Hepatitis

What is Hepatitis?

Hepatitis A

HAV is a liver disease caused by the hepatitis A virus. In the United States, HAV can occur in situations ranging from isolated cases of disease to widespread epidemics. Good handwashing and proper sanitation can help prevent spread. Vaccines are also available for long-term prevention of HAV infection in persons 2 years of age and older. Immune globulin is available for short-term prevention of hepatitis A.

Hepatitis B

HBV is a serious disease caused by a virus that attacks the liver. HBV can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. HBV can affect anyone. Each year in the United States, more than 200,000 people of all ages get hepatitis B and close to 5,000 die of sickness caused by HBV. If you have had other forms of hepatitis, you can still get hepatitis B. Vaccines are available for long-term protection of HBV infection. Hepatitis B immune globulin is available for post exposure protection.

Hepatitis C

HCV is a liver disease caused by the hepatitis C virus, which is found in the blood of persons who have this disease. HCV is serious for some persons, but not for others. Some do not feel sick from the disease. Most persons who get HCV carry the virus for the rest of their lives and have some liver damage. Others may develop cirrhosis (scarring) of the liver and liver failure, but this process can take many years.

How can I get it?

Hepatitis A

• Eating raw shellfish harvested from sewage-contaminated water
• Swallowing contaminated water or ice
• Eating fruits, vegetables, or other food that may have become contaminated during handling
• Use of street drugs

HAV is found in the stool of persons with hepatitis A. HAV can affect anyone, and is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person infected with hepatitis A. HAV can spread in areas where there are poor sanitary conditions or where good handwashing is not observed. Persons with HAV can spread it to household members or sexual partners.

A person can spread HAV about one week before symptoms appear and during the first week of symptoms. Persons with no symptoms can still spread the virus. This often happens with young children who unknowingly spread HAV to older children and adults.

Casual contact as in the usual office, factory or school setting, does not spread the virus.

Hepatitis B

• Direct contact with the blood or body fluids of an infected person
• Having sex or sharing neeedles with an infected person
• Use of street drugs
• Exposure to your infected mother at birth

Women who are infected with HBV can give it to their babies. Babies who get HBV at birth may have the virus for the rest of their lives. They can spread the disease and get cirrhosis of the liver or liver cancer.

Sometimes, people who are infected with HBV never recover fully from the infection. They can remain infectious for the rest of their lives. In the United States, about one million people carry HBV.

HBV is not spread through food or water or by casual contact.

Hepatitis C

• Use of tatoo or body piercing tools contaminated with someone else's blood
• The artist or piercer not following good health practices, including handwashing and using disposable gloves
• Sexual contact with multiple partners
• Use of street drugs

The infection is spread by contact with the blood of an infected person. Almost 4 million Americans are infected with the Hepatitis C virus.

Hepatitis C virus is not spread by:

• Breast feeding
• Sneezing
• Hugging
• Coughing
• Food or water
• Sharing eating utensils or drinking glasses
• Casual contact

Who is at risk?

Hepatitis A

You are at risk if you:

• Have household or sexual contacts with someone who has HAV
• Travel to countries where HAV is common and where clean water and proper sewage disposal are not available
• Are a man who has sex with men
• Use street drugs
• Work in child care centers (especially settings that have children in diapers)
• Live or work in an institution for developmentally disabled persons
• Work in research laboratory setting (excluding laboratories doing routine testing) and handle HAV-infected non-human primates
• Receive factor concentrates for clotting factor disorder

Hepatitis B

You are at risk if you:

• Have sexual contact with an infected person
• Have multiple sex partners
• Are a man who has sex with men
• Have household contact with someone who has chronic HBV infection
• Work with human blood products
• Shoot street drugs
• Live or work in a home for the developmentally disabled
• Have hemophilia
• Travel to areas where HBV is common
• Your parents were born in Southeast Asia, Africa, the Amazon Basin in South America, the Pacific Islands and the Middle East

One out of 20 people in the United States will get HBV at some time if not vaccinated.

Hepatitis C

You are at risk if you:

• Ever injected street drugs, even if you experimented a few times many years ago
• Were treated for clotting problems with a blood product made before 1987
• Received a blood transfusion or solid organ transplant (e.g. kidney, liver, heart) before July 1992, or you were notified that you received blood that possibly contained HCV
• Were ever on long-term kidney dialysis

Many people who are at risk for HCV are at risk for hepatitis A and hepatitis B. Check with your doctor to see if you should get hapatitis A and B vaccines.

Could I already have hepatitis C?
Ask your doctor for a blood test for hepatitis C.

Symptoms

Hepatitis A

Three of every four adults who get HAV have symptoms that usually develop over a period of several days. Children who are infected often have no symptoms.

If you have symptoms:

• Your eyes may turn yellow and you may have dark urine
• You may be tired
• You may lose your appetite
• You may have nausea, vomiting, fever, or stomach ache

Unlike HBV and HCV, HAV causes no long-term liver damage, and usually does not cause death. There is no chronic carrier state with HAV. Having had the disease produces lifelong immunity from future HAV infection.

Hepatitis B

You may have hepatitis B (and be spreading the disease) and not know it; sometimes a person with HBV infection has no symptoms at all.

If you have symptoms:

• Your eyes or skin may turn yellow
• You may lose your appetite
• You may have nausea, vomiting, fever, stomach or joint pain
• You may feel extremely tired, and not be able to work for weeks or months

Hepatitis C

Most people have no symptoms until the disease is very advanced. Fatigue is most common. Only 25%-30% develop malaise, weakness, or anorexia and some develop jaundice. Fulminant hepatitis with liver failure following acute HCV infection has been reported but is rare.

Why should I be tested for hepatitis C?
Early diagnosis is important so you can:

• Be checked for liver disease
• Get treatment, if indicated. Drugs are licensed for the treatment of persons with long-term hepatitis C.
• Learn how you can protect your liver from further harm
• Learn how you can prevent spreading HCV to others

Prevention

Hepatitis A

Always wash your hands after using the bathroom, changing a diaper, and before eating or preparing food.

Hepatitis A vaccines provide long-term protection against hepatitis A and are licensed for use in persons 2 years of age and older. Children and adults need two shots of hepatitis A vaccine for long-term protection.

Who should receive hepatitis A vaccine?

• Persons who work in or travel to areas where hapatitis A is common (first dose should be given at least 4 weeks before travel)
• Children in communities with high rates of hepatitis A, such as Alaska Native villages, American Indian reservations, and Pacific Islanders and selected religious communities
• Men who have sex with men
• Persons who use street drugs
• Persons with chronic liver disease
• Persons with clotting factor disorders, such as hemophelia
• Persons with HAV-infected non-human primates or work with HAV in a research setting (hepatitis A vaccine is not generally recommended for health care workers)
• Anyone who wants protection

Hepatitis A is preventable. Get vaccinated!

Hepatitis B

Hepatitis B vaccine is the best protection against HBV. Three doses are needed for complete protection.

Who should get vaccinated?

• All babies, beginning at birth, should get hapatitis B vaccine
• All children and adolescents who have not been vaccinated
• Persons of any age whose behavior puts them at a high risk for HBV infection
• Persons whose jobs expose them to human blood

All pregnant women should be tested for HBV early in their pregnancy. Children born to HBV positive mothers should receive vaccine along with hepatitis B immune globulin (called H-BIG) at birth. The vaccine series should be completed during the first 6 months of life.

There is no cure for HBV; this is why prevention is so important. Hepatitis B is preventable. Get vaccinated!

Hepatitis C

An ounce of prevention is worth a pound of cure!

• Don't ever shoot drugs. If you shoot drugs, stop and get into a treatment program. If you can't stop, never reuse or share syringes, water, or drug works, and get vaccinated against hepatitis A and hepatitis B.
• Do not share toothbrushes, razors, or other personal care articles.
• Health care workers should always follow routine barrier precautions and safely handle needles and other sharps.
• Get vaccinated for HBV.
• Consider the health risks if you are thinking about getting a tatoo or body piercing.
• Use latex condoms correctly and every time.
• The surest way to prevent the spread of any disease by sex is not to have sex at all.

There is no vaccine to prevent hepatitis C.

Adapted from:

Minnesota Department of Health, Acute Disease Prevention and Control materials;
Hepatitis A and Hepatitis B brochure, August 1999.
Centers for Disease Control and Prevention materials, Hepatitis C brochure, October 1998.

More Information:

• Call the Hepatitis Hotline at 1-888-443-7232
• Visit the Center for Disease Control and Prevention web site.
• Visit the Minnesota Department of Health web site.