Who Is At Risk For Hepatitis B
Although unprotected sex is the most common way of becoming infected with hepatitis B, infection is more likely for people who have multiple sex partners. Shared needles also are an important means of spreading hepatitis B. Other risk factors are being a health care worker, but infection usually is related to needle sticks. There also is a risk of becoming infected by living with someone who has chronic hepatitis B, in part due to sexual transmission.
Hepatitis B: What Happens
Many adults who get hepatitis B have mild symptoms for a short time and then get better on their own. But some people are not able to clear the virus from the body, which causes a long-term infection. Nearly 90% of infants who get the virus will carry it for life. Over time, hepatitis B can lead to serious problems, such as liver damage, liver failure, and liver cancer.
Common Symptoms Of Hepatitis
If you are living with a chronic form of hepatitis, like hepatitis B and C, you may not show symptoms until the damage affects liver function. By contrast, people with acute hepatitis may present with symptoms shortly after contracting a hepatitis virus.
Common symptoms of infectious hepatitis include:
It is crucial to understand what is causing hepatitis in order to treat it correctly. Doctors will progress through a series of tests to accurately diagnose your condition.
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How Is It Treated
Hepatitis A is treated using supportive methods. These can include things like rest, fluids, and healthy foods. Medications can also help to ease some symptoms like fever, aches, and pains.
Theres a vaccine available to protect against infection with HAV. This is typically recommended for children as well as for people at an increased risk for contracting the virus.
Also, receiving a single dose of the hepatitis A vaccine may prevent you from becoming ill if youve been exposed to HAV. For it to be effective, the vaccine needs to be given of exposure.
How Are Hepatitis B And C Treated
Hepatitis B: Not all patients with chronic hepatitis B infection require treatment. At Yale Medicine, specialists decide on an individual basis whether a patient is an appropriate candidate for treatment. Generally, patients require treatment when their hepatitis B virus level is high, and when laboratory tests demonstrate significant inflammation or injury to the liver.
There are currently seven approved drugs for hepatitis B, two of which are considered to be first-line treatments. These drugs are oral pills taken once daily, and while they’re very effective at suppressing the virus to very low or undetectable levels over the long term, they are not considered curative.
Therefore, the goal of treatment is to control the virus long-term and decrease the risk of hepatitis B related complications such as cirrhosis and liver cancer.
Hepatitis C: For the greater part of the last 20 years, treatment of hepatitis C required the use of a chemotherapy-like injection drug called interferon, which has been associated with serious side effects and a low cure rate. Fortunately, advances in hepatitis C treatments within the last three years now allow for the use of oral medications that are significant improvements in terms of safety and effectiveness.
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What Is The Outlook
Most people with hepatitis A recover without any complications. Once youve had hepatitis A, you cant get it again. Antibodies to the virus will protect you for life.
Some people may be at an increased risk for serious illness from hepatitis A. These include:
- older adults
acute hepatitis B infections in the United States in 2018.
Parenteral Routes: Transmission Of Hepatitis B Hepatitis D And Hepatitis C
Hepatitis B, C, and D viruses are all transmitted by what is known as the parenteral route. Parenteral simply means that these viruses can be introduced by all routes except through the intestinal tract, which leaves the door wide open in terms of possible exposure. Let’s look at the possible transmission routes for each of these types of hepatitis virus more closely.
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Testing Treating And Reducing Risk Of Hepatitis
If you think youre at risk for hepatitis infection, talk to your healthcare provider about getting tested. A blood test is usually done to see if you have been exposed to the virus. Women who are pregnant or trying to become pregnant should get tested for hepatitis.
Get treated for hepatitis infection
There are treatments for hepatitis. Treating long-lasting hepatitis B or C infection can reduce the amount of the virus in a person, which may lower the risk of liver cancer.
Chronic Hepatitis B And C
Most people with hepatitis B clear the virus from their bodies as they get better. But some dont clear the virus these people have chronic hepatitis B. Some people with chronic hepatitis B stay well for a long time and then get very sick many years later. People with chronic hepatitis B can spread the virus to others even if they do not look or feel sick.
Many people with chronic hepatitis C have no symptoms and dont know they have the disease. However, because the virus is in their bodies, they can spread it to other people. Chronic hepatitis C is a long term illness that can lead to serious liver problems, including scarring of the liver or liver cancer.
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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.
Clinical Outcomes Of Dual Chronic Hepatitis C And B Are Usually Worse
Several hospital or community-based studies demonstrated that in patients co-infected with chronic hepatitis C and B, the disease outcomes are usually worse than those with either chronic HCV or HBV infection 1-7. Patients with HCV/HBV co-infection may exhibit various fluctuating virological profiles basically HCV and HBV can alternate their dominance during long-term follow-up. In Italy, a longitudinal follow-up study revealed the patterns and dynamics of virological dominance in these cases 11. Of 103 untreated HBV/HCV coinfected patients, active infection with HBV and HCV was revealed in 24 cases, inactive infection of both viruses was seen in 15 cases, active HBV and inactive HCV infection was seen in 15 cases, and active HCV and inactive HBV infection was found in 49 cases. During one year follow-up, fluctuation of HBV and/or HCV viremia levels was documented in 32 subjects . Based on these findings, careful evaluation of serum HBV DNA and HCV RNA levels is essential before the diagnosis of the viral dominance which will influence the therapeutic strategies in the co-infected patients.
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How To Reduce Your Risk
Dont share needles or other drug-use equipment. If you use intravenous drugs, take part in a needle exchange program.
Dont share personal care articles, such as razors, scissors, nail clippers or toothbrushes, with an infected person.
If you get a tattoo, body piercing or acupuncture, make sure all equipment is clean and sterile. Needles should always be new, not used, and never homemade.
Wear latex gloves whenever you might come into contact with someone elses blood or body fluids.
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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How Do You Get Hepatitis C
Hepatitis C is only contracted through contact with another person who is infected with the hepatitis C virus . It is not acquired through contact with animals or insects.
Hepatitis C is present primarily in the blood, and to a lesser degree in specific other body fluids, of an infected person. Today, it is passed most commonly through the sharing of used needles by injection drug users. Prior to 1990, it was commonly passed through blood transfusions. However, since 1990, all donated blood is tested for hepatitis C virus, so it is extremely rare for hepatitis C to be acquired through a blood transfusion.
Transmission of hepatitis C occasionally occurs in healthcare settings, such as hospitals and clinics, when established infection control protocols are not followed. Health care professionals who do not follow these protocols can become infected if they sustain a needle stick from a patient who carries hepatitis C virus.
While uncommon, one mode of transmission is through organ transplantation when the donated organ comes from a person who carries the hepatitis C virus. The use of HCV-positive organs is currently reserved for the most serious cases requiring transplantation.
How Does Hepatitis C Spread?
Tattooing and body piercing have been documented to transmit the hepatitis C virus when recommended sterilization and infection control procedures are not followed.
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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.
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How Serious Is It
- People can be sick for a few weeks to a few months
- Most recover with no lasting liver damage
- Although very rare, death can occur
- 15%25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
- More than 50% of people who get infected with the hepatitis C virus develop a chronic infection
- 5%-25% of people with chronic hepatitis C develop cirrhosis over 1020 years
About Jaundice And Jaundice Hepatitis Difference
Jaundice is a condition in which the below organs turn yellow:
- Skin
- Sclera and
- Mucous membranes.
This yellow color is caused by a high level of bilirubin which is a yellow-orange bile pigment. Liver secretes a fluid called bile.
Jaundice has many causes. These may include hepatitis, gallstones and tumors. The difference between jaundice and hepatitis therefore lies in the fact that jaundice can be caused by hepatitis.
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Recommendations For Frequency Of Repeat Testing In An Asymptomatic Patient
The frequency of testing depends on the history of sexual exposure and number of sexual partners. However, in the case of hepatitis A and B, once the patient has completed a course of vaccination no further repeat testing is required.
For those at continuing risk and who have not received a course of vaccination, the following is recommended.
What Is The Treatment For Hepatitis
Each type of hepatitis is treated differently.
Hepatitis A often goes away on its own and home treatment is all that is needed to help the liver recover, such as:
- Rest
- Avoiding alcohol
- Avoiding certain medicines that can be harmful to the liver
Hepatitis B often goes away on its own in about 6 months, and can also be treated at home with the above remedies. Other treatments for hepatitis B include:
- Antiviral medications
- Liver transplant in severe cases
Treatment for hepatitis C is effective on certain forms of the hepatitis C virus. The choice of medications depends on the type of hepatitis C you have, whether you have been treated for the illness before, how much liver damage has occurred, any other underlying medical issues, and other medicines you take. Treatment for hepatitis C usually involves 8 to 12 weeks of oral antiviral medications, such as:
- Elbasvir-grazoprevir
- Sofosbuvir-velpatasvir-voxilaprevir
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Eating Diet And Nutrition For Hepatitis B
If you have hepatitis B, you should eat a balanced, healthy diet. Obesity can increase the chance of nonalcoholic fatty liver disease , and NAFLD can increase liver damage in people who have hepatitis B. Talk with your doctor about healthy eating and maintaining a healthy weight.
You should also avoid alcohol because it can cause more liver damage.
How Can I Prevent Spreading Hepatitis B To Others
If you have hepatitis B, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they arent infected, get the hepatitis B vaccine. You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis B. Dont donate blood or blood products, semen, organs, or tissue.
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What Are The Risk Factors For Getting Hepatitis B
Due to the way that hepatitis B spreads, people most at risk for getting infected include:
- Children whose mothers have been infected with hepatitis B.
- Children who have been adopted from countries with high rates of hepatitis B infection.
- People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
- People who live with or work in an institutional setting, such as prisons or group homes.
- Healthcare providers and first responders.
- People who share needles or syringes.
- People who live in close quarters with a person with chronic hepatitis B infection.
- People who are on dialysis.
Recommendation For Test Of Cure
-
Not relevant for these infections.
-
Patients with newly diagnosed infection caused by HBV or HCV should have serological markers of infection measured 3 and 6months later to establish whether the infection has become chronic,,, .
-
Serological follow up after antiviral therapy is beyond the scope of this guideline.
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How Hcv Is Spread
The hepatitis C virus is transmitted primarily through blood to blood contact, meaning that a person can become infected with the virus should the blood of a person who carries the virus be introduced into another person’s bloodstream.
Therefore, as with hepatitis B, blood transfusions , tattooing and body piercing, occupational exposure, medical procedures, and intravenous drug use can all lead to possible exposure to the virus. Unlike hepatitis B, however, sexual contact and childbirth have both been shown to be an inefficient route of exposure to HCV.
The hepatitis G virus is thought to be transmitted in a similar way to HCV.
Who Should Be Vaccinated
Children
- All children aged 1223 months
- All children and adolescents 218 years of age who have not previously received hepatitis A vaccine
People at increased risk for hepatitis A
- International travelers
- Men who have sex with men
- People who use or inject drugs
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
Any person who requests vaccination
There is no vaccine available for hepatitis C.
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Hepatitis C: How Does It Spread
It spreads through infected blood. In the U.S., sharing needles or other items used to inject drugs is the most common cause of infection. Getting a tattoo or body piercing with an infected needle is another means of exposure. A mother may pass the virus to their child at birth. In rare cases, unprotected sex spreads hepatitis C, but the risk appears small. Having multiple sex partners, HIV, or rough sex seems to raise risk for spreading hepatitis C.
What If You Test Positive For Hepatitis
If testing discloses that you have viral hepatitis there are steps to prevent your passing the viruses to family and friends. Washing the hands helps prevent transmission of hepatitis A. Not sharing needles, razors, nail clippers, or toothbrushes also will reduce transmission of viral hepatitis. Everyone should be vaccinated against hepatitis B.
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What Happens With Hepatitis C
Is hepatitis C a virus? Yes. With acute hepatitis C, the virus is eliminated in 25% of people. The rest of the people become chronically infected and later may develop serious complications such as liver failure and liver cancer. There is treatment, however, for hepatitis C that usually can prevent the complications.