Hepatitis A B And C: What Is The Difference
A, B, C D and E.
Aside from the letters associated with it, how much do you know about hepatitis? Whats the difference between the types? And if you get a vaccination for hepatitis, which are you protected from?
We spoke with Moises Ilan Nevah, MD, a transplant hepatologist/gastroenterologist and medical director of the Liver Transplant Program at Banner University Medical Center Phoenix, to help better understand the similarities and differences between the various types of hepatitis, who is at risk and when to get vaccinated.
How Do Doctors Treat Hepatitis C
Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.
Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.
Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:
You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on
- which hepatitis C genotype you have
- how much liver damage you have
- whether you have been treated for hepatitis C in the past
Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.
Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.
For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.
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What Is Hepatitis C
Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected persons blood.
Hepatitis C can cause an acute or chronic infection.
Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.
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Should I Be Screened For Hepatitis C
Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C dont have symptoms and dont know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.
No Identifiable Source Of Infection
According to the Centers for Disease Control and Prevention, injection drug use accounts for approximately 60% of all HCV infections in the United States, while other known exposures account for 20-30%. Approximately 10% of patients in most epidemiological studies, however, have no identifiable source of infection. HCV exposure in these patients may be from a number of uncommon modes of transmission, including vertical transmission, and parenteral transmission from medical or dental procedures prior to the availability of HCV testing. There are no conclusive data to show that persons with a history of exposures such as intranasal cocaine use, tattooing or body piercing are at an increased risk for HCV infection based on these exposures solely. It is believed, however, that these are potential modes of HCV acquisition in the absence of adequate sterilization techniques.
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How Is Hepatitis C Transmitted
Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.
What Can I Do To Manage Hepatitis C
- Do not drink alcohol or use illegal drugs. Alcohol and drugs can increase liver damage. Ask your healthcare provider for more information if you need help quitting.
- Do not smoke. Nicotine can damage blood vessels and make it more difficult to manage hepatitis C. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
- Eat a variety of healthy foods. Healthy foods include fruits, vegetables, low-fat dairy products, beans, and lean meats and fish. Ask if you need to be on a special diet.
- Get more rest. Slowly return to your normal activities when you feel better.
- Talk to your healthcare provider about vaccines. You may need to get vaccines to protect you from hepatitis A or B. You may also need a pneumonia vaccine. Get the flu vaccine each year as soon as it is available. Ask your healthcare provider about other vaccines you need.
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Diagnosis Of Hepatitis C
If you are at risk of hepatitis C infection, or think you may have been exposed to hepatitis C in the past, see your doctor for an assessment of your liver health. This will include blood tests and possibly a non-invasive test for liver damage .
There are 2 blood tests used to diagnose hepatitis C. Usually these can be done at the same time but sometimes they will be done separately.
The first test known as a hepatitis C antibody test can tell you whether you have ever been exposed to hepatitis C.
It may take 2 to 3 months from the time of infection until a blood test can detect antibodies to hepatitis C, so there is a window period during which you cannot tell if you are or have been infected. In this time, take precautions to prevent the potential spread of the virus.
The second test is called hepatitis C PCR, which will be done if the antibody test is positive. This determines if the virus is still present in your blood or liver or if you have already cleared the infection.
If you have cleared the virus or had successful treatment to cure it, the PCR test will be negative.
A liver ultrasound or Fibroscan can also be performed to assess if you have any liver damage.
If your doctor is inexperienced in diagnosing hepatitis C you can call the LiverLine on for information, and to find a GP who can help you.
Finding A Hep C Specialist
Hep C treatments can be prescribed by many different Hep C Specialists, including gastroenterologists, general practitioners, nurse practitioners, and addiction medicine specialists.
To find a Hep C Specialist near you, enter your city and state or ZIP code.
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Gastroenterologists
A gastroenterologist is a doctor who specializes in the treatment of diseases that affect the digestive system.
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Hepatologists
A hepatologist is a doctor who specializes in the treatment of diseases that affect the liver.
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Other Specialists
Other specialists who treat Hep C may include, but are not limited to, infectious disease specialists, primry care physicians , internal medicine specialists , family doctors, nurse practitioners , and physician assistants .
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What Do I Need To Know About Hepatitis C Screening
Screening means you are tested for hepatitis C before you have signs or symptoms. This helps healthcare providers find and treat hepatitis C early. Screening is usually recommended 1 time for all adults who are 18 to 79 years of age. Screening may also be recommended during pregnancy to lower the risk for HCV being passed from mother to baby. Screening may start before age 18 or after 79 if your risk is high and continue regularly if your risk remains high.
What Are The Side Effects Of Drug Treatment
Common side effects for some treatments for hepatitis C may include the following:
Side effects are usually worst during the first few weeks of treatment. They become less severe over time. If you are having trouble dealing with the side effects of your medicine, talk to your doctor. He or she can suggest ways to relieve some of the side effects. For example, if your medicine makes you feel nauseated, it may help to take it right before you go to sleep.
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Blood Transfusion/receipt Of Blood Products
Early case-control studies of patients with newly acquired, symptomatic non-A, non-B hepatitis found a significant association between disease acquisition and a history six months prior to illness of blood transfusions, injection drug use, health care employment with frequent exposure to blood, personal contact with others who had hepatitis, multiple sexual partners or low socioeconomic status. Today, HCV is rarely transmitted by blood transfusion or transplantation of organs due to thorough screening of the blood supply for the presence of the virus and inactivation procedures that destroy bloodborne viruses. In the last several years, blood banks have instituted techniques that utilize nucleic acid amplification of the hepatitis C virus, which will detect the presence of virus even in newly-infected patients who are still hepatitis C antibody-negative. These techniques are estimated to have prevented 56 transfusion-associated HCV infections per year in the U.S. since 1999, and have lowered the current risk of acquiring HCV via transfused blood products to 1 in 2 million.
Tips For Preventing Transmission Through Sex
If youre sexually active with a person who has hepatitis C, there are ways that you can prevent contracting the virus. Likewise, if you have the virus, you can avoid infecting others.
A few steps you can take to reduce the likelihood of sexual transmission include:
- using a condom during every sexual contact, including oral sex
- learning to use all barrier devices correctly to prevent ripping or tearing during intercourse
- resisting engaging in sexual contact when either partner has an open cut or wound in their genitals
- being tested for STIs and asking sexual partners to be tested too
- practicing sexual monogamy
- using extra precautions if youre HIV-positive, as your chance of contracting HCV is much higher if you have HIV
If you have hepatitis C, you should be honest with all sexual partners about your status. This ensures that youre both taking the proper precautions to prevent transmission.
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Can I Travel Abroad
You can travel abroad if you have hepatitis C, but you should speak to your doctor in advance.
You may need to have vaccinations and special arrangements may need to be made to ensure you’re able to transport and store your hepatitis C medication safely.
It might also be a good idea to take any documentation, such as details of blood tests or medical records, in case you need medical treatment abroad.
Read more about travel vaccinations and accessing healthcare abroad.
How Does Hepatitis C Spread
Hepatitis C is spread only through exposure to an infected person’s blood.
High-risk activities include:
- Sharing drug use equipment. Anything involved with injecting street drugs, from syringes, to needles, to tourniquets, can have small amounts of blood on it that can transmit hepatitis C. Pipes and straws to smoke or snort drugs can have blood on them from cracked lips or nosebleeds. Get into a treatment program if you can. At the very least, don’t share needles or equipment with anyone else.
- Sharing tattoo or piercing tools. Nonsterile items and ink can spread contaminated blood.
- Blood transfusions in countries that donât screen blood for hepatitis C.
- Nonsterile medical equipment. Tools that arenât cleaned properly between use can spread the virus.
- Blood or cutting rituals. Sharing the tools or exchanging blood can transmit hepatitis C.
Medium-risk activities include:
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How Are Hepatitis B And Hepatitis C Spread From Person To Person
Like HIV, the hepatitis B and hepatitis C viruses spread:
- From mother to child: Pregnant women can pass these infections to their infants. HIV-HCV coinfection increases the risk of passing on hepatitis C to the baby.
- Sexually: Both viruses can also be transmitted sexually, but HBV is much more likely than HCV to be transmitted sexually. Sexual transmission of HCV is most likely to happen among gay and bisexual men who are living with HIV.
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Blood Donations Before September 1991
Since September 1991, all blood donated in the UK is checked for the hepatitis C virus.
There’s a small chance you may have been infected with hepatitis C if:
- you received a blood transfusion or blood products before September 1991
- you received an organ transplant before 1992
Before 1992 donated organs were not routinely screened for hepatitis C and there is a very small risk a donated organ from someone with hepatitis C could spread the infection.
There are blood tests to check for hepatitis C infection
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Is There Anything Else I Can Do To Help Myself
As well as cutting out alcohol, it can help to:
- control your weight with a healthy diet and regular exercise
- get vaccinated against hepatitis A and hepatitis B
This is because being overweight, smoking and having more than one type of hepatitis can increase the chances of your liver being damaged if you have hepatitis C.
The A B Cs Of Hepatitis
Hepatitis A
The hepatitis A virus causes acute inflammation of the liver that almost always gets better on its own, although it can be more serious if you get it when you are older or if you already have liver disease. It is easily spread from person to person, in food and water, and can infect many people at once. For example, if a food handler at a restaurant is infected with hepatitis A, those who eat food prepared by that handler may be infected. Hepatitis A can be prevented by getting vaccinated.
Hepatitis B
The hepatitis B virus can be both acute and chronic and is spread through blood or other body fluids in various ways. Hepatitis B is very common in Asia and Africa and those who were born or lived in these areas should be checked for hepatitis B. Like hepatitis A, a vaccine is available to prevent HBV infection as long as you have not been previously exposed. Although chronic HBV cannot be cured, there are oral medications available to treat and control the virus.
Hepatitis C
The hepatitis C virus is almost always chronic and spreads mostly by direct blood to blood contact. Although hepatitis A and B can be prevented by vaccination, hepatitis C cannot. However, there are currently oral medications available that are able to cure Hepatitis C in 95% of all cases regardless of prior treatment history.
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How Is Monitoring Done After Treatment For Hepatitis C
Once patients successfully complete treatment, the viral load after treatment determines if there is an SVR or cure. If cure is achieved , no further additional testing is recommended unless the patient has cirrhosis. Those who are not cured will need continued monitoring for progression of liver disease and its complications.
While cure eliminates worsening of fibrosis by hepatitis C, complications may still affect those with cirrhosis. These individuals still need regular screening for liver cancer as well as monitoring for esophageal varices that may bleed.
Because hepatitis B co-infection may reactivate or worsen even after treatment for HCV, monitoring for hepatitis symptoms may be needed after the end of therapy.
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Who Gets Hepatitis C
Who gets hepatitis C?
Anyone can get hepatitis C virus. But unlike a cold or flu virus, HCV isnât easy to catch. The virus is transmitted only by direct contact with human blood that contains the virus. There are several ways infection can occur. Those at risk of being infected with hepatitis C virus include:
What about tattooing?
Several studies have shown there is no link between licensed commercial tattooing parlors and HCV infection, âbut transmission of Hepatitis C is possible when poor infection-control practices are used during tattooing or piercing,â according to the Centers for Disease Control and Prevention .
The agency advises people thinking about getting tattoos or body piercing to consider the health risks. Itâs possible to get infected with HCV, the CDC says, if the tools used have someone elseâs blood on them, or if the piercer or tattoo artist fails to use proper hygiene, such as washing hands, sterilizing tools, and using disposable gloves.
Is it possible to contract HCV from a shared razor or toothbrush?
There are no documented cases of transmission, but the CDC warns that people should not share toothbrushes, razors, or other personal care items: They might have small amounts of infected blood on them.
The CDC stresses that the hepatitis C virus is NOT spread by casual contact or by breast feeding, hugging or kissing, sneezing, coughing, or sharing utensils, drinking glasses, food, or water.
Is sex safe?
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