Can Hbv Infection Be Prevented
Yes. The best way to prevent HBV is to get the hepatitis B vaccine.
CDC recommends that people with HIV and people who are at risk for HIV get the HBV vaccine . The housemates and sexual partners of people with HBV should get the HBV vaccine, too.
People, including people with HIV, can also take the following steps to reduce their risk of HBV infection:
- Use condoms during sex to reduce the risk of HBV infection and infection with other sexually transmitted diseases, such as gonorrhea and syphilis.
- Do not inject drugs. But if you do, do not share needles, syringes, or other drug injection equipment.
- If you get a tattoo or body piercing, make sure the instruments used are sterile.
The Need For Vaccination
To prevent the contraction or development of hepatitis A, the following individuals should be sure to get vaccinated:
- 1 to 2-year-old children
- Men who have sexual contact with other men
- People who use drugs on the streets
- Employees working in various parts of the world, except countries such as Canada, the U.S., and Japan
- People who have personal or close contact with persons who come from HAV-infected countries
- People with chronic liver disease
- People experiencing homelessness
How Does Hbv Spread From Person To Person
HBV is spread through contact with the blood, semen, or other body fluid of a person who has HBV. Among adults in the United States, HBV is spread mainly through sexual contact.
HBV can also spread from person to person in the following ways:
- From contact with the blood or open sores of a person who has HBV
- From an accidental prick or cut from an HBV-contaminated needle or other sharp object
- From a mother who has HBV to her child during childbirth
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Viral Hepatitis Definition And Overview
Hepatitis means inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs, alcohol, chemicals, and autoimmune diseases. Many viruses, for example, the virus causing mononucleosis and the cytomegalovirus, can inflame the liver. Most viruses, however, do not attack primarily the liver the liver is just one of several organs that the viruses affect. When most doctors speak of viral hepatitis, they are using the definition that means hepatitis caused by a few specific viruses that primarily attack the liver and are responsible for about half of all human hepatitis. There are several hepatitis viruses they have been named types A, B, C, D, E, F , and G. As our knowledge of hepatitis viruses grows, it is likely that this alphabetical list will become longer. The most common hepatitis viruses are types A, B, and C. Reference to the hepatitis viruses often occurs in an abbreviated form The focus of this article is on these viruses that cause the majority of human viral hepatitis.
Hepatitis viruses replicate primarily in the liver cells. This can cause the liver to be unable to perform its functions. The following is a list of major functions of the liver:
What Is The Risk Of Coinfection
A coinfection is when someone has two or more infections at the same time. People living with HIV are at risk of developing coinfections such as hepatitis C because HIV weakens the immune system, which leaves the body more vulnerable to other infections and illnesses.
HIV and HCV are also transmitted in similar ways, which means that people who have HIV may be at higher risk of exposure to HCV. In the United States, over a third of people living with HIV also have hepatitis C.
Coinfection of HCV and HIV is higher among those who use injected drugs. According to the Centers for Disease Control and Prevention , HCV coinfection occurs in between 62 and 80 percent of people with HIV who use injected drugs.
A systematic review of 783 studies concluded that people living with HIV were six times more likely to have hepatitis C than people without HIV.
Hepatitis C infections are more serious in people with HIV and can lead to more severe damage of the liver. HIV and HCV coinfections can increase the risk of:
- liver fibrosis and cirrhosis, which is a buildup of scar tissue in the liver
- end-stage liver disease
A person can contract HCV through direct contact with blood or other body fluids that contain the virus. Possible modes of transmission include:
Ways to prevent hepatitis C include:
- not sharing needles
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Is Hepatitis A The Same As Hepatitis B
One might believe that hepatitis A and B are basically the same thing. However, many are unfamiliar with what hepatitis is and does. Learn more about hepatitis, such as the various types and the difference between them by reading further. When you overhear the term hepatitis, it just means one thing: inflammation of your liver. There are several ways that you can develop this health condition. Alcohol and certain medications are some of these causes. It is typically proliferated through viruses of different types these have been named A, B, C, D, and E. To make everything easier for you, here are well-defined differences between the notable hepatitis viruses, hepatitis A and hepatitis B .
How Does Drug Use Affect Symptoms And Outcomes Of A Viral Infection
Drug use can worsen the progression of HIV and its symptoms, especially in the brain. Studies show that drugs can make it easier for HIV to enter the brain and cause greater nerve cell injury and problems with thinking, learning, and memory. Drug and alcohol use can also directly damage the liver, increasing risk for chronic liver disease and cancer among those infected with HBV or HCV.
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What Is The Treatment For Viral Hepatitis
Treatment of acute viral hepatitis and chronic viral hepatitis are different. Treatment of acute viral hepatitis involves resting, relieving symptoms, and maintaining an adequate intake of fluids. Treatment of chronic viral hepatitis involves medications to eradicate the virus and taking measures to prevent further liver damage.
In patients with acute viral hepatitis, the initial treatment consists of relieving the symptoms of nausea, vomiting, and abdominal pain . Careful attention should be given to medications or compounds, which can have adverse effects in patients with abnormal liver function . Only those medications that are considered necessary should be administered since the impaired liver is not able to eliminate drugs normally, and drugs may accumulate in the blood and reach toxic levels. Moreover, sedatives and “tranquilizers” are avoided because they may accentuate the effects of liver failure on the brain and cause lethargy and coma. The patient must abstain from drinking alcohol since alcohol is toxic to the liver. It occasionally is necessary to provide intravenous fluids to prevent dehydration caused by vomiting. Patients with severe nausea and/or vomiting may need to be hospitalized for treatment and intravenous fluids.
Medications for chronic hepatitis C infection include:
- oral daclatasvir
Medications for chronic hepatitis B infection include:
- oral entecavir
- oral tenofovir
How Is Hepatitis A Transmitted
Hepatitis A is found in the feces of an infected person. The virus is transmitted when the fecal matter of an infected person makes its way into the mouth of another person who has not been previously exposed to hepatitis A or who has not been vaccinated against hepatitis A. A person becomes immune to the virus after being infected.
Hepatitis A can also be transmitted if a person ingests food or water that has been contaminated with the feces of someone with hepatitis A.
Hepatitis A can be spread by sexual activities involving fecal-oral contact . The virus can also be transmitted by fingers , a penis if having anal intercourse, and sex toys if they have come into direct contact with infected feces during sex and then enter another persons mouth. Handling a used condom after anal sex and then putting fingers in the mouth can also transmit hepatitis A.1,3,4,5,6
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Who Should Be Tested
Testing for hepatitis A is not routinely recommended.
CDC recommends hepatitis B testing for:
- Men who have sex with men
- People who inject drugs
- Household and sexual contacts of people with hepatitis B
- People requiring immunosuppressive therapy
- People with end-stage renal disease
- People with hepatitis C
- People with elevated ALT levels
- Pregnant women
- Infants born to HBV-infected mothers
CDC recommends hepatitis C testing for:
- All adults aged 18 years and older
- All pregnant women during each pregnancy
- About 24,900 new infections each year
- About 22,600 new infections in 2018
- Estimated 862,000 people living with hepatitis B
- About 50,300 new infections in 2018
- Estimated 2.4 million people living with hepatitis C
How Is It Spread
Hepatitis A is spread when a person ingests fecal mattereven in microscopic amountsfrom contact with objects, food, or drinks contaminated by feces or stool from an infected person.
Hepatitis B is primarily spread when blood, semen, or certain other body fluids- even in microscopic amounts from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus can also be transmitted from:
- Birth to an infected mother
- Sex with an infected person
- Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
- Sharing personal items such as toothbrushes or razors
- Poor infection control has resulted in outbreaks in health care facilities
Hepatitis C is spread when blood from a person infected with the Hepatitis C virus even in microscopic amounts enters the body of someone who is not infected. The hepatitis C virus can also be transmitted from:
- Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
- Receiving a blood transfusion or organ transplant before 1992
- Poor infection control has resulted in outbreaks in health care facilities
- Birth to an infected mother
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Managing Hepatitis C And Hiv
Having both hepatitis C and HIV, called a coinfection, can increase your risk for liver damage if not properly diagnosed and managed.
According to the Centers for Disease Control and Prevention , 21 percent of HIV-positive people across the country have also tested positive for a past or current hepatitis C infection, although the danger varies greatly depending on your personal risk factors. If you have both conditions, that alone places you at increased risk for liver damage compared with those who have hepatitis C only.
Coinfection with hepatitis C and HIV usually represents an intersection of risk factors for each virus, says Kenneth E. Sherman, MD, PhD, a hepatologist who is the director of the division of digestive diseases and Gould Professor of Medicine at the University of Cincinnati College of Medicine.
How Do People With Hiv Use Descovy
Descovy is used in combination with several other antiretroviral drugs, usually including drugs from different classes, such as integrase inhibitors, protease inhibitors and/or non-nucleoside reverse transcriptase inhibitors . Combinations such as this are called antiretroviral therapy, or ART. For more information on ART, see CATIEs Your Guide to HIV Treatment.
Neither Descovy nor any other anti-HIV medication is a cure for HIV. It is therefore important that you see your doctor regularly so that he/she monitors your health.
Evidence shows that HIV-positive people who are on ART, engaged in care, and have an ongoing undetectable viral load are substantially less likely to transmit HIV to others, be it through sex, when sharing equipment to use drugs or during pregnancy and birth. In fact, the evidence for sexual transmission shows that people on ART who maintain an undetectable viral load do not pass HIV to their sexual partners. For further information see the CATIE fact sheet HIV treatment and an undetectable viral load to prevent HIV transmission. However, it is still a good idea to use condoms because they can reduce your risk for getting and passing on other sexually transmitted infections.
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What Is The Connection Between Hiv And Hbv
Both HIV and HBV spread from person to person in semen, blood, or other body fluids. For this reason, the main risk factors for HIV and HBV are the same: having sex without a condom and injection drug use.
According to the Centers for Disease Control and Prevention , approximately 10% of people with HIV in the United States also have HBV. Infection with both HIV and HBV is called HIV/HBV coinfection.
Chronic HBV advances faster to cirrhosis, end-stage liver disease, and liver cancer in people with HIV/HBV coinfection than in people with only HBV infection. But chronic HBV does not appear to cause HIV to advance faster in people with HIV/HBV coinfection.
Myth #: It Is Not Possible To Treat Hepatitis
Fact: Some types of hepatitis will heal without treatment. But sometimes hepatitis can cause serious problems like liver cirrhosis and the patient may require liver transplantation. Thus, it is essential to take prescribed medication and avoid alcohol while recovering from hepatitis. The treatment may differ based on the type of hepatitis you have. So, do not worry, it is possible to cure hepatitis.
What Are The Common Types Of Viral Hepatitis
Although the most common types of viral hepatitis are HAV, HBV, and HCV, some clinicians had previously considered the acute and chronic phases of hepatic infections as “types” of viral hepatitis. HAV was considered to be acute viral hepatitis because the HAV infections seldom caused permanent liver damage that led to hepatic failure. HBV and HCV produced chronic viral hepatitis. However, these terms are outdated and not currently used as frequently because all of the viruses that cause hepatitis may have acute phase symptoms . Prevention techniques and vaccinations have markedly reduced the current incidence of common viral hepatitis infections however, there remains a population of about 1 to 2 million people in the U.S. with chronic HBV, and about 3.5 million with chronic HCV according to the CDC. Statistics are incomplete for determining how many new infections occur each year the CDC documented infections but then goes on to estimate the actual numbers by further estimating the number of unreported infections .
Types D, E, and G Hepatitis
Individuals who already have chronic HBV infection can acquire HDV infection at the same time as they acquire the HBV infection, or at a later time. Those with chronic hepatitis due to HBV and HDV develop cirrhosis rapidly. Moreover, the combination of HDV and HBV virus infection is very difficult to treat.
Contaminated Food And Water
Hepatitis A is most commonly passed on by eating food prepared by someone with the virus whose hands have not been washed properly. You can also get it by drinking dirty water and by eating raw or undercooked shellfish from dirty water.
You can protect yourself by:
- Washing your hands each time you go to the toilet, before you prepare or eat food, after coughing or sneezing, or handling rubbish or other dirty items.
- Peeling and washing all your fresh fruit and vegetables avoiding raw or undercooked meat and fish avoiding all drinks if youre not sure if theyre safe with or without ice.
- If tap water isnt safe and bottled water isn’t available, boil tap water before drinking it.
- People living in places with poor sanitation and hygiene are at a greater risk of hepatitis A infection. You may also be exposed to hepatitis A through your work, for example, sewage workers, staff in institutions where levels of personal hygiene may be poor , people working with animals that may be infected with hepatitis A and daycare centres.
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Treating Hcv And Hiv Coinfection
If you have hepatitis C, be sure to get tested for HIV. The CDC also recommends that all people over 18, including those with HIV, get screened for hepatitis C. You should continue to get tested regularly if you have risk factors for HCV, including injection drug use.
If you test positive for either hepatitis C or HIV, both are treatable. In fact, people who are coinfected and receive treatment for both infections can achieve viral suppression meaning both viruses are undetectable in the blood according to the CDC.
The key is getting diagnosed and starting treatment as soon as possible to prevent serious liver complications.
In general, treatment of hepatitis C in HIV-positive people is similar to the treatments for HCV alone. Direct-acting antivirals , the treatment of choice for hepatitis C, can still be used with HIV antiretroviral drugs.
If youre diagnosed with hepatitis C while on treatment for HIV, do not interrupt or discontinue your HIV care to manage your HCV. While there are possibly harmful interactions between the drugs used to treat the two infections, your healthcare team should work together to prescribe the safest regimen that works best for your coinfection. Be sure to work with healthcare providers who have experience treating both conditions.
Symptoms And Disease Progression
The majority of people do not experience symptoms when they first acquire hepatitis C, a period known as acute infection. Among people living with HIV, routine liver function tests sometimes reveal elevated liver enzymes that can be a sign of liver inflammation due to hepatitis C.
When they do occur, signs and symptoms of acute hepatitis C infection may include the following:
- pain in the upper abdomen or belly
- feeling generally unwell
- yellowing of the skin and whites of the eyes .
Around 10 to 25% of people who acquire hepatitis C will clear the virus without treatment. Most people develop chronic hepatitis C that lasts more than six months. People living with HIV appear less likely to spontaneously clear hepatitis C. People with chronic infection will continue to be infectious and can pass on the virus to others, whether or not they have symptoms.
Over the longer term, about half of people with chronic hepatitis C will experience some symptoms. The most common include fatigue, loss of appetite, muscle and joint pain, and feeling generally unwell. Some people may experience ‘brain fog’ or depression. Symptoms may worsen or become more numerous over time.
These symptoms can have a negative impact on work, family life, social life and sex life. If this is the case for you, be sure to tell your doctor about the problems the symptoms cause you.
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