Hepatitis A, Hepatitis B

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What is hepatitis A, and what causes it?

Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). It is one of the most widely reported diseases that is preventable by a vaccine.

Other viruses can cause hepatitis, most commonly the hepatitis B and C viruses. However, hepatitis has many causes, including certain medications, long-term alcohol use, and exposure to certain industrial chemicals. Viral hepatitis can be spread from one person to another, but the other types of hepatitis cannot.

What Is Hepatitis B?

Hepatitis B is a serious disease caused by the hepatitis B virus (HBV). Infection with this virus can cause scarring of the liver, liver failure, liver cancer, and even death.

Hepatitis B is spread in infected blood and other bodily fluids such as semen, vaginal secretions, saliva, open sores, and breast milk.

What Happens to People With Hepatitis B?

In most cases (90%-95%), hepatitis B causes limited infection. Usually people manage to fight off the infection successfully within a few months, developing an immunity that lasts a lifetime. (This means you won't get the infection again.) Blood tests show evidence of this immunity, but no signs of active infection.

However, some people don't get rid of the infection. If you are infected with hepatitis B for more than 6 months, you are considered a carrier, even if you have no symptoms. This means that you can transmit the disease to others by having unprotected sex, deep kissing, or sharing food or drinks. Being a carrier also means that your liver is more prone to injury. For unknown reasons, the infection eventually goes away in a very small percentage of carriers.

Some carriers go on to develop chronic hepatitis B. Chronic hepatitis is an ongoing infection of the liver that can lead to cirrhosis. Cirrhosis, or hardening of the liver, causes liver tissue to scar and stop working.

If you are carrying the virus you should not donate blood, plasma, body organs, tissue, or sperm. Tell your doctor, dentist, and sex partner that you are a hepatitis B carrier.

How Common Is Hepatitis B?

Nearly 300,000 Americans contract Hepatitis B each year, making infection with this virus much more common than infection with HIV, the virus that causes AIDS.

Approximately 5%-10% of people with hepatitis B infection go on to develop chronic infection.

Approximately 1 million people in the U.S. are carriers of the hepatitis B virus.

How Do I Know I Have Hepatitis B?

Symptoms of acute infection (when a person is first infected with hepatitis) include:

Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine)
Unusually light colored stool
Unexplained fatigue that persists for weeks or months
Flu-like symptoms such as fever, loss of appetite, nausea, and vomiting
Abdominal pain

Often, symptoms occur 1-6 months after exposure. An estimated 40% of those infected do not know how they acquired the infection.

People with chronic active hepatitis experience similar symptoms, but their fatigue is much more severe, and they can have confusion or disorientation.

How Is Hepatitis B Diagnosed?

If your doctor suspects that you may have hepatitis B, he will perform a complete physical examination and order blood tests to look at the function of your liver. Hepatitis B is confirmed with blood tests that detect various antibodies (infection fighting cells) against the virus.

If your disease becomes chronic, liver biopsies (tissue samples) may be obtained to detect the severity of the disease.

How Is Hepatitis B Treated?

If you get to a doctor within 2 weeks of an exposure, you'll receive immediate immunization with the Hepatitis B vaccination and a shot to boost the immune system to fight off the infection.

But if you get sick, bed rest is usually necessary to speed recovery. Some doctors recommend a high-calorie, high-fat diet, and suggest that sufferers try to eat as much as possible despite the nausea.

Also, take extra care of your liver! Now is not the time to drink alcohol, or take Tylenol (acetaminophen) as they can harm the liver. Check with your doctor before taking any other medications, herbal remedies, or supplements as some of them can worsen liver damage.

If your hepatitis persists beyond 6 months and is active (chronic active hepatitis), your doctor may prescribe much more aggressive treatment. If it's chronic but not active, your doctor may just watch you closely.

People with chronic active hepatitis are treated with a combination of drugs.

Interferon.The immune system boosting medicine interferon alpha is injected for at least 6 months. This drug does not cure the disease, but improves the liver inflammation in about 20% of sufferers. Interferon does have some undesirable side effects, including: malaise, depression, and loss of appetite and it can lower the number of white blood cells.

Epivir.Another drug often given in combination with interferon is lamivudine (Epivir). This drug is taken orally once a day. Usually, this drug is well tolerated, but it can cause a worsening of liver functioning in rare instances.

Other treatments include Famvir, a pill that works similarly to Epivir, but doesn't appear to be as effective. Hepsera is a newer drug for treating hepatitis B. It works well in people whose disease doesn't respond to Epivir. In high doses it can cause kidney problems.

Can a Pregnant Woman Give Hepatitis to her Baby?

Yes. A pregnant woman can spread the hepatitis virus to her baby at the time of birth. (It is unlikely that an infected woman will spread the virus to her baby during pregnancy.)

Many babies infected with hepatitis B develop long-term liver problems. All newborn babies should be given the vaccine for hepatitis at birth and during their first year of life.

How Can I Avoid Becoming Infected, or Infecting Others?

Get vaccinated (if you have not already been infected)
Use condoms every time you have sex
Wear gloves when touching or cleaning up body secretions on personal items, such as bandages/band aids, tampons, and linens
Cover all open cuts or wounds
Do not share razors, toothbrushes, manicuring tools, or pierced earrings with anyone
Do not share chewing gum or pre-chew food for a baby
Make certain that any needles for drugs, ear piercing, or tattooing are properly sterilized
Clean areas with blood on them with 1 part household bleach and 10 parts water

Can I Catch Hepatitis B From Blood Transfusions?

The chance of catching hepatitis B from receiving blood transfusions is unlikely because donated blood is tested for the virus. Any infected blood is discarded.

Who Should Be Vaccinated for Hepatitis B?

All newborn babies
People who are exposed to infected blood or body fluids of friends or family members
People who use needles to take recreational drugs
All people who have sex with more than one person
Health care providers who may come in contact with the virus
People working in day care centers and institutions caring for children and prisoners

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