American Association For The Study Of Liver Diseases
The American Association for the Study of Liver Disease hepatitis B guidance has served as the dominant HBV treatment guidance in the United States and it includes comprehensive recommendations. The most recent guidanceUpdate on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidancewas developed by consensus of an expert panel and was published in 2018. The 2018 AASLD Hepatitis B Guidance recommends initiating HBV treatment in the following situations in persons with chronic HBV.
- : Initiation of oral antiviral treatment is recommended in conjunction with referral for consideration of liver transplantation.
- Cirrhosis: Treatment is recommended for persons with cirrhosis if HBV DNA levels are greater than 2,000 IU/mL, regardless of HBeAg status or ALT levels.
- Immune-Active Disease: Treatment is recommended for persons with immune-active disease. For treatment purposes, immune-active disease is defined as elevation of ALT or evidence of significant histologic disease and elevated HBV DNA above 2,000 IU/mL if HBeAg negative or above 20,000 IU/mL if HBeAg positive. The AASLD recommends using an ALT upper limit of normal of 35 U/L for males and 25 U/L for females to guide management decisions.
- Selected Older Patients: Treatment is recommended in the select group of adults older than 40 years of age who have normal ALT levels, elevated HBV DNA levels, and a liver biopsy specimen that shows significant necroinflammation or fibrosis.
How Do I Know If I Have Hepatitis
Viral hepatitis, such as hepatitis A , hepatitis B and hepatitis C , is diagnosed by your symptoms, a physical exam and blood tests. Sometimes imaging studies such as a sonogram or CAT scan and a liver biopsy are also used.
What are the types of Hepatitis?
There are several types of hepatitis, but the three most common in the U.S. are:
- Hepatitis A â It is considered highly contagious but is not a long-term infection and usually has no complications. Your liver usually heals within two months. Preventable with a vaccination, it can be spread by eating or drinking something that has been contaminated with the stool of a person who has the virus.
- Hepatitis B â While it can lead to long-term liver damage, most children and adults recover within 6 months. You can spread the virus even though you show no symptoms. Pregnant women who are infected by the virus can pass it along to their newborn. Also, preventable through vaccine, hepatitis B is spread by:
- Having sex with someone who’s infected
- Sharing dirty needles
- Having direct contact with infected blood or the body fluids of someone who’s got the disease
Who’s at Risk for Hepatitis Infection?
You are at increases risk hepatis A if you meet one or more of these criteria:
- Children born to mothers who have HBV
- People with certain high liver function blood tests
- Feeling sick to the stomach
How Do You Get Hepatitis B
Hepatitis B is really contagious. Its transmitted through contact with semen , vaginal fluids, and blood. You can get it from:
having vaginal, anal, or oral sex
sharing toothbrushes and razors
sharing needles for shooting drugs, piercings, tattoos, etc.
getting stuck with a needle that has the Hep B virus on it.
Hepatitis B can also be passed to babies during birth if their mother has it.
Hepatitis B isnt spread through saliva , so you CANT get hepatitis B from sharing food or drinks or using the same fork or spoon. Hepatitis B is also not spread through kissing, hugging, holding hands, coughing, sneezing, or breastfeeding.
You May Like: What Does Hepatitis B Do To You
Treatment For Acute Hepatitis B
If you’re diagnosed with hepatitis B, your GP will usually refer you to a specialist, such as a hepatologist .
Many people do not have any troublesome symptoms, but if you do feel unwell, it can help to:
- get plenty of rest
- take over-the-counter painkillers, such as paracetamol or ibuprofen, for tummy pain
- maintain a cool, well-ventilated environment, wear loose clothing, and avoid hot baths or showers if itching is a problem
- take medication, such as metoclopramide, to stop you feeling sick, and chlorphenamine to reduce itching your doctor can give you a prescription for these if necessary
Most people recover completely in a couple of months, but you’ll be advised to have regular blood tests to check that you’re free of the virus and have not developed chronic hepatitis B.
Current Cdc Recommendations For Hepatitis A And Hepatitis B Vaccination
Hepatitis A vaccination is recommended for:
All children at age 1
Children and adolescents ages 2-18 who live in states or communities with a high incidence of disease
Travelers to intermediate or high rates of hepatitis A
Men who have sex with men
Users of illegal injection and non-injection drugs
Persons with clotting factor disorders
Persons how work with hepatitis A infected primates or with hepatitis A in a research laboratory
Persons with chronic liver disease
Anyone else who seeks long-term protection
Hepatitis B vaccination is recommended for:
All infants beginning at birth
Older children not previously vaccinated
Sex partners of people that are hepatitis B surface antigen positive
Men who have sex with men
People seeking evaluation or treatment of a sexually transmitted disease
Injection drug user
People with chronic liver disease
Patients with HIV
Patients with end stage renal disease, including predialysis, hemodialysis, peritoneal dialysis and home dialysis
Household contacts of people that are hepatitis B surface antigen positive
Healthcare and public safety workers exposed to blood or blood-contaminated body fluids
Residents and staff in institutions for the developmentally disabled persons
Travelers to intermediate or high rates of hepatitis B
Anyone else seeking long term protection
Don’t Miss: If You Have Hepatitis B Do You Have Hiv
Exposure That Might Place A Dentist At Risk Of Hepatitis Infection Includes The Following
Contact with potentially infectious blood, tissues, or other body fluids
Mucus membranes of the eye, nose, or mouth or non-intact skin .
Percutaneous injuries pose a greater risk of transmission. The majority of exposures in dentistry are preventable, and methods to reduce the risk of blood contacts have included use of standard precautions and engineering controls and modifications of work practice. These approaches might have contributed to the decrease in percutaneous injuries among dentists during recent years. However, needlesticks and other blood contacts continue to occur, which is a concern because percutaneous injuries pose the greatest risk of transmission.
When a patient enters a dental clinic, his/her medical history should be recorded. All patients with a history of hepatitis must be managed as they are potentially infectious. Whether or not an individual becomes a chronic carrier of hepatitis B depends on geographic, socioeconomic, immunologic, and genetic factors. A high carrier rate is found among patients with the following:
Patients on chronic renal dialysis
Drug abusers having history of hepatitis.
Treatment For Hepatitis A
There is no specific treatment for hepatitis A. In most cases, your immune system will clear the infection and your liver will completely heal. Treatment aims to ease symptoms and reduce the risk of complications. Options may include:
- Rest hepatitis A can make you tired and lacking in energy for day-to-day life, so rest when you can.
- Eat small meals more often nausea can affect your ability to eat and can contribute to tiredness, so eat small amounts of high-calorie foods often if nausea is a problem.
- Drink fluids.
- Protect your liver the liver processes medication and alcohol, so avoid alcohol and review any medication with your doctor.
You May Like: Interferon Treatment For Hepatitis C
Hepatitis A And B Vaccine Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction:hives difficulty breathing swelling of your face, lips, tongue, or throat.
Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.
You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.
Becoming infected with hepatitis is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.
You may feel faint after receiving this vaccine. Some people have had seizure like reactions after receiving this vaccine. Your doctor may want you to remain under observation during the first 15 minutes after the injection.
numbness, tingling, or burning pain
red or blistering skin rash with burning or tingly feeling
easy bruising or bleeding or
unexplained muscle pain, tenderness, or weakness.
Common side effects include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.
What Are Clinical Trials For Hepatitis B
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of hepatitis B, such as
- progression of hepatitis B and long-term outcomes
- new treatments for hepatitis B
- prevention of reactivated or worsening hepatitis B in people receiving cancer treatment
Recommended Reading: How Do You Get Viral Hepatitis
Hepatitis A Vaccine And International Travel
Who should get the hepatitis A vaccine before traveling internationally?
All unvaccinated people, along with those who have never had hepatitis A, should be vaccinated before traveling to countries where hepatitis A is common. Travelers to urban areas, resorts, and luxury hotels in countries where hepatitis A is common are still at risk. International travelers have been infected, even though they regularly washed their hands and were careful about what they drank and ate. Those who are too young or cant get vaccinated because of a previous, life-threatening reaction to the hepatitis A vaccine or vaccine component should receive immune globulin. Travelers to other countries where hepatitis A does not commonly occur are not recommended to receive hepatitis A vaccine before travel.
How soon before travel should I get the hepatitis A vaccine?
You should get the first dose of hepatitis A vaccine as soon as you plan international travel to a country where hepatitis A is common. The vaccine will provide some protection even if you get vaccinated closer to departure. For older adults , people who are immunocompromised, and people with chronic liver disease or other chronic medical conditions the health-care provider may consider, based on several factors, giving an injection of immune globulin at the same time in different limbs.
What should I do if I am traveling internationally but cannot receive hepatitis A vaccine?
Can Hepatitis B Be Prevented
The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.
The disease has also been more widely prevented thanks to:
- Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
- Safer blood injection practices, using clean needles.
- Safe-sex practices.
You can help prevent hepatitis B infections by:
- Practicing safe sex .
- Never sharing personal care items like toothbrushes or razors.
- Getting tattoos or piercings only at shops that employ safe hygiene practices.
- Not sharing needles to use drugs.
- Asking your healthcare provider for blood tests to determine if you have HBV or if you are immune.
Recommended Reading: What Are The Signs Of Hepatitis C
Preventing Hepatitis A B & C
The three most common types of hepatitis, a disease characterized by inflammation of the liver, are those caused by the hepatitis A, B, and C viruses. All viral types are contagiousthat is, they can be spread from one person to anotheralthough the methods of transmission vary.
NYU Langone doctors recommend specific preventive steps for each type to limit your risk of acquiring or spreading infection.
Control Testing And Advising After Exposure To Hcv Include The Following
Repeat the test for anti-HCV antibodies and ALT at the earliest 46 months after exposure
Do the test for HCV RNA for 46 weeks for early diagnosis
During the testing period, the exposed person must not donate blood, plasma, organs, tissue, or sperm
Exposed person should abstain from changes in sexual activity, pregnancy, breastfeeding, or professional activities
Counseling services should be offered.
Also Check: Hepatitis C Symptoms In Women
How To Protect Yourself Against Hepatitis B
Dr. Fried emphasizes that hepatitis B infection can be prevented by avoiding risky behaviors involving sex and drugs and by getting vaccinated. The hepatitis B vaccination is required for infants at birth, and subsequent vaccinations for adults are also important. There are separate vaccines for hepatitis A and B, but there is also a combination A and B vaccine so you can take care of both types at once. In North Carolina, newborn vaccinations have been required since 1994. Anyone born before this year should talk to their health care provider about being vaccinated for hepatitis B.
Whats The Difference Between Hepatitis A B And C
Youve probably seen stories in the news about hepatitis A outbreaks linked to infected restaurant workers, or how a rising rate of hepatitis C infections is causing increased health care costs.
But you might not know the difference between hepatitis A, B and C, or why you should be concerned about them.
Heres why: Hepatitis, or inflammation of the liver, affects more than 50,000 new people each year and is a leading cause of liver cancer and liver transplants. The Centers for Disease Control and Prevention estimates as many as 6 million people in the U.S. are living with hepatitis.
Having hepatitis can be dangerous and uncomfortable. Symptoms are similar for hepatitis A, B and C and may include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, gray-colored stools, joint pain and jaundice . Even worse, chronic hepatitis often has no symptoms, and people dont know theyre infected until they get very sick.
Don’t Miss: Life Insurance For Hepatitis B Carrier
How Do I Get Hepatitis A
Hepatitis A is spread through close contact with an infected person, or by eating hepatitis A contaminated food or drinking water. Because the virus is found in the stool of infected people, eating food prepared by an infected person, who does not wash his/her hands properly after using the washroom, is one way of getting the virus.
Eating raw or undercooked seafood and shellfish from water polluted with sewage, or eating salad greens that are rinsed in contaminated water are other ways of becoming infected. Sharing drug-use equipment, or having sexual contact with an infected person can also give you hepatitis A.
While often considered to be a travellers disease, hepatitis A can be contracted in Canada. Hepatitis A outbreaks or scares in Canada are most often associated with infected food handlers in restaurants and grocery stores or with contaminated produce.
Treatment For Chronic Hepatitis B
If blood tests show that you still have hepatitis B after 6 months, your doctor may recommend medication to reduce the risk of complications of hepatitis B and regular tests to assess the health of your liver.
Treatment is usually offered if:
- your immune system is unable to control the hepatitis B by itself
- there’s evidence of ongoing liver damage
Hepatitis B medications can help keep the virus under control and stop it damaging your liver, although they will not necessarily cure the infection and some people need lifelong treatment.
The main medicines for chronic hepatitis B include peginterferon alfa 2-a and antiviral medicines.
Read Also: Hepatitis C Can You Get It From Intercourse
How Is Hepatitis A Diagnosed
The health care professional will ask questions about the illness and symptoms, and about any possible exposures to other people diagnosed with hepatitis, especially the type of hepatitis .
If the healthcare professional determines that the patient may be at risk for contracting hepatitis, then it is likely the patient will undergo blood tests.
- The blood will be tested to determine how well the liver is functioning.
- A test will be ordered to detect antibody to hepatitis A. The results of this test will also determine if the patient has been recently exposed to HAV.
- Blood probably will be tested for the hepatitis B and hepatitis C viruses, as well as others others. For example, if a patient has had a large amount of vomiting or has not been able to take in liquids, the blood electrolytes may be out of balance. Blood chemistry may be tested to check electrolytes.
YOU MAY ALSO LIKE
There are no specific medicines to cure infection with hepatitis A. Most people require no treatment except to relieve symptoms. However, if symptoms become severe or dehydration develops, the person should seek medical care emergently.
There is a vaccine for hepatitis A . If you have been exposed to someone who is infected with HAV, a treatment called immune serum globulin is available and may prevent you from becoming infected. Immune serum globulin is more likely to be effective when given within 2 weeks of exposure.