What is viral hepatitis? Viral hepatitis is an infection of the liver caused by a virus
that attacks liver cells. The resulting inflammation may impair
the liver's ability to aid in digestion of food and to remove toxins
from the blood. Symptoms range from mild to severe, but some individuals
have no symptoms. Infrequently, acute infections can be fatal.
There are several types of viral hepatitis, called A, B, C, D,
E, F and G. Of all types of hepatitis, A, B and C are the most common
in the US and so will be described below.
Hepatitis A (formerly called
infectious hepatitis) is caused by the hepatitis A virus (HAV).
Hepatitis A is more common in developing countries than in the US.
Transmission is through fecally contaminated
food or water, through anal/oral contact and rarely through blood.
Symptoms Some people with hepatitis A have
no noticeable symptoms. Onset is usually abrupt with fever, tiredness,
lack of appetite, nausea, abdominal discomfort and diarrhea, followed
within a few days by jaundice (which results in a yellow appearance
of skin and eyes). Symptoms can vary from a mild illness lasting
a few weeks to (rarely) a disabling disease lasting several months.
Complete recovery, without chronic liver disease, is usual. Incubation
period is 15-50 days, averaging 28-30 days.
Diagnosis A blood test is available, but it is not useful unless initial
symptoms develop.
Treatment There is no treatment for hepatitis A. In 99% of reported cases,
the infection will clear up over a period of a few weeks to months.
Prevention A vaccine is available and is recommended for:
All children 1 year and older
Travelers over 1 year of age
Persons who share a household or have sexual contact with someone who has hepatitis A
Day care workers and children in day care
Residents and staff of institutions for developmentally disabled persons
The vaccine consists of two doses which should be received at least 6 months apart, and travelers
should receive the second dose 4-6 weeks before departure.
Hepatitis B is caused
by the hepatitis B virus (HBV).
Transmission is through blood and other body fluids contaminated with blood. All individuals who
are chronically infected may be able to transmit it. Routes of transmission
include:
Sexual contact including vaginal intercourse, anal intercourse
(more likely because of greater tearing of tissues) and oral sex
Exposure to infected blood that comes into contact with cuts,
open sores or mucous membranes
Sharing unsterilized needles and other equipment while injecting
substances such as heroin, cocaine, steroids, etc.
Piercing the skin with unsterilized instruments such as those
used in tattooing, body piercing, electrolysis or acupuncture
Sharing personal hygiene items such as razors or toothbrushes
From mother to newborn
Symptoms Many people have no noticeable symptoms.
Symptoms may develop slowly and include lack of appetite, abdominal
discomfort, nausea and vomiting, sometimes joint pain and rash,
often progressing to jaundice (which results in a yellow appearanceof
the skin and eyes). Fever may be absent or mild. Incubation period
is 45-180 days, rarely as long as 9 months, averaging 60-90 days.
Approximately 2-10% of adults and 25-80% of children under the
age of 5 will not be able to clear the virus in six months following
infection and are considered to be chronically infected. Long term,
chronic hepatitis B can cause liver cell damage, leading to cirrhosis
and cancer.
Diagnosis A blood test is available.
Treatment Antiviral drugs are occasionally used for chronic infections. New
treatments show promise.
Prevention A vaccine is available for people of any age and especially recommended
for:
Babies at birth
Children 0-18 who have not been vaccinated
People with occupational risk, e.g. healthcare and public safety
workers
Childcare workers and teachers
People traveling to high risk countries for more than 6 months
Household contacts and sex partners of HBV carriers
People who have intimate and/or sexual contact with chronic
carriers of hepatitis B
Hepatitis C is caused
by the hepatitis C virus (HCV).
Transmission is primarily through infected
blood or blood products. The primary current route of transmission
is injection drug use. It is not easily transmitted through sex.
In about 10-20% of cases, transmission route has not been identified.
Symptoms 70-75% of people have no noticeable
symptoms. Symptoms may develop gradually with loss of appetite,
fatigue, abdominal discomfort, nausea and vomiting, sometimes progressing
to jaundice (which results in a yellow appearance of skin and eyes).
Incubation period ranges from 2 weeks to 6 months, averaging 6-9
weeks.
Up to 85% of people with hepatitis C develop chronic infection
(which is often asymptomatic). Some develop cirrhosis (scarring
of the liver). Chronic hepatitis C infection also substantially
increases risk for liver cancer.
Diagnosis A blood test is available. Tests
for hepatitis C typically become positive within 6 months after
infection occurs. You
may be at risk for hepatitis C and should contact your health care
provider for a blood test if you:
Were notified that you received blood from a donor who later
tested positive for hepatitis C
Have ever injected illegal drugs, even if you experimented a
few times many years ago
Received a blood transfusion or solid organ transplant before
July, 1992
Received a blood product for clotting problems produced before
1987
Have ever been on long-term kidney dialysis
Have evidence of liver disease
Are a health care or public safety worker who has been exposed
to infected blood
Treatment At this time, no cure is available. Complete eradication of the
virus is an infrequent outcome of drug therapy. New treatments show
some promise.
Prevention No vaccine is available. Prevention methods include:
Abstain from sex or practice safer sex, including using latex
or polyurethane condoms.
Do not share injection drug equipment. If you do share equipment,
clean it with 100% bleach twice, then rinse with water twice and
do not reuse cotton.
Treat all body fluids as if potentially infectious and protect
yourself accordingly.
Choose a reputable business for tattoos and piercing; inquire
about sterilization techniques.
Do not share personal hygiene items such as razors and toothbrushes.
The Allergy, Immunization and Travel
Health Clinic offers hepatitis A and B vaccines. Call 734-764-8304
to make an appointment. If you are planning to travel, please make
an appointment at least 4 weeks before intended travel because some
vaccines take several weeks to take effect.
Please visit a clinician if you are concerned about your risk for
viral hepatitis. See Appointment
or Walk-in.
