is preventable through vaccination. Since hepatitis D can only coexist with hepatitis B, getting vaccinated against hepatitis B also protects you against hepatitis D.
The HBV vaccine is given in a series of three doses.
The first and second doses must be given at least one month apart.
The first and third doses must be given at least 4 months apart.
If a dose is missed, it should be given as soon as possible.
The series should not be restarted if a dose is missed.
Routine booster doses of the HBV vaccine are NOT currently recommended.
Consult your health care provider for more information about the HBV vaccine and if it is right for you.
HIV can impair the response to the hepatitis vaccine.
A new combination vaccine called Twinrix has been approved for protection from both HAV and HBV in persons 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three.
Hepatitis B vaccine has been recommended as a routine infant vaccination since 1991 and as a routine adolescent vaccination since 1995. It is recommended for everyone 18 years of age and younger and for adults over 18 who are at risk for HBV infection. (However, anyone seeking immunity from HBV may be vaccinated.) Vaccination against hepatitis B is recommended for those who are at high risk of infection, including:
Health care professionals
Clients/staff of institutions for the developmentally disabled
Sexually active men who have sex with men
Household/sexual contacts of chronic HBV carriers
Travelers to and immigrants from countries with high incidence of HBV
Sexually active heterosexual men and women, including: those in whom another STD was recently diagnosed (hepatitis B infection with an HIV infected individual is more likely to lead to chronic HBV); those who have had more than one sex partner in the preceding six months; those who have received treatment in an STD clinic; and, those who are sex workers or prostitutes
Injecting and non-injecting drug users
Hemodialysis patients
Recipients of certain blood products
Inmates of long-term correctional facilities.
Immune Globulin (IG) after exposure to HAV:
Post exposure treatment to prevent illness (Immune globulin and HBV vaccine); if a person is exposed to hepatitis B and has NOT been vaccinated before the exposure:
For unvaccinated individuals who have had recent exposure to someone with acute hepatitis B, a dose of hepatitis B immune globulin (HBIG) may prevent illness.
The hepatitis B vaccine given with HBIG is also recommended. (The hepatitis B vaccine in conjunction with HBIG is more effective than administering the hepatitis B vaccine alone.)
Both should be administered within 7 days after the exposure, as treatment is recommended even without testing.
Since 1985, all plasma units for preparation of immune globulin have been screened for HIV.
Sexual Prevention:
Abstinence and mutual monogamy between two uninfected partners also offer a high level of protection.
Latex condoms offer effective prevention during vaginal and anal sex by reducing contact with infected bodily fluids (semen, vaginal secretions and blood).
A non-lubricated latex condom can be used for mouth-to-penis contact. Household plastic wrap, dams or a latex condom cut lengthwise and opened flat can reduce the risk of transmission during mouth-to-vulva or oral-anal contact.
Non-Sexual Prevention:
Avoid contact with infected blood or other body fluids directly or on objects such as needles, razors, toothbrushes, etc.
Clean surfaces contaminated with blood or other body fluids with a solution of 1 part household bleach and 10 parts water.
Cover cuts, sores, and rashes with bandages.
Talk to your partner
If you have an acute or chronic hepatitis B infection, you should discuss it with your partner so that he or she can learn how to protect themselves from becoming infected with HBV.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunization Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
Share your story
Do you have an experience related to hepatitis B that you are willing to share with others? Triumphs? Challenges? Please send your story to mystory@ashastd.org.
ASHA sincerely appreciates every submission and each is confidential and anonymous. It is ASHA's intent to collect these comments for use in our patient advocacy work, including potential publication. All submissions are property of ASHA and can be edited for length and clarity. Due to the large volume of emails, we regret that we cannot provide a response to each submission.
Please note: This email service cannot answer questions about hepatitis B. For any questions, please contact your health care provider or call the CDC at (800) CDC-INFO.
HEPATITIS-A
HEPATITIS-A
What is hepatitis A (HAV)?
Hepatitis A is a liver disease caused by the hepatitis A virus.
How common is it?
According to Centers for Disease Control and Prevention, it is estimated there are between 125,000 and 200,000 total infections per year in the United States. It is estimated that 84,000 to 134,000 of the total infections will show symptoms of HAV. Each year, approximately 100 people will die because of hepatitis A.
How is it transmitted?
Hepatitis A (HAV) is transmitted primarily through oral contact with feces (oral-fecal contact). This includes contaminated food or water sources and sexual contact, especially oral-anal sex.
Hepatitis A can easily spread among young children in day care settings because many are in diapers and cannot wash their own hands, and no one may know they have the disease since children normally do not have symptoms.
HAV has on rare occasions been transmitted through blood transfusion, use of blood products or sharing needles or other injecting equipment contaminated with HAV-infected blood. Transmission by blood is rare because the presence of virus in the blood occurs with the onset of infection and is not thought to be present long.
Symptoms
Most adults infected with HAV usually develop some symptoms. Symptoms may develop about 15-50 days after exposure; the average is 28 days. These may include:
Low-grade fever
Malaise (feeling of ill-health)
Fatigue (feeling tired all the time)
Loss of appetite
Nausea
Abdominal discomfort
Dark-colored urine
Jaundice (yellowing of the skin and eyes)
Children under 6 years of age seldom develop symptoms, although some may experience diarrhea.
Testing/Diagnosis
There are currently three blood tests available to detect HAV antibodies; antibodies may be detected for up to six months following the onset of symptoms. HAV antibodies usually disappear after this time.
Talk to your health care provider for more information about HAV testing.
Treatment
There is no cure for hepatitis A. Most people with severe infection will experience short-term illness and then recover completely. They are often told to rest for one to four weeks and to avoid intimate contact with others. Some doctors recommend a high-protein, low-fat diet during recovery and avoidance of alcohol, sedatives, or strong painkillers, such as narcotics. Once recovered, an individual is immune and will not get hepatitis A again.
What does it mean for my health?
Fortunately, complications from HAV are rare, and few deaths result from it. It is not known to cause chronic infections. However, it can make some people very sick, and it is easily preventable.
Reduce your risk - get vaccinated!
Vaccination before exposure to HAV:
HAV is preventable by vaccination. The hepatitis A vaccine is made from inactive hepatitis A virus particles. The body reacts with the inactive virus to produce an antibody that protects against infection of the liver by the hepatitis A virus. Clinical trials have shown that the vaccine is effective in preventing infection in about 95% of people who were exposed. There are generally no side effects, except for soreness at the site of injection. Less than 10% of those vaccinated become tired and nauseous.
The two-dose vaccine series, given at least six months apart, provides pre-exposure protection from HAV infection in children aged 1 years or older and in adults. Vaccination against HAV is recommended for those who are at risk of infection, including:
People 1 year of age and older traveling or working in countries with high rates of HAV
People who live in communities that have prolonged HAV outbreaks or high rates of HAV
Men who have sex with men
People who use street drugs
People with chronic liver disease
People who receive clotting factor concentrates
As of October 2005, the CDC ACIP (Advisory Committee on Immunization Practices) recommends that the hepatitis A vaccine become a routine childhood vaccine for U.S. children between 1 and 2 years of age in all states. (Previously the vaccine was only recommended for children in 17 states with the highest rates of disease; however, about two-thirds of cases are now reported from states in which hepatitis A vaccination of children was not recommended.)
A combination vaccine called Twinrix has been approved for protection from both HAV and HBV in persons 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three.
Immune Globulin (IG) after exposure to HAV:
People who have been exposed to hepatitis A may talk with their health care provider about a post-exposure immune globulin (IG) injection. Immune Globulins (IG) are sterile solutions of antibodies made from human plasma. They are important tools in preventing illness.
A dose of IG, if given within 14 days after contact with HAV, may prevent illness from occurring. In some cases, the hepatitis A IG may also be given before a possible exposure.
Sexual Prevention:
Abstinence (not having sex)
Mutual monogamy (having sex with only one uninfected partner)
Cut-up non-lubricated latex condoms or use of other moisture barriers, such as household plastic wrap or dams (square pieces of latex) can reduce the risk of transmitting HAV during oral-anal sex.
Non-Sexual Prevention:
Avoid sharing drug needles and other drug-injection equipment.
Avoid contaminated food or water sources
Practicing good personal hygiene, especially hand-washing after using the toilet or changing diapers
To inactivate HAV, heat foods at temperatures above 185 degrees Fahrenheit for 1 minute or disinfect surfaces with a 1:100 dilution of household bleach in tap water (1 part bleach for 100 parts of water)
Talk to your partner
If you have tested positive for hepatitis A, you may want to tell to your sex partner(s) that you have the virus. As part of good partner communication, deciding to use latex condoms and moisture barriers during sexual contact helps reduce the risk of transmitting a sexually transmitted disease. HAV can be transmitted through oral-anal sex so it is recommended to always use safer sex methods to reduce the risk of transmission.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
What is hepatitis A (HAV)?
Hepatitis A is a liver disease caused by the hepatitis A virus.
How common is it?
According to Centers for Disease Control and Prevention, it is estimated there are between 125,000 and 200,000 total infections per year in the United States. It is estimated that 84,000 to 134,000 of the total infections will show symptoms of HAV. Each year, approximately 100 people will die because of hepatitis A.
How is it transmitted?
Hepatitis A (HAV) is transmitted primarily through oral contact with feces (oral-fecal contact). This includes contaminated food or water sources and sexual contact, especially oral-anal sex.
Hepatitis A can easily spread among young children in day care settings because many are in diapers and cannot wash their own hands, and no one may know they have the disease since children normally do not have symptoms.
HAV has on rare occasions been transmitted through blood transfusion, use of blood products or sharing needles or other injecting equipment contaminated with HAV-infected blood. Transmission by blood is rare because the presence of virus in the blood occurs with the onset of infection and is not thought to be present long.
Symptoms
Most adults infected with HAV usually develop some symptoms. Symptoms may develop about 15-50 days after exposure; the average is 28 days. These may include:
Low-grade fever
Malaise (feeling of ill-health)
Fatigue (feeling tired all the time)
Loss of appetite
Nausea
Abdominal discomfort
Dark-colored urine
Jaundice (yellowing of the skin and eyes)
Children under 6 years of age seldom develop symptoms, although some may experience diarrhea.
Testing/Diagnosis
There are currently three blood tests available to detect HAV antibodies; antibodies may be detected for up to six months following the onset of symptoms. HAV antibodies usually disappear after this time.
Talk to your health care provider for more information about HAV testing.
Treatment
There is no cure for hepatitis A. Most people with severe infection will experience short-term illness and then recover completely. They are often told to rest for one to four weeks and to avoid intimate contact with others. Some doctors recommend a high-protein, low-fat diet during recovery and avoidance of alcohol, sedatives, or strong painkillers, such as narcotics. Once recovered, an individual is immune and will not get hepatitis A again.
What does it mean for my health?
Fortunately, complications from HAV are rare, and few deaths result from it. It is not known to cause chronic infections. However, it can make some people very sick, and it is easily preventable.
Reduce your risk - get vaccinated!
Vaccination before exposure to HAV:
HAV is preventable by vaccination. The hepatitis A vaccine is made from inactive hepatitis A virus particles. The body reacts with the inactive virus to produce an antibody that protects against infection of the liver by the hepatitis A virus. Clinical trials have shown that the vaccine is effective in preventing infection in about 95% of people who were exposed. There are generally no side effects, except for soreness at the site of injection. Less than 10% of those vaccinated become tired and nauseous.
The two-dose vaccine series, given at least six months apart, provides pre-exposure protection from HAV infection in children aged 1 years or older and in adults. Vaccination against HAV is recommended for those who are at risk of infection, including:
People 1 year of age and older traveling or working in countries with high rates of HAV
People who live in communities that have prolonged HAV outbreaks or high rates of HAV
Men who have sex with men
People who use street drugs
People with chronic liver disease
People who receive clotting factor concentrates
As of October 2005, the CDC ACIP (Advisory Committee on Immunization Practices) recommends that the hepatitis A vaccine become a routine childhood vaccine for U.S. children between 1 and 2 years of age in all states. (Previously the vaccine was only recommended for children in 17 states with the highest rates of disease; however, about two-thirds of cases are now reported from states in which hepatitis A vaccination of children was not recommended.)
A combination vaccine called Twinrix has been approved for protection from both HAV and HBV in persons 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three.
Immune Globulin (IG) after exposure to HAV:
People who have been exposed to hepatitis A may talk with their health care provider about a post-exposure immune globulin (IG) injection. Immune Globulins (IG) are sterile solutions of antibodies made from human plasma. They are important tools in preventing illness.
A dose of IG, if given within 14 days after contact with HAV, may prevent illness from occurring. In some cases, the hepatitis A IG may also be given before a possible exposure.
Sexual Prevention:
Abstinence (not having sex)
Mutual monogamy (having sex with only one uninfected partner)
Cut-up non-lubricated latex condoms or use of other moisture barriers, such as household plastic wrap or dams (square pieces of latex) can reduce the risk of transmitting HAV during oral-anal sex.
Non-Sexual Prevention:
Avoid sharing drug needles and other drug-injection equipment.
Avoid contaminated food or water sources
Practicing good personal hygiene, especially hand-washing after using the toilet or changing diapers
To inactivate HAV, heat foods at temperatures above 185 degrees Fahrenheit for 1 minute or disinfect surfaces with a 1:100 dilution of household bleach in tap water (1 part bleach for 100 parts of water)
Talk to your partner
If you have tested positive for hepatitis A, you may want to tell to your sex partner(s) that you have the virus. As part of good partner communication, deciding to use latex condoms and moisture barriers during sexual contact helps reduce the risk of transmitting a sexually transmitted disease. HAV can be transmitted through oral-anal sex so it is recommended to always use safer sex methods to reduce the risk of transmission.
Where can I get more information?
Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program
Hepatitis Foundation International
American Liver Foundation
Immunization Action Coalition (IAC)
Parents of Kids with Infectious Diseases (PKID)
What is hepatitis?
Hepatitis is an inflammation of the liver that can be caused by a group of viruses. There are five major types of viral hepatitis:
HAV, HBV and HCV are the most common types of viral hepatitis found in the United States.
IT HAS 5 TYPES OF HEPATITIS
1)HEPATITIS-A
2)HEPATITIS-B
3)HEPATITIS-C
4)HEPATITIS-D
5)HEPATITIS-E
How does someone get hepatitis?
The hepatitis A virus can enter a person's body when he or she eats or drinks something contaminated with the stool or blood of someone who has the disease. Symptoms usually appear suddenly, but are not followed by the chronic (long-lasting) problems that hepatitis B and C viruses can cause. The hepatitis B virus can infect a person if his or her mucous membranes or blood are exposed to an infected person's blood, saliva, semen, or vaginal secretions. Hepatitis C is spread by contact with the blood of an infected person. Symptoms appear more gradually than in hepatitis A. Unlike hepatitis A, the hepatitis B and C viruses can stay in the body--sometimes for a lifetime--and eventually cause chronic, serious liver diseases.
What are the symptoms of hepatitis?
When hepatitis viruses damage liver cells, scar tissue is formed and those cells can no longer function. With fewer healthy liver cells, the body begins to show symptoms ranging from mild (such as fatigue) to more severe symptoms (such as mental confusion).
What are the complications of hepatitis?
Although many cases of hepatitis are not a serious threat to health, the disease can sometimes become chronic (long-lasting) and may lead to liver failure and death. In many cases, though, viral hepatitis is a self-resolving illness.
Is hepatitis sexually transmitted?
Sexual activity poses a different level of risk for each type of viral hepatitis, but is most closely associated with HBV. Blood transfusion, IV needle sharing, and organ transplants may also pose a risk for transmission.
Is there a way to prevent infection with hepatitis?
Hepatitis A and B are preventable through vaccination, though no vaccination currently exists for hepatitis C or E. Since hepatitis D only infects persons with active hepatitis B, the vaccine for hepatitis B prevents hepatitis D. For more information, see specific HAV, HBV, HCV, HDV and HEV sections.
HAV, HBV and HCV are the most common types of viral hepatitis found in the United States.
IT HAS 5 TYPES OF HEPATITIS
1)HEPATITIS-A
2)HEPATITIS-B
3)HEPATITIS-C
4)HEPATITIS-D
5)HEPATITIS-E
How does someone get hepatitis?
The hepatitis A virus can enter a person's body when he or she eats or drinks something contaminated with the stool or blood of someone who has the disease. Symptoms usually appear suddenly, but are not followed by the chronic (long-lasting) problems that hepatitis B and C viruses can cause. The hepatitis B virus can infect a person if his or her mucous membranes or blood are exposed to an infected person's blood, saliva, semen, or vaginal secretions. Hepatitis C is spread by contact with the blood of an infected person. Symptoms appear more gradually than in hepatitis A. Unlike hepatitis A, the hepatitis B and C viruses can stay in the body--sometimes for a lifetime--and eventually cause chronic, serious liver diseases.
What are the symptoms of hepatitis?
When hepatitis viruses damage liver cells, scar tissue is formed and those cells can no longer function. With fewer healthy liver cells, the body begins to show symptoms ranging from mild (such as fatigue) to more severe symptoms (such as mental confusion).
What are the complications of hepatitis?
Although many cases of hepatitis are not a serious threat to health, the disease can sometimes become chronic (long-lasting) and may lead to liver failure and death. In many cases, though, viral hepatitis is a self-resolving illness.
Is hepatitis sexually transmitted?
Sexual activity poses a different level of risk for each type of viral hepatitis, but is most closely associated with HBV. Blood transfusion, IV needle sharing, and organ transplants may also pose a risk for transmission.
Is there a way to prevent infection with hepatitis?
Hepatitis A and B are preventable through vaccination, though no vaccination currently exists for hepatitis C or E. Since hepatitis D only infects persons with active hepatitis B, the vaccine for hepatitis B prevents hepatitis D. For more information, see specific HAV, HBV, HCV, HDV and HEV sections.
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