The ABC of Hepatitis

The term Hepatitis refers to inflammation of the liver. The commonest cause of inflammation is due to viral infection. There are three common types of viral hepatitis- hepatitis A ,hepatitis B and Hepatitis C.

Hepatitis A

This is more commonly known as ‘infectious hepatitis’.

Hepatitis A is typically transmitted through the ingestion of contaminated water and food or contact with someone carrying the infection. Hepatitis A is most likely to be found in people who

• Have not been vaccinated or previously infected
• Are very young (most infections occur during early childhood)
• Live in areas with poor sanitation and/or a lack of safe drinking water
• Live with infected persons
• Use drugs recreationally
• Have a sexual partner who has hepatitis A

Hepatitis A is a self limiting infection and symptoms can range from feeling generally off colour and nauseous to developing jaundice. There is no specific treatment and the symptoms can last from a few days to a few months depending on severity. There is usually no lasting liver damage. Sometimes the illness is so mild that people do not know they have had it.

Diagnosis

Diagnosis is made on the clinical picture and blood testing.

Prevention

• Always wash your hands thoroughly after using the restroom and when you come in contact with an infected person’s blood, stools, or other bodily fluid.
• Avoid unclean food and water.
• Immunisation

Immunisation

Hepatitis A is easily preventable with a very safe and effective vaccine. There is one initial vaccination with a booster after 6 months and this gives at least 15 years of immunity.

Hepatitis A and B vaccination can be combined in the same vaccine course.

Hepatitis A is most commonly given for travel.

Hepatitis B

Hepatitis B is caused by the Hepatitis B virus.

Many people with hepatitis B will not experience any symptoms and may fight off the virus without realising they had it. If symptoms do develop, they tend to occur 2 or 3 months after exposure to the hepatitis B virus.

Over time chronic Hepatitis B can cause liver damage and even cancer. Chronic hepatitis B often requires long-term or lifelong treatment and regular monitoring to check for any further liver problems.

The hepatitis B virus is transmitted through blood and bodily fluids. This can most commonly occur in the following ways:

• Direct contact with infected blood
• Unprotected sex
• Use of illegal or “street” drugs
• Needles that are contaminated or not sterile
• From an infected woman to her new born during pregnancy and childbirth

Body piercing, tattooing, acupuncture and even nail salons are other potential routes of infection unless sterile needles and equipment are used. In addition, sharing sharp instruments such as razors, toothbrushes, nail clippers, earrings and body jewellery can be a source of infection.

Hepatitis B is NOT transmitted casually. It cannot be spread through toilet seats, doorknobs, sneezing, coughing, hugging or eating meals with someone who is infected with hepatitis B.

High-risk groups for hepatitis B

1. Health care providers and emergency responders
2. Sexually active individuals (more than 1 partner in the past six months)
3. Men who have sex with men
4. Individuals diagnosed with a sexually transmitted disease
5. Illicit drug users (injecting, inhaling, snorting, pill popping)
6. Sexual partners or those living in close household contact with an infected person
7. Individuals born in countries where hepatitis B is common (Asia, Africa, South America, Pacific Islands, Eastern Europe, and the Middle East)
8. Individuals born to parents who have emigrated from countries where hepatitis B is common
9. Children adopted from countries where hepatitis B is common
10. Adoptive families of children from countries where hepatitis B is common
11. Kidney dialysis patients and those in early kidney (renal) failure
12. Inmates and staff of a correctional facility
13. Residents and staff of facilities for developmentally disabled persons
14. ALL pregnant women

Diagnosis

A blood test can be carried out to check if you have hepatitis B or have had it in the past.

Prevention

• Practice safe sex – always use a condom
• Avoid contact with blood or blood products
• Immunisation
• All sexual partners, family and close household members living with a chronically infected person should be tested and immunised.

There is a very safe and effective vaccination for prevention of Hepatitis B. It is given in three doses , the second dose after a month and the final dose at 6 months. This is now offered routinely to new born babies in the UK, and to anyone who is at risk through their occupation, or is in a high risk group.

Treatment

If you have had the infection for more than 6 months (chronic hepatitis B), you may be offered treatment with medicines that can keep the virus under control and reduce the risk of liver damage. Babies and children are more likely to develop a chronic infection.

Hepatitis C

Hepatitis C is a liver disease caused by the hepatitis C virus. Most people who get infected will develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems including liver disease, liver failure, and even liver cancer.

In fact, rates of new infections have been on the rise, due in part to the increase in injection drug use.

Hepatitis C is spread only through exposure to an infected person’s blood.

Hepatitis C is most likely to be found in people who…

• Had a blood transfusion or organ donation prior to June 1992 (the time when sensitive tests for hepatitis C virus [HCV] were introduced)
• Work in healthcare and might experience needle-stick accidents
• Inject or used to inject illicit drugs
• Were born to mothers with HCV
• People who have had tattoos with non sterile equipment
• Have high risk, unprotected sex

Diagnosis

People with hepatitis C often have no symptoms so testing is the only way to know if you are infected. This is done by a blood test.

Prevention

• Never share needles. Intravenous drug users have the highest chance of getting infected with hepatitis C because many share needles. Besides needles, the virus can be spread by sharing straws or bank notes when snorting cocaine.
• Avoid direct exposure to blood or blood products. If you are a medical worker or health care provider, avoid coming into direct contact with blood. Any tools that draw blood in the workplace should be thrown out safely or sterilized.
• Don’t share personal care items.
•  Choose tattoo and piercing parlours carefully. Only use a licensed tattoo and piercing artist who does the right sanitary procedures. A new, disposable needle and ink well should be used for each customer.
• Practice safe sex. It is rare for hepatitis C to be transmitted through sexual intercourse, but there is a higher chance of getting hepatitis C if you have HIV, another STD, multiple sex partners, or if you engage in rough sex.

Unfortunately, there is currently no vaccine for Hepatitis C.

Treatment

New treatments that enhance the immune system offer a cure for most people. Once diagnosed, most people with hepatitis C can be cured in just 8 to 12 weeks, reducing liver cancer risk by 75%.

Take home points

• If you think you are at risk of hepatitis testing is available by a simple blood test
• Immunisation is available for hepatitis A and B.
• Check what immunisations are required if you are travelling abroad
• Practice Safe sex -always use a condom
• STI checks include hepatitis testing

Our doctors are highly trained, discreet and available for appointments quickly. If you have any concerns about Hepatitis, please don’t hesitate to get in touch here.