Hepatitis A And B: Diseases Of The Liver
Hepatitis is an inflammation of the liver, most often caused by a viral infection. There are three common types of hepatitis caused by viruses: hepatitis A, hepatitis B, and hepatitis C. Vaccines have been developed that protect people from contracting hepatitis A and B. There is no vaccine for hepatitis C.
Hepatitis A and hepatitis B can be spread from person to person, although in different ways. They have similar symptoms, which include abdominal pain, fever, fatigue, joint pain, and jaundice .
Over the last 20 years, there has been a 90% decrease in cases of hepatitis A and an 80% decrease in hepatitis B cases in the U.S. Health experts believe that immunization efforts have led to this drop in rates of infection.
Hepatitis C And Injecting Drugs
If you inject drugs, avoid sharing needles, syringes or other equipment such as tourniquets, spoons, swabs or water.
Where possible, always use sterile needles and syringes. These are available free of charge from needle and syringe programs and some pharmacists. To find out where you can obtain free needles, syringes and other injecting equipment, contact DirectLine
Try to wash your hands before and after injecting. If you cant do this, use hand sanitiser or alcohol swabs from a needle and syringe program service.
How Is Hepatitis Contracted
There are various ways of contracting hepatitis, depending on the type. Contracting a viral form of hepatitis depends on the mode of transmission, which the table above shows.
A person may sometimes contract hepatitis nonvirally. In autoimmune hepatitis, the immune system attacks the liver cells. Ingesting substances that contain toxins, such as alcohol, can also induce some types of hepatitis.
A doctor may use a blood test to diagnose viral hepatitis.
A healthcare professional will check a persons blood for:
- HAV-specific immunoglobulin G antibodies to diagnose HAV
- the surface antigen HBsAg to diagnose HBV
- anti-HCV antibodies to diagnose HCV
- high immunoglobulin G and anti-HDV immunoglobulin M levels to diagnose HDV
- virusspecific IgM antibodies to identify HEV
To autoimmune hepatitis, a doctor may consider:
- symptoms
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Therapeutic Hcv Vaccine Candidates
The objective of an HCV therapeutic vaccine is to activate HCV-specific T cells to target and eliminate virus-infected liver cells, mainly by CTL. Because the non-structural proteins are relatively conserved, HCV therapeutic vaccine candidates are mainly designed to target NS proteins, in a variety of delivery modalities including viral vector , inactivated yeast , synthetic peptides or DNA plasmid . Therapeutic HCV vaccine candidates that have been advanced into clinical trials are listed in Table . The Ad6-Nsmut/AdCh3-Nsmut and MVA-NSmut/AdCh3-NSmut vaccines are still in phase I trials and the efficacy results have not been available yet. The other vaccine candidates have been proved to be safe and immunogenic, capable of inducing specific T-cell responses that are correlated with viral load reductions in chronic HCV patients . Among these vaccine candidates, efficacies of IC41 and TG4040 were limited as only a minority of patients showed significant decline in viral load.
Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.
Refer to Reporting Adverse Events Following Immunization in Canada and Vaccine Safety and Pharmacovigilance in Part 2 for additional information about AEFI reporting.
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Hcv Cell Culture Models And In Vitro Neutralization Assay
Since HCV was first identified in 1989, the lack of an in vitro assay to evaluate NAbs has greatly hindered the development of HCV vaccine. In 2003, lentivirus/retrovirus-based HCV pseudo-particles systems were established , in which a packaging plasmid expressing HIV/MLV gag proteins and a plasmid expressing HCV envelope protein E1/E2 are cotransfected into human embryonic kidney 293 cells to produce lenti- or retro-viruses pseudotyped with the HCV envelope proteins. HCVpp mimics at least in part the entry process of authentic HCV virions, and has been used as a surrogate infection model to study HCV-specific NAbs. However, because HCVpp is produced in non-hepatocytes and generally not associated with lipoproteins, this system does not fully recapitulate the natural HCV infection.
How Do You Get Hepatitis C
The hepatitis C virus is usually spread through blood-to-blood contact.
Some ways the infection can be spread include:
- sharing unsterilised needles particularly needles used to inject recreational drugs
- sharing razors or toothbrushes
- from a pregnant woman to her unborn baby
- through unprotected sex although this is very rare
In the UK, most hepatitis C infections happen in people who inject drugs or have injected them in the past.
It’s estimated around half of those who inject drugs have been infected with the virus.
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What Medications Are Available To Treat Hepatitis C
Many medications can treat and cure hepatitis C. The first medication for hepatitis C was interferon alfa-2b, but other medications are now available too.
Oral antiviral medications called direct acting antivirals were first introduced in 2011. Theyre now first-choice medications to treat hepatitis C, but the best DAA to treat hepatitis C depends on the person. Before choosing and starting a DAA, your healthcare provider will consider your medical history, take blood work, and assess how well your liver and kidneys are working.
Choosing a DAA can depend on the HCV genotype that you have. While determining if you have hepatitis C, your healthcare provider may run tests to determine your HCV genotype. But, this isnt necessary for all people some DAAs can treat many identified genotypes. The CDC recommends that people should be tested for their HCV genotype if they have cirrhosis or were previously treated unsuccessfully for hepatitis C.
DAA medications are often taken for 8 to 12 weeks when treating an acute infection, but this timeframe can vary. Recommended DAAs available to treat hepatitis C include:
If DAA medications cant be used, other medications are available. Medications like pegylated interferon , interferon , and ribavirin may be considered. The best medication to treat hepatitis C varies by person, so your healthcare provider can talk with you about which medication may be best for you.
Vaccines For Hepatitis A And B
Our immune system battles foreign invaders every day, such as when we get a cold virus. When this happens, we develop immunity to that specific virus. This means that our body will fight off the virus if it is ever exposed to it again.
The same protection happens with vaccines. However, the benefit of a vaccination is that you don’t have to go through being sick to enable your body to fight off disease.
Gregory Poland, MD, director of the Mayo Clinic’s Vaccine Research Group, explains that hepatitis vaccinations contain a small amount of the inactive virus. When you get a dose of the vaccine, he says, your immune cells respond by developing immunity against the virus. This immunity lasts over a long period of time.
“So if I get these two doses of hepatitis A vaccine, and then I get exposed 30 years from now, my body will remember that immunity to the vaccine and rapidly start producing antibodies again,” says Poland.
Due to the way hepatitis vaccinations are developed, it is impossible to contract the virus from the vaccine itself, according to Poland.
The hepatitis A vaccine is usually given in two shots and the hepatitis B vaccine is administered as a series of three shots. The most common side effects are redness, pain, and tenderness where the shots are given.
To get long-term protection from these viruses, it’s important to receive all the shots as scheduled. However, if you received one shot and never went back for the others, it’s not too late to catch up.
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How Do People Get Hepatitis C
Hepatitis C virus is found in the blood of people with HCV infection. It enters the body through blood-to-blood contact.
Until reliable blood tests for HCV were developed , people usually got hepatitis C from blood products and blood transfusions. Now that blood and blood products are tested for HCV, this is no longer the typical means of infection.
Currently, people usually get hepatitis C by sharing needles for injection drug use. An HCV-infected woman can pass the infection to her baby during birth. It is also possible to get hepatitis C from an infected person through sexual contact, an accidental needlestick with a contaminated needle, or improperly sterilized medical, acupuncture, piercing, or tattooing equipment.
Hiv And Hepatitis B And Hepatitis C Coinfection
Hepatitis B and hepatitis C are liver infections caused by a virus. Because these infections can be spread in the same ways as HIV, people with HIV in the United States are often also affected by chronic viral hepatitis.
Viral hepatitis progresses faster and causes more liver-related health problems among people with HIV than among those who do not have HIV. Liver disease, much of which is related to HBV or HCV, is a major cause of non-AIDS-related deaths among people with HIV.
Given the risks of hepatitis B or hepatitis C coinfection to the health of people living with HIV, it is important to understand these risks, take steps to prevent infection, know your status, and, if necessary, get medical care from someone who is experienced in treating people who are coinfected with HIV and HBV, or HIV and HCV.
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Where Can I Get A Covid
Check the guidelines outlined by your state or local health department. Pharmacies and doctors offices near you are likely administering the vaccines, and some counties have also set up mass vaccination sites. You can also visit VaccineFinder.org to find locations where the vaccine is being administered near you.
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Getting Tested For Hepatitis C
Seek medical advice if you have persistent symptoms of hepatitis C or there’s a risk you’re infected, even if you do not have any symptoms.
A blood test can be carried out to see if you have the infection.
GPs, sexual health clinics, genitourinary medicine clinics or drug treatment services all offer testing for hepatitis C.
Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.
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Hepatitis C Vaccine Could Be Rolled Out Within Five Years Says Nobel Prize Winner Who Discovered Virus
European Society of Clinical Microbiology and Infectious Diseases
A vaccine to protect against infection with hepatitis C could be in use within 5 years, says Professor Sir Michael Houghton, who won the Nobel Prize for Medicine and Physiology along with three other scientists for discovering the hepatitis C virus in 1989. Sir Michael will discuss the development of a vaccine in a special presentation at this year’s European Congress of Clinical Microbiology and Infectious Diseases , held online this year.
Up to 2 million new HCV infections occur every year around the world, with an estimated 70 million carriers of the virus globally, most of whom are not diagnosed. The virus is estimated to cause some 400,000 deaths annually. Many infected with the virus go on to develop liver cirrhosis and liver cancer.
“While the advent of directly acting antivirals to cure hepatitis C has given us a huge weapon to turn the tide on this pandemic, there is no doubt that a vaccine is required to help the world reach its ambitious target of reducing new hepatitis C infections by 90% and mortality rates by 65% by 2030,” explains Sir Michael, who is currently based at the Li Ka Shing Applied Virology Institute, University of Alberta, Canada.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
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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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Limited Animal Models Of Hepatitis C Infection
A hepatitis C infection in chimpanzees is similar to an infection in humans. However, ethical and cost concerns limit medical research with these animals.
Although researchers are still working to develop an effective vaccine, new medications can cure nearly everyone who is infected with hepatitis C.
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Symptoms Of Hepatitis C
It is very important to know that not everyone with hepatitis C has symptoms. The only way to know if you have hepatitis is by talking to your doctor and getting a blood test.
Many people living with hepatitis C feel well and only have symptoms once the disease has progressed and there is serious liver damage.
If you do not have symptoms this does not mean that the virus isnt causing damage.
When first infected, some people may find:
- their urine becomes dark
- their eyes and skin turn yellow
- they experience a minor flu-like illness.
These symptoms may disappear within a few weeks, but this does not necessarily mean that the infection has been cleared.
Over time, symptoms that may develop include:
- tiredness and fatigue
- flu-like symptoms
- pain in the abdomen where the liver is located
- not feeling hungry and indigestion.
Around 30% of people who have been infected may clear the virus from their blood naturally, with no treatment, within 6 months. These people no longer have the hepatitis C virus and are not infectious, but will always have hepatitis C antibodies in their blood. The presence of hepatitis C antibodies shows that someone has been exposed to the virus, but does not offer any immunity against hepatitis C. People can become reinfected after clearing the virus naturally, or after treatment.
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Can We Expect A Hepatitis C Vaccine To Be Available In The Near Future
Its a safe bet to assume that eventually a hepatitis C vaccine will be available. Unfortunately, there isnt any information that allows us to predict when one will be available.
Given recent advances in antiviral treatments and an improved understanding of HCV, theres hope that a safe and effective vaccine may be approved for use in the coming years. But, all current hepatitis C vaccine candidates are still in the early stages of the research process. In a non-pandemic setting, it usually takes several years for a vaccine to make it through clinical trials if everything goes to plan.
Although a specific vaccine timeline cannot be made, the World Health Organization has a goal of eliminating the hepatitis C public health issue by 2030. A hepatitis C vaccine is crucial to meeting this goal.
These updates may be somewhat disappointing, but medications used to treat and cure hepatitis C are discussed next.
What Types Of Hcv Vaccine Will We Eventually Have
Many studies have revealed the minimal benefit of therapeutic HCV vaccines. Although the combinations of therapeutic vaccine with Peg-IFN/RBV have improved SVR, its efficacy is still less than recently reported interferon-free DAA therapies. Therefore, therapeutic vaccine might not be a priority of HCV vaccine development. On the other hand, DAA-mediated cure of HCV patients confer no immune protection and can be reinfected with HCV. Therefore, prophylactic HCV vaccines are still urgently needed to effectively control HCV infection and to possibly eradicate the pathogen. While the success of DAAs in HCV therapeutics may understandably diminish the enthusiasms of industry in HCV vaccine development, public funding should continue to support the prophylactic HCV vaccine development as vaccine remains the most cost-effective way to control worldwide HCV infection.
Individuals at high-risk HCV infection should especially benefit from a prophylactic HCV vaccine. The high-risk group includes people who frequently expose to blood or blood products like intravenous drug users, patients with pediatric hematologic malignancies such as thalassemia and hemophilia. Also, people living in high-prevalence regions, such as Egypt, are also target populations of HCV vaccination.
We thank Dr Xia Jin for critical reading of the manuscript and suggestions. We apologize for being unable to cite all top-quality literature due to the space limitation.
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Why Isn’t There A Hepatitis C Vaccine
Medically reviewed by Drugs.com. Last updated on Oct 28, 2020.
Efforts to develop a hepatitis C vaccine started more than 30 years ago, when the hepatitis C virus was identified. Since then, researchers have studied several potential vaccines in animals. Some of these vaccines, developed mainly in the past decade, have undergone limited testing in people.
One ongoing clinical trial includes:
-
A therapeutic vaccine trial. Researchers are testing a vaccine therapy on people who already have chronic hepatitis C. The purpose is to determine if the vaccine can help the body build an immune response and thereby treat the hepatitis C infection. It will also determine if the vaccine is safe and able to protect against future infection.
If this trial has good results, larger trials will be necessary to verify this effect and determine the best way to deploy the vaccine.
Progress on developing a successful vaccine has been slow for a number of reasons, including: