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
Hepatitis B Vs Hepatitis C
Hepatitis has many different types. HBV and the hepatitis C virus have both acute and chronic forms.
The main difference between HBV and HCV is how they spread from person to person. Although HCV is transmissible via sexual activity, this is rare. HCV usually spreads when blood that carries the virus comes into contact with blood that does not.
Who Is At Risk
Anyone who has not been vaccinated or previously infected can get infected with the hepatitis A virus. In areas where the virus is widespread , most hepatitis A infections occur during early childhood. Risk factors include:
- poor sanitation
- living in a household with an infected person
- being a sexual partner of someone with acute hepatitis A infection
- use of recreational drugs
- travelling to areas of high endemicity without being immunized.
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Symptoms Of Hepatitis A
Not everyone who is infected will have symptoms. Symptoms are more likely to occur in adults than in children.
Symptoms of hepatitis A include:
- fever
- stomach cramps or abdominal pain
- jaundice
After you have been exposed to hepatitis A, symptoms:
- typically appear 14 to 28 days later
- may occur up to 50 days later
Symptoms usually last less than 2 months.
Symptoms may be:
- mild and last only 1 or 2 weeks
- severe and last up to 9 months
Treatment: Chronic Hepatitis C
The latest drug to be approved by the FDA is glecaprevir and pibrentasvir . This medication offers a shorter treatment cycle of 8 weeks for adult patients with all types of HCV who donât have cirrhosis and who have not been previously treated. The length of treatment is longer for those who are in a different disease stage. The prescribed dosage for this medicine is 3 tablets daily.
There are several other combination drugs available, as well as some single drugs that may be used in combination. Your doctor will choose the right one for you depending on the type of hepatitis C you have, how well your liver is functioning and any other medical problems you may have. Also be sure to discuss your insurance coverage since these medications are expensive.
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Symptoms Of Infection With Hepatitis C
Symptoms of acute infection with hepatitis C
Acute infection is the period when you first contract the virus, during this period most people do not seem to experience any noticeable symptoms.
For the 25-35% of people who do, the symptoms are normally vague and non-specific.They can include: Abdominal pain Nausea and vomiting
About 20% of the people who develop symptoms experience jaundice. This can be seen in the yellowing of the skin and eyes. This is a sign of the livers functions being affected as bilirubin begins to build up in the body. Jaundice is a recognised sign of liver problems and may lead to a test for hepatitis C being suggested.The problem for most people is that they are unaware that they have been infected because of the lack of symptoms. As these symptoms are similar to many other short term infections most people are unlikely to seek medical attention.
And even when they do, most doctors will not necessarily suspect or test for hepatitis C.
Symptoms of chronic infection with hepatitis C
Chronic infection doesn’t mean that you have symptoms, chronic means that the infection is ongoing, that you are living with the virus.
The hepatitis C virus is associated with a wide spectrum of liver disease. This ranges from minor inflammation to cirrhosis, and in certain cases liver cancer.
Chronic fatigue
Pains in the upper part of the abdomen
Dry eyes, irritable bowel and irritable bladder
Do not assume that all of your aches and pains are related to hepatitis.
Who Should Be Vaccinated For Hepatitis B
All newborns should be vaccinated. Also, people who are under 18 who were not vaccinated at birth should also get the vaccine. Other groups who should be sure to be vaccinated are those in certain high-risk categories, such as:
- People who have more than one sexual partner.
- Men who have sex with men.
- Adults with diabetes.
- Sexual partners of infected people and people who share households with infected individuals.
- People who are exposed to blood and other bodily fluids, including healthcare and public safety professionals, and people who work in jails and other places taking care of people who cant take care of themselves.
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How Does Hepatitis B Spread
Persons infected with hepatitis B can pass the virus to others through blood or body fluids. In the U.S., the most common way of becoming infected is through unprotected sex, although sharing an infected person’s needles to inject illicit drugs also is quite common. Less common ways are by contaminated razors or toothbrushes. As previously mentioned, hepatitis B is passed from infected mother to infant in over 90% of cases.
What Are The Treatments For Hepatitis
Treatment for hepatitis depends on which type you have and whether it is acute or chronic. Acute viral hepatitis often goes away on its own. To feel better, you may just need to rest and get enough fluids. But in some cases, it may be more serious. You might even need treatment in a hospital.
There are different medicines to treat the different chronic types of hepatitis. Possible other treatments may include surgery and other medical procedures. People who have alcoholic hepatitis need to stop drinking. If your chronic hepatitis leads to liver failure or liver cancer, you may need a liver transplant.
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How Does Hepatitis A Spread
Hepatitis A is spread from person to person via fecal contamination because the virus is present in the stool. It is spread via contaminated food or water by an infected person who gets small amounts of stool on his or her hands, does not wash his or her hands, and passes the stool onto food that is eaten by others. An example of this is outbreaks of hepatitis A in daycare centers for young children when employees don’t wash their hands after changing diapers, and they then pass the viruses to the next child they feed. In addition, fecal contamination of water in which shellfish live can contaminate the shellfish, and the shellfish can pass the virus to people who eat the shellfish raw.
How Is Hepatitis Diagnosed
Chronic hepatitis can quietly attack the liver for years without causing any symptoms. Unless the infection is diagnosed, monitored, and treated, many of these people will eventually have serious liver damage. Fortunately, blood tests can determine whether you have viral hepatitis, and if so, which kind.
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Chronic Hepatitis B Treatment
For hepatitis B, treatment is aimed at controlling the virus and preventing damage to the liver. Antiviral medications are available that will benefit most people, but the medications need to be chosen carefully, and the treatment needs to be monitored in order to assure successful treatment and to prevent or treat medication-related side effects. For some individuals, the risks of treatment may not be justified.
When To See Your Doctor
Always check with your doctor if you have any of the signs of hepatitis. If you don’t get treatment it can lead to cirrhosis, a serious scarring of your liver.
Also make an appointment if a friend or member of your family comes down with the disease. There’s a risk you could get infected, too.
Be on the lookout for symptoms of hepatitis if you travel to a country where the disease is common. Call your doctor if you think you’re showing any signs.
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History And Physical Exam
To diagnose hepatitis, first your doctor will take your history to determine any risk factors you may have for infectious or noninfectious hepatitis.
During a physical examination, your doctor may press down gently on your abdomen to see if theres pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam.
What Is The Outlook For Hepatitis
Hepatitis A and E usually only cause short-term infections that your body can overcome. The others can also cause acute infections, but might also cause chronic infections. The chronic forms are more dangerous. Hepatitis non-E is usually acute, but can become chronic.
Most people recover fully from hepatitis even though it might take several months for the liver to heal. To help improve your health and to help speed up your recovery:
- Avoid alcohol.
- Practice good nutrition.
- If you feel sick, rest.
- Talk to your healthcare provider about your medicines, even over-the-counter drugs or vitamins and supplements, to know which ones you should take and which to avoid until you are recovered.
With hepatitis, your healthcare provider will also be looking for long-term damage to the liver in the forms of cirrhosis or liver failure. You may be asked to take other types of tests, such as liver function tests, imaging tests or possibly a liver biopsy.
If you have questions, new symptoms, or worsening of any existing symptoms, you should call the office of your healthcare provider.
In the U.S., A, B and C are the most common viral forms of hepatitis. It doesnt matter how you were infectedwhat matters is taking care of yourself once you have been diagnosed and taking care not to spread the infection to anyone else.
Last reviewed by a Cleveland Clinic medical professional on 01/06/2020.
References
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Treatment For Chronic Hbv Infection
For chronic HBV infection, antiviral medications are available.
This is not a cure for chronic HBV. However, it can stop the virus from replicating and prevent its progression into advanced liver disease.
A person with a chronic HBV infection can develop cirrhosis or liver cancer rapidly and without warning. If a person does not have access to adequate treatment or facilities, liver cancer can be fatal within months of diagnosis.
People with a chronic HBV infection require ongoing medical evaluation and an ultrasound of the liver
Getting Tested Is The Only Way To Know If You Have Hepatitis C
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C viruseither recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
- Are 18 years of age and older
- Are pregnant
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Have abnormal liver tests or liver disease
- Are on hemodialysis
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What Is Acute Fulminant Hepatitis
Rarely, individuals with acute infections with HAV and HBV develop severe inflammation, and the liver fails . These patients are extremely ill with the symptoms of acute hepatitis already described and the additional problems of confusion or coma , as well as bruising or bleeding . In fact, up to 80% of people with acute fulminant hepatitis can die within days to weeks therefore, it is fortunate that acute fulminant hepatitis is rare. For example, less than 0.5% of adults with acute infection with HBV will develop acute fulminant hepatitis. This is even less common with HCV alone, although it becomes more frequent when both HBV and HCV are present together.
What Are The Symptoms Of Chronic Hepatitis B
About 1 in 20 people who get hepatitis B as adults become carriers, which means they have a chronic hepatitis B infection. Carriers are more likely to pass hepatitis B to other people. Most carriers are contagious meaning they can spread hepatitis B for the rest of their lives.
Hepatitis B infections that last a long time may lead to serious liver diseases like cirrhosis and liver cancer. About 1 in 5 people with chronic hepatitis B die from it. There are medicines that can help treat chronic hepatitis B infections.
Most babies who get hepatitis B develop chronic infection, unless they get treated right away. But treatments almost always work if your baby gets them quickly. Thats why its important for pregnant people to get tested for hepatitis B.
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What Is Chronic Viral Hepatitis
Patients infected with HBV and HCV can develop chronic hepatitis. Doctors define chronic hepatitis as hepatitis that lasts longer than 6 months. In chronic hepatitis, the viruses live and multiply in the liver for years or decades. For unknown reasons, these patients’ immune systems are unable to eradicate the viruses, and the viruses cause chronic inflammation of the liver. Chronic hepatitis can lead to the development over time of extensive liver scarring , liver failure, and liver cancer. Liver failure from chronic hepatitis C infection is the most common reason for liver transplantation in the U.S. Patients with chronic viral hepatitis can transmit the infection to others with blood or body fluids as well as infrequently by transmission from mother to newborn.
How Common Is Hepatitis B
Hepatitis B is fairly common in Africa and the western Pacific region. Throughout the world, there are about 292 million people who are infected with chronic hepatitis B. In the U.S., the figure exceeds 2 million people.
The number of infections had been falling in the U.S., but fewer vaccinations among adults combined with the onset of the opioid crisis and injected drug usage has resulted in the numbers rising again. Infected women can pass the infection on to their babies. Children who are infected before age 5 are more likely to have chronic infection than those infected later in life.
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Chronic Hepatitis C Treatment
Treatment of chronic hepatitis C has evolved, rendering many earlier drugs obsolete. The drugs currently used include pegylated interferon, ribavirin, elbasvir, grazoprevir, ledipasvir, sofosbuvir, paritaprevir, ritonavir, ombitasvir, dasabuvir, simeprevir, daclatasvir. These are always used in various combinations, never alone. Interferon is given by injection while the other medications are pills. Studies have shown that combinations of these drugs can cure all but a small proportion of patients however, serious side effects of treatment can occur.
Treatment options need to be discussed with a knowledgeable physician, as the appropriate combination is dependent upon multiple factors. These include genotype , prior treatment and results, drug intolerances, presence of compensated liver disease or uncompensated cirrhosis, presence of HIV co-infection, other complicating conditions and liver transplantation.
Chronic Hepatitis C Symptoms
If you donât get diagnosed and treated, you could have the disease for years and not know it. Doctors call this the chronic form, because it lasts a long time. Some people who’ve had it for a while get scarring of the liver, which is called cirrhosis. or liver cancer.
In addition to the above symptoms, signs that your liver isnât working the way it should include:
- Ascites — fluid buildup in your belly
- Easy bleeding
- Hepatic encephalopathy — confusion, drowsiness, and slurred speech
- Jaundice of the skin
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How Is Hepatitis B Spread
You can become infected with hepatitis B through exposure to blood, semen and other bodily fluids of an infected person. You can get the infection by:
- Having unprotected sex.
- Sharing or using dirty needles for drug use, tattoos or piercing.
- Sharing everyday items that may contain body fluids, including razors, toothbrushes, jewelry for piercings and nail clippers.
- Being treated medically by someone who does not use sterile instruments.
- Being bitten by someone with the infection.
- Being born to a pregnant woman with the infection.
Hepatitis B is not spread by:
- Kissing on the cheek or lips.
- Coughing or sneezing.
- Hugging, shaking hands or holding hands.
- Eating food that someone with the infection has prepared.
- Breastfeeding.
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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