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Hepatitis - What is it?

Hepatitis is an inflammation of the liver and can cause liver damage. Viral Hepatitis is an infection of the liver caused by one of several viruses. Three types are common in the U.S.; 

Hepatitis A (HAV), Hepatitis B (HBV) and Hepatitis C (HCV).

Originally viral Hepatitis was divided into two types called infectious and serum Hepatitis. In the late 1950's, Hepatitis B was first identified and was felt to be similar to serum Hepatitis. For many years, we were only able to identify Hepatitis A and B. We knew there were other types of Hepatitis and they were called non A-non B Hepatitis. We now recognize that this is mostly caused by Hepatitis C.

 
How do you catch Hepatitis?

Hepatitis A can be transmitted by food, contaminated water and person-to-person. It is not highly infectious but one of the most common diseases of adolescence.

Hepatitis B is transmitted through contact with infected body fluids, blood, urine, saliva, seminal fluid, vaginal secretions and breast milk. It can be transmitted through sexual contact as well as through sharing of razors, toothbrushes, IV needles, tattooing and other sharp instruments. Unfortunately, about 30-40% of the time, the source of the virus cannot be traced. The Hepatitis B virus can live outside the body for up to ten days on a dry surface.

Hepatitis C is transmitted by blood. It is unclear whether other body fluids can transmit the virus. However, all people with Hepatitis C virus are potentially infectious. Previous infection does not produce immunity. While HCV accounts for 90% of blood transfusion associated Hepatitis, transfusions today hardly ever transmit the infection because the donors are tested.

Are there Vaccines for Hepatitis?

A vaccine for Hepatitis A was recently approved. Individuals who would benefit from the vaccine include travelers to developing countries, military personnel, users of illicit injectable drugs, certain institutional workers, and day care center workers. People who have had Hepatitis A do not need to be vaccinated.

Hepatitis B vaccines are safe and effective for at least 10 years. Three injections over a six-month period are required. Health care workers and other people who are at increased risk of developing Hepatitis B should be vaccinated. There is currently no vaccine for Hepatitis C.

Treatment of Hepatitis

90% of patients with Hepatitis A will recover without serious side effects. There is no specific therapy for Hepatitis A except for treating the symptoms, i.e., nausea, vomiting, and diarrhea.

The majority of patients with Hepatitis B will also recover without any side effects. Most patients do not even realize that they had Hepatitis - they think that it is a bad "bug" for several weeks. They may not turn yellow or become "jaundiced". A small percentage of patients will develop chronic Hepatitis. This can lead to chronic liver disease and permanent liver scarring (cirrhosis).

Unlike the previous viruses, infection with Hepatitis C is usually long lasting. It is necessary to wait six months to determine if a spontaneous resolution will occur. Special blood testing is necessary to determine if the virus is still active. Certain forms of chronic Hepatitis with Hepatitis B and Hepatitis C may be treated by a drug called Interferon. Early treatment is recommended. About 30% of patients with Hepatitis B and 50% of patients with Hepatitis C will respond to six months of therapy.

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