How Hepatitis B Is Spread
The hepatitis B virus is found in the blood and bodily fluids, such as semen and vaginal fluids, of an infected person.
It can be spread:
- from a mother to her newborn baby, particularly in countries where the infection is common
- within families in countries where the infection is common
- by having sex with an infected person without using a condom
- by having a tattoo, body piercing, or medical or dental treatment in an unhygienic environment with unsterilised equipment
Hepatitis B is not spread by kissing, holding hands, hugging, coughing, sneezing or sharing crockery and utensils.
How Are Hepatitis B And C Transmitted
A key difference between hepatitis B and C is the way they are transmitted. Hepatitis B is typically transmitted through the exchange of bodily fluids like blood and semen, while Hepatitis C can only be transmitted through blood-to-blood contact.
This means that needle sharing is a big problem for the spread of both of these viruses, especially since most people are symptomless and dont know that they’re infected.
Hepatitis C is much more limited in how it can be spread. By contrast, hepatitis B can be spread several ways, including:
- Birth: can be transmitted to a newborn during childbirth.
- Sex: can be transmitted to or contracted from a partner through intercourse.
- Sharing Items of Personal Hygiene: can be transmitted to or contracted from anyone through the use of items like razors and toothbrushes.
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.
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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.
Hbv Genotypes And Their Geographical Distribution
HBV genotype plays a significant role in the clinical outcome following viral-host interaction. There are 10 different genotypes of HBV , that determine the liver disease clinical progression, prognosis, and the response to antiviral therapy. Genotypes A, B, C, D, and F are associated with rapid progression to cirrhosis and hepatocellular carcinoma. The HBV genotypes A and B are commonly isolated in acute HBV infected individuals .
The HBV genotypes geographical distribution varies from one genotype and subtype to the other. The variations in the HBV genotype distributions are related to mode and route of transmission, where vertical transmissions are associated with genotypes B and C . The HBV genotype A is prevalent in Africa, and North Europe genotypes B and C are widespread in Asia genotype D is also common in Africa, some parts of Europe, and Asia genotype E is predominantly in West and Central Africa genotype F is common in America genotype G is common in Western countries genotype H is found in Central and South America genotype I was reported in Vietnam and Laos while genotype J was reported in Japan .
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Acute And Chronic Hepatitis C
Hepatitis C can be either acute or chronic:
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
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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.
How To Prevent Hepatitis B
Hepatitis B is a liver infection caused by a virus . It can be serious and theres no cure, but the good news is its easy to prevent. You can protect yourself by getting the hepatitis B vaccine and having safer sex. If you have oral, anal, and vaginal sex, use condoms and dental dams to help stop the spread of hepatitis B and other STDs.
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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.
Determine The Dominant Virus To Be Treated
Active hepatitis C is found in at least 50% of dually infected patients 11. Moreover, HCV can be successfully eradicated in at least 50% of patients with chronic HCV mono-infection using combination therapy of Peg-IFN and RBV worldwide 3. Therefore, HCV seems to be the priority target to be managed in dually infected patients with active hepatitis C.
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What Is Hepatitis C
Hepatitis C is a liver infection that can result in severe liver damage. According to the Centers for Disease Control and Prevention , viral hepatitis is usually caused by a virus, but it may also be caused by excessive alcohol use, pollutants, some medicines, and certain medical diseases. It affects around 2.4 million individuals in the United States. The majority of individuals are uninformed of it because it has few symptoms. The virus is spread by an infected persons blood or body fluids.
Living With Hepatitis B Or C
Taking care of yourself
Its important to take care of yourself if you have hepatitis B or C. Hepatitis stops the liver from working properly and there are things you can do to reduce the amount of work your liver has to do:
- cut back on alcohol
Talk to your doctor or nurse for advice.
Telling others
You do not have to tell others if you have hepatitis B or C. But you do need to do everything you can to prevent spreading the disease to others see below for more information. Letting your sexual and household contacts know that you the disease means they can get tested to see if they have caught it. They can also be vaccinated against hepatitis B.
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Who Should Be Tested For Hepatitis
Testing is important for anyone with the risk factors we’ve mentioned, particularly injected drug users and people who have had multiple sex partners. Health advocates are also urging people of Asian heritage to get tested. Stanford University’s Asian Liver Center estimates that 1 in 10 Asians living in the U.S. has chronic hepatitis B. Many of them have probably had the virus since birth.
Also, the U.S. Preventive Services Task Force recommends that health care providers offer a one-time hepatitis C screening for anyone born between 1945 and 1965.
Serological And Molecular Markers Of Hbv And Hcv Infections
Table 1. Detectable serological and molecular markers of HBV and HCV infection.
HCV is initially diagnosed through serology by the use of an enzyme immunoassay which typically detects anti-HCV in serum or plasma . Primary serological results are normally confirmed by an orthogonal immunoassay approach, an immunoassay signal to cutoff ratio or by use of molecular tools such as nucleic acid amplification tests using polymerase chain reaction to detect the HCV RNA . As a positive antibody test alone cannot differentiate acute from chronic HCV infection , laboratory diagnosis of acute HCV infection is aided by observed seroconversion, or a positive test for viral detection in a seropositive case not previously reported, consistent with epidemiological risk and exposure history.
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How Can You Prevent Hepatitis B And Hepatitis C
Hepatitis B: Vaccination is the best way to prevent all of the ways that hepatitis B is transmitted. People with HIV who do not have active HBV infection should be vaccinated against it. In addition to the 3-dose series of hepatitis B vaccine given over 6 months, as of 2017, there is a 2-dose series given over 1 month.
Hepatitis C: No vaccine exists for HCV and no effective pre- or postexposure prophylaxis is available. The best way to prevent hepatitis C infection is to never inject drugs or to stop injecting drugs by getting into and staying in drug treatment. If you continue injecting drugs, always use new, sterile needles or syringes, and never reuse or share needles or syringes, water, or other drug preparation equipment.
The Hepatitis B Vaccine
The first version of the hepatitis B vaccine was approved by the Food and Drug Administration in 1981. Since the early 1990s, the World Health Organization has recommended that all countries add the vaccine to their public immunization plans.
Several types of approved hepatitis B vaccines are available, including one suitable for people of all ages, from infants to adults. The Center for Disease Control recommends that everyone under age 19 get the vaccine, with infants receiving the first dose at birth. The agency also recommends that most adults get the vaccine, especially those who:
- have sexual or common household contact with someone with hepatitis B
- have more than one sexual partner
- have experienced sexual abuse
- are likely to be in contact with blood and bodily fluids at work
- have other liver conditions, including hepatitis C
- are being treated for sexually transmitted diseases, including HIV
The most common version of the vaccine requires three separate doses. There’s also a version that the FDA approved for adults that only requires two doses.
You can get the hepatitis B vaccine at the same time as other vaccines. You’ll never catch hepatitis B from the vaccine.
Combination vaccines also exist that protect against both hepatitis A and B. Once you’re vaccinated against hepatitis B, you should be immune for the rest of your life and won’t need a booster.
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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.
Are Hepatitis B And C Preventable
Hepatitis B is a vaccine-preventable disease.
There is a three-shot vaccination series that is very effective in protecting people against the virus if theyre exposed. In the United States, all newborns are vaccinated for hepatitis B and all pregnant women are screened for hepatitis B during pregnancy. This way, mothers infected with hepatitis B can take protective steps to decrease the risk of transmission of the virus to the child.
There is no vaccine for hepatitis C.
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Treatment Of Hepatitis C In Dual Hcv/hbv Patients With Active Hepatitis C By Peg
In the treatment of patients with HCV mono-infection, Peg-IFN in combination with RBV remains the standard of care in many Asian Pacific countries. Our multicenter trial data demonstrated the efficacy of treatment of dually infected patients through Peg-IFN plus RBV 8: for genotype 1 infection, HCV SVR rate was 72.2% in dually infected patients and was 77.3% in mono-infected patients for genotype 2/3 infections, SVR rate was 82.8% in dually infected patients and 84.0% in mono-infected patients.
Durability of HCV responses post-treatment
Hepatitis C virus may reappear in 0.9~10% of chronic hepatitis C mono-infected patients achieving initial HCV SVR. To clarify this issue, the durability of HCV SVR in the dually infected patients was investigated by a 5-year follow-up study 9. Our results revealed that after a median follow-up of 4.6± 1.0 years, only 6 of the 232 patients achieving SVR developed HCV RNA reappearance. Our data suggested that the HCV SVR was durable in dually infected patients receiving Peg-IFN alfa and ribavirin combination therapy.
Clearance of HBsA and HBV reactivation
HBsAg clearance at 6 months after end of therapy was found in 18 of the 161 dually infected patients. During 5-year post-treatment follow-up, the rate of HBsAg seroclearance was 5.4% per year, reaching 30% at the end of follow-up 9,12.
Improvement of long-term outcomes post-treatment
Hepatitis A: Who Is At Risk
A prime risk factor for hepatitis A is traveling to or living in a country with high infection rates. You can check the CDC’s travel advisories to learn about recent outbreaks. Eating raw foods or drinking tap water can raise your risk while traveling. Children who attend daycare centers also have a higher risk of getting hepatitis A.
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When To Get Medical Advice
Hepatitis B can be serious, so you should get medical advice if:
- you think you may have been exposed to the hepatitis B virus emergency treatment can help prevent infection if given within a few days of exposure
- you have symptoms associated with hepatitis B
- you’re at a high risk of hepatitis B high-risk groups include people born in a country where the infection is common, babies born to mothers infected with hepatitis B, and people who have ever injected drugs
You can go to your local GP surgery, drug service, genitourinary medicine clinic or sexual health clinic for help and advice.
A blood test can be carried out to check if you have hepatitis B or have had it in the past.
The hepatitis B vaccine may also be recommended to reduce your risk of infection.
You Can Have It And Not Know It
What is hepatitis B?
Hepatitis B is a liver disease caused by the hepatitis B virus . HBV is far more infectious than HIV and can be prevented by a vaccine. People who have not been vaccinated may be at risk of getting infected.
About 95 percent of adults will recover within 6 months of becoming infected and as a result will develop lifelong protection against it. The remaining 5 percent are unable to clear the virus and will become chronically infected. Chronic hepatitis B infection is treatable.
It is estimated that less than 1 percent of Canada’s population is infected with either acute or chronic HBV. People who are infected before the age of 7 are at a higher risk of developing chronic infection. In 2011, the overall reported rate of acute hepatitis B infection in Canada was 0.6 reported cases per 100,000 people living in Canada.
Why is hepatitis B a health concern?
Many people infected with HBV do not know they have the virus because symptoms can take two to six months to appear and only about 50 percent of people develop symptoms. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. Potential complications from chronic HBV infection include cirrhosis of the liver, liver failure, liver cancer and premature death.
Why do I need my liver?
How is hepatitis B spread?
HBV is spread through contact with infected blood and body fluids including semen and vaginal fluid.
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