Viral Hepatitis (A, B, C, etc.)

Hepatitis is a disease that causes inflammation of the liver.  Inflammation can also be caused by viral or bacterial infections, drugs, alcohol, chemicals and autoimmune diseases.  The liver is a very important organ in the body and is responsible for several major bodily functions that are necessary for proper survival.  The liver:

Currently, there are three major forms of hepatitis: A, B and C.  There are also a few less common versions of hepatitis: D, E, F and G.  This section will focus primarily on the three major types of hepatitis including transmission of the virus, risks, symptoms, diagnosis and treatment including vaccinations.

Transmission

Hepatitis A Virus (HAV)

There are 150,000 new cases of Hepatitis A infection every year.  HAV is primarily transmitted through food, water or skin contact that has been contaminated with human feces.  Therefore, you should avoid environments that are unsanitary or have come into contact with human sewage.  Some environments such as restaurants and day care centers, where there is a lot of human contact, are havens for the hepatitis virus.  Make sure to follow good sanitary practices such as washing your hands before you prepare food and after bowel movements.  Try to remain in sanitary conditions as much as possible.  HAV is an acute infection, which means the infection will go away after a relatively short period of time.  HAV will not transform into chronic liver infection.  Hepatitis E is very similar in terms of transmission to HAV.  Hepatitis E is transmitted primarily through poor sanitation habits.  This type of infection is more common in 3rd world countries and those without proper sanitation.

Hepatitis B Virus (HBV)

HBV is transmitted through the close contact of individuals, especially sexual contact, when bodily fluid is transferred between individuals.  You should avoid situations where there may be a transfer of blood such as sharing razors or toothbrushes.  Also, proceed with extreme caution when undergoing body piercing or getting tattoos; blood can also be transferred through this type of equipment.  Avoid sharing needles at all times.  Blood transfusions are not a leading cause of hepatitis infection now that blood is screened regularly; however, if you are going to undergo surgery, you may want to store some of your own blood to be used if necessary; this will ensure that you will not be infected with hepatitis or other diseases such as HIV.  There are approximately 200,000-300,000 new cases of HBV reported in the U.S. year.  Of these, 6-10% will develop into chronic liver infection.  Chronic infetion implies that the disease has been active for six months or longer.  Chronic infection could develop into cirrhosis or scarring of the liver.  Hepatitis D is very similar to HBV in terms of transmission.  In fact, a person must be infected with HBV before they can be diagnosed with Hepatitis D.  Hepatitis D seems to be very common among illegal IV drug users.

Hepatitis C Virus (HCV)

HCV is transmitted primarily through the transfer of blood.  Needles, hemodialysis and blood transfusions are all possible  sources for infection.  Infection through sexual contact is possible, but rare.  There are 150,000 new cases of HCV infection a year in the U.S. and 50-70% of these will lead to chronic infection.  Chronic HCV infection may lead to cirrhosis or scarring of the liver.

There are certain types of people that are at greater risk of becoming infected with the hepatitis virus.  Health care professionals, individuals with multiple sex partners, IV drug users and hemophiliacs are all high risk candidates for hepatitis.  One-third of hepatitis cases are from unknown sources; therefore, above all it is important to prevent infection as much as possible.

Prevention

Hepatitis A Virus

There is a vaccine for Hepatitis A virus.  Children are given 3 shots: the first two at one-month intervals and the third shot 6-12 months later.  Adults are given two shots, 6-12 months apart.  Immune Serum Globulin (ISG) can also be administered to prevent infection from short exposure to HAV.  Individuals may receive ISG either before coming into contact with HAV, which might be necessary for travelers, or after having come in contact with an HAV-infected individual.  Also, good sanitation and personal hygiene habits are excellent preventative measures for HAV.  Water should be boiled and fruits and vegetables should be peeled and washed thoroughly if contamination with HAV is possible.   Individuals should wash there hands, utensils, bedding and clothing with soap and water to avoid infection among friends and family.

Hepatitis B and C Virus

There is also a vaccine for HBV.  All newborns, children and high risk adults should be immunized with the HBV vaccination .  Hepatitis B Immuno-Globulin (HBIG) can be administered, like ISG, to prevent acute HBV infection.  Currently, there is no vaccination for HCV.  Individuals should also avoid the blood and bodily fluids of an infected or unknown person.  Latex condoms are also an excellent preventative tool for HBV infection among sexual partners.  Avoid sharing scissors, razor and toothbrushes with infected or unknown individuals.  Never share needles that are used for IV drug use, tattooing or body piercing.

Symptoms

Symptoms for the hepatitis virus are very non-specific.  Oftentimes, there may be no symptoms and the individual can go for months or years without knowing that he or she is infected with the hepatitis virus.  Symptoms that do arise are very similar to those associated with the flu: nausea, vomiting, loss of appetite, weakness, fatigue and general aching throughout the body.  Less common symptoms include: dark urine, light stools and jaundice (yellowing of the skin and eyes).  Symptoms caused by acute infection may last for several weeks or months.  Symptoms associated with chronic infection will last 6 months or longer.

Diagnosis

Individuals who show symptoms suggesting hepatitis infection will undergo procedures to diagnose or rule out hepatitis.  A physician will conduct a physical examination and recommend blood tests to analyze liver function.  These tests will look for abnormal levels of substances such as bilirubin, which is the cause of jaundice, and liver enzymes.  If the results of these tests further suggest hepatitis infection, then more specific blood tests will be done in order to determine what type of hepatitis virus is present.  Since symptoms are not always a reliable source for hepatitis detection, individuals who are high risk or have potentially come into contact with infected people should be screened for hepatitis infection--regardless of whether they are showing symptoms.

Treatment

With acute infection the primary goal is to relieve symptoms such as nausea, vomiting and discomfort.  Special attention is given to the type of medications prescribed so as not to disturb the liver any further. Tranquilizer and sedative type medications are generally not prescribed.  No alcohol should be consumed during treatment.  Your physician may also recommend I.V. fluids to prevent dehydration caused by vomiting.  Hospitalization is, usually, unnecessary unless the patient suffers from severe symptoms.

For HBV and HCV infections, whether acute or chronic, treatment may include Intron A (Interferon alta-2b).  Intron A is the synthetic version of a protein produced by the body to fight disease.  The goal of this type of treatment is to eradicate the virus completely from the body.  Scientists are currently working on more effective forms of treatment.

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<http://www.focusondigestion.com> 30 Mar. 2002
"Chronic Viral Hepatitis."  The American Gastroenterological Association of America.  2002.
<http://www.gastro.org/public/cvh.html>  30 Mar. 2002