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.
Is There A Way To Prevent Hepatitis C
Although currently theres no vaccine to protect people from contracting hepatitis C, there are vaccines for other hepatitis viruses, including hepatitis A and hepatitis B.
If you receive a hepatitis C diagnosis, your healthcare provider may advise you to get vaccinated against hepatitis A and B.
The vaccinations are recommended because these hepatitis viruses can lead to additional health and liver complications, especially in those with preexisting liver disease.
Since you cant prevent hepatitis C through a vaccine, the best prevention is to avoid exposure. Hepatitis C is a bloodborne pathogen, so you can limit your chances of exposure through these healthy lifestyle practices:
- Avoid sharing needles, razor blades, or nail clippers.
- Use proper safety precautions if youll be exposed to bodily fluids, such as when performing first aid.
- Hepatitis C isnt usually transmitted through sexual contact, but its possible. Limit your exposure by practicing sex with a condom or other barrier method. Its also important to openly communicate with sexual partners and to get tested if you suspect youve been exposed to the hepatitis C virus.
Because hepatitis C is transmitted through blood, its possible to contract it through a blood transfusion.
However, since the early 1990s, blood product screening tests have been standard protocol for minimizing the risk of this type of transmission.
Subsequent testing is based on risk. Talk to your doctor about your needs.
What Should You Know About Pregnancy And Hepatitis B
A pregnant woman who has hepatitis B can pass the infection to her baby at delivery. This is true for both vaginal and cesarean deliveries.
You should ask your healthcare provider to test you for hepatitis B when you find out you are pregnant. However, while it is important for you and your healthcare provider to know if you do have hepatitis B, the condition should not affect the way that your pregnancy progresses.
If you do test positive, your provider may suggest that you contact another healthcare provider, a liver doctor, who is skilled in managing people with hepatitis B infections. You may have a high viral load and may need treatment during the last 3 months of your pregnancy. A viral load is the term for how much of the infection you have inside of you.
You can prevent your infant from getting hepatitis B infection by making sure that your baby gets the hepatitis B vaccine in the hours after they are born along with the hepatitis B immunoglobulin. These two shots are given in two different locations on the baby. They are the first shots needed.
Depending on the type of vaccine used, two or three more doses must be given, usually when the baby is 1 month old and then 6 months old, with the last by the time the baby is 1 year old. It is critical that all newborns get the hepatitis B vaccination, but even more important if you have hepatitis B yourself.
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Is There A Cure For Chronic Hepatitis B
Currently, there is no complete cure for hepatitis B. But when managed properly, those living with the virus can expect to live a normal life. Maintaining a healthy diet and avoiding alcoholic beverages and tobacco products are crucial components in managing the disease.
You should also visit a doctor familiar with hepatitis B at least annuallythough twice a year might be best to monitor your liver through blood tests and medical imaging. As with most diseases, detecting it early leads to a better outcome. If youre exposed to the virus, you should get an antibody injection within 12 hours of exposure.
Management Of Inactive Hbsag Carrier
Differentiation from chronic HBsAg negative hepatitis B, requires serial testing of ALT and HBV DNA for one year before designating carrier state . In subject with inactive carrier state testing of HBV DNA and liver biopsy are not recommended. Treatment is not recommended as there is no evidence that available therapy affects HBsAg status. Family screening with HBsAg and anti-HBs, if negative vaccinate them and success of vaccination should be confirmed with anti-HBs testing. Protected sexual intercourse until partner has developed protective antibodies. The offspring need active and passive vaccination . Use of alcohol should be avoided, possibility of reactivation or super infection by other viruses and advised if there is jaundice, malaise or increased fatigue. Regular follow-up at every 612 months intervals with ALT . If the age of the patient is more than 50 yrs family history of HCC-AFP and ultrasonography every 612 monthly should be done. Universal precaution should be taken while treating these patients in the hospital. They should not be allowed to donate the blood or organ or semen. For pregnant women vaccinate the new born at birth with active and passive immunization with in 12 hours of the birth, close monitoring required if undergoing chemotherapy or immunosuppressive medication.
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Who Should Get The Hepatitis B Vaccine
All newborn babies should get vaccinated. You should also get the shot if you:
- Come in contact with infected blood or body fluids of friends or family members
- Use needles to take recreational drugs
- Have sex with more than one person
- Are a health care worker
- Work in a day-care center, school, or jail
What Do I Need To Know About Having Hepatitis B
If you have chronic hepatitis B, getting the right medical care can help you stay healthy. Taking good care of your liver is important. Talk with your doctor before you take any prescription medication, over-the-counter drugs, vitamins, or nutritional supplements to make sure they wont hurt your liver. You should also stay away from alcohol, because drinking can damage your liver.
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Transmission Symptoms And Treatment
How is HBV transmitted?
HBV is transmitted through activities that involve percutaneous or mucosal contact with infectious blood or body fluids , including
- sex with an infected partner
- injection-drug use that involves sharing needles, syringes, or drug-preparation equipment
- birth to an infected mother
- contact with blood from or open sores on an infected person
- exposures to needle sticks or sharp instruments and
- sharing certain items with an infected person that can break the skin or mucous membranes , potentially resulting in exposure to blood.
How long does HBV survive outside the body?
HBV can survive outside the body and remains infectious for at least 7 days .
What should be used to clean environmental surfaces potentially contaminated with HBV?
Any blood spills should be disinfected using a 1:10 dilution of one part household bleach to 10 parts of water. Gloves should be worn when cleaning up any blood spills.
Who is at risk for HBV infection?
The following populations are at increased risk for becoming infected with HBV:
- Infants born to infected mothers
- Sex partners of infected people
- Men who have sex with men
- People who inject drugs
- Household contacts or sexual partners of known people with chronic HBV infection
- Health-care and public-safety workers at risk for occupational exposure to blood or blood-contaminated body fluids
- Hemodialysis patients
Who should be screened for HBV?
CDC recommends that the following people be screened for HBV :
What Is The Outlook For People With Hepatitis B
The outlook for people with HBV is better now than ever before. You are certainly able to live a full life and help yourself stay healthy. You should make sure to have regular check-ups with a healthcare provider who is qualified to treat hepatitis B, possibly a liver doctor.
Make sure you are vaccinated against hepatitis A. Check with your healthcare provider or pharmacist before taking other medications or over-the-counter products, including supplements and natural products. These could interfere with your medication or damage your liver. For instance, taking acetaminophen in large doses may harm your liver.
Follow the usual guidelines for living a healthy life:
- Eat nutritious foods, choosing from a variety of vegetables, fruits and healthy proteins. It is said that cruciferous vegetables are especially good at protecting the liver.
- Exercise regularly.
- Dont smoke and dont drink. Both tobacco and alcohol are bad for your liver.
- Do things that help you cope with stress, like journaling, talking with others, meditating and doing yoga.
- Avoid inhaling toxic fumes.
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How Is It Currently Treated
There is no cure for chronic hepatitis B virus.
In most cases, treatment requires taking a pill every day for life to remain effective and to reduce the risk of liver cancer. Even then, it doesnt eliminate the risk.
Chronic hepatitis B hasnt been cured so far in part because current therapies have failed to destroy the viral reservoir, where the virus hides in the cell.
This is in contrast to hepatitis C virus, which has no such viral reservoir and can now be cured with as little as 12 weeks of treatment.
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Despite the huge human and economic toll of chronic hepatitis B, research to cure the disease remains underfunded. There is a misconception that because there is a vaccine, hepatitis B is no longer a problem.
The availability of effective cures for the unrelated hepatitis C virus has also led people to believe that viral hepatitis is no longer a problem.
Experts estimate that liver cancer deaths will substantially increase in coming decades without a cure for hepatitis B, despite deaths from most cancers decreasing.
Diagnosis Of Hepatitis B
Blood tests are available to determine if you are or have been infected with hepatitis B. It may take 6 months from the time of infection before a blood test can detect antibodies to hepatitis B, so follow-up testing may be required. During this 6-month period, until you know whether you are infected or not, take action to prevent potential infection of other people.
There are also tests that can assess liver damage from hepatitis B. The interpretation of these tests can be complicated and specialist advice is needed, so talk to your doctor.
All pregnant women are tested for hepatitis B. If you are found to have chronic hepatitis B, your doctor can help reduce the risk of transferring the infection to your newborn child.
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Complications Of Hepatitis B
In some people, chronic hepatitis can lead to cirrhosis of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The damaged areas of the liver stop working and cant cleanse the body of wastes. Cirrhosis can lead to liver failure and even liver cancer.
If you have hepatitis B, you are also susceptible to hepatitis D . Hepatitis D can only develop in people who already have hepatitis B. It can make your symptoms of hepatitis B or liver disease worse. It is spread through contact with infected blood or other body fluids of people who have hepatitis D.
What Are The Symptoms
- Symptoms can take 2 to 6 months to appear.
- Many people who are infected with hepatitis B have either no symptoms or only mild symptoms.
- Symptoms of acute hepatitis B can include fatigue, loss of appetite, joint pain, abdominal pain, nausea, vomiting, fever, and dark urine. A small number of people will develop jaundice .
- Some people develop chronic hepatitis B and most remain contagious for the rest of their lives. Chronic infection may lead to cirrhosis and/or liver cancer. Most people with chronic hepatitis B are unaware of their infection.
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Prognosis Improvement After Hbsag Clearance
These related studies provide clear recommendations that patients who achieve HBsAg clearance have favourable clinical outcomes compared to patients who achieve only HBV DNA suppression and HBeAg seroconversion. HBsAg clearance leads to biochemical, virological and liver histological improvements, and it significantly reduces the risk of HCC. However, HCC may occur after HBsAg seroclearance despite it being the ultimate treatment endpoint recommended by current guidelines. The risk factors associated with HCC include the presence of cirrhosis, male sex, and age50 years at the time of HBsAg clearance . Closer attention should be given to patients with one or more of these risk factors.
These high-risk patients should be re-examined in a timely manner even if HBsAg clearance is obtained. These results also suggest that achieving a functional cure early in the absence of cirrhosis results in a better prognosis .
Change In The Terminology Of Hbv Carriers
HBV infection is termed as chronic if it continues to be HBsAg +ve for 6 months. Chronic HBV infection is a dynamic process with a wide spectrum of spectrum of affliction. On one hand patients are asymptomatic with no clinical evidence of liver diseases, while on other being end-stage cirrhosis and hepatocellular carcinoma. For many decades the patients were considered to have a benign, non progression infection and were designated as hepatitis B “carriers”. Probably the word ‘carrier’ was mistakenly chosen for hepatitis B as in true sense, a carrier is an individual who harbors a specific infectious agent has no discernible clinical disease and serves as a potential source of infection. For this infection the second and third points should be looked at carefully. One the basis of Asian collaborative survey the term ‘carrier’ was replaced by the term ‘chronic hepatitis B virus infection’ . Later on for this infection the term ‘Inactive HBsAg carrier’ was adopted .
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What Not To Eat When You Have Hepatitis B
You should keep one thing in mind that an unhealthy diet can lead to liver damage. If you eat lots of fried, highly processed food, such as pasta, noodles, burger sugary foods, fatty foods, on daily basis then this will lead to fat consumption in your liver and ultimately you could face the problem of “Fatty Liver“. Which is directly associated with cirrhosis. So you need to avoid the things which are mentioned below:
- Avoid soda, packed high fat dairy products.
- Fast foods
- Sugary items like cookies packed baked goods etc.
- Fried foods
Hbeag Positive Chronic Hepatitis
Patients with HBeAg-positive chronic hepatitis B usually present in the third or fourth decade of life. Men outnumber women, liver damage ranges from mild to moderate or severe chronic hepatitis or active cirrhosis . Chronic hepatitis B tends to be milder in children. Nevertheless, severe liver disease including cirrhosis may occur in a small proportion of patients during childhood . A key event in the natural history of HBeAg positive chronic hepatitis is HBeAg seroconversion. Several studies have shown that seroconversion with marked reduction of HBV replication is associated with biochemical and histologic remission of inflammatory activity in the majority of patients . Regression of fibrosis occurs gradually months to years after HBeAg seroconversion. In longitudinal studies the observed probability of clearing HBeAg was about 50% and 70% within 5 and 10 years of diagnosis, respectively . Most studies have found that the mean annual rate of spontaneous HBeAg seroconversion ranges from 8 to 15% in children or adults with elevated ALT . Among Asian, most of whom have normal ALT, spontaneous HBeAg seroconversion occurs at a very low rate, less than 2% during the first 3 years of age and 4 to 5% in children older than 3 years . Several determinants for HBeAg seroconversion have been reported, including gender, age, ALT level, and more recently HBV genotypes. Older carriers and females are more likely to clear HBeAg .
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Is Hepatitis Testing Recommended For People With Hiv
Yes. Everyone living with HIV should be tested for HBV and HCV when they are first diagnosed with HIV and begin treatment. People living with HIV who have ongoing risk factors for getting hepatitis B or hepatitis C should be tested annually.
In addition, new HCV screening recommendations from the Centers for Disease Control and Prevention call for:
- One-time screening for all adults 18 years and older
- Screening of all pregnant women during every pregnancy
- Testing for all persons with risk factors, with testing continued periodic testing those with ongoing risk.
A Revolution In Hep C Treatment
More than 3 million Americans have a long-lasting hepatitis C infection. Most donât know it, because there usually aren’t symptoms.
Sofosbuvir was one of the first direct-acting antivirals to target hep C,the viru a disease spread through direct blood-to-blood contact. DAAs work in different ways to stop hep C from making copies of itself.
These drugs are kinder and gentler than the old standard of care — interferon shots and ribavirin alone. That route could take as long as a year, it only cured about half of the people, and the side effects were brutal.
âImagine taking an injection and a pill that made you feel — every day — worse than you ever felt from the infection that was being treated,â says Alexea Gaffney-Adams, MD, an infectious disease specialist in Smithtown, NY.
Side effects included flu-like symptoms, joint pain, anemia, and depression.
Limes says the old treatment felt like pouring gasoline into his system. âIt was like killing me to keep me alive.â In fact, it made his hep C worse, so his doctors took him off it.
Todayâs therapies are pills only and donât need interferon. They have very few side effects and double the cure rate — to 90% to 100%. They work in as little as 8 or 12 weeks.
âMy who had been on the older regimens — and failed, and now have the luck of being able to experience these new medications — canât believe the difference,â says Gaffney-Adams.
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