What is Hepatitis (Definitions)

What is Hepatitis A

Hepatitis A is an infection of the liver caused by the hepatitis A virus.

What is Hepatitis B

Hepatitis B is a liver disease caused by the hepatitis B virus. Most hepatitis B infections resolve within 1 to 2 months without treatment. When the infection lasts more than six months, it can turn into a chronic hepatitis B, which leads to:

• Chronic inflammation of the liver
• Cirrhosis (scarring of the liver)
• Hepatic cancer
• Hepatic impairment
• Death

What is Hepatitis C

Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV)

Hepatitis A Causes

The virus is usually found in the fecal matter (feces) of infected people. It spreads by:

• Put something in your mouth that is contaminated with the hepatitis A virus
• Drink water contaminated with sewage
• Eat food contaminated with the hepatitis A virus, especially if not cooked properly
• Eat raw seafood or partially cooked that have been contaminated with sewage
• Sexual contact with a partner infected with the hepatitis A virus, especially anal sex

Hepatitis B Causes

This virus is usually spread by contact with the body fluids of an infected person. Fluids include:

• Blood
• Semen
• Vaginal flows
• Saliva

A woman with hepatitis can transmit the virus to the baby during delivery. The hepatitis B virus is not transmitted by food or water.

Hepatitis C Causes 

The hepatitis C virus is transmitted through contact with the blood of an infected person. 

A woman with hepatitis can pass the virus to the baby during delivery. The hepatitis C virus is not transmitted by food or water.

Risk Factors for Viral Hepatitis

A risk factor is something that increases your chance of getting a disease or condition. It is possible to develop viral hepatitis with or without the risk factors listed below. However, the more risk factors you have, the greater your chance of developing viral hepatitis. If you have numerous risk factors, ask your doctor what you can do to reduce your risk.

The risk factors for hepatitis vary, depending on the type of hepatitis.

People at Higher Risk

• Babies of mothers with hepatitis B or C
• Children in day care centers
• Workers in child care who change diapers or train children to go to the bathroom
• Men who have sex with men
• People who have anal sex
• People who have multiple sexual partners
• People who inject illicit drugs and share needles

Lifestyle Factors

• Close contact with someone who has the disease
• Use household items that were used by an infected person and not were properly cleaned
• Sexual contact with multiple partners
• Sexual contact with someone who has hepatitis or a sexually transmitted disease
• Injecting drugs, especially if you used shared needles
• Using intranasal cocaine
• Getting a tattoo or body piercing (because the needles may not be adequately sterilized)
• Having a job that involves contact with body fluids, as:
• Caring for children who are not trained to go to the bathroom
• First aid or emergency worker
• Funeral director
• Health care workers
• Dentist
• Dentist assistant
• Fireman
• Police personnel

For hepatitis A or E, people at risk include those who travel (or spend long periods of time) in a country where hepatitis A or E is common, such as in underdeveloped countries, or where health services are deficient.

Medical Conditions and Procedures

Health conditions and procedures that increase the risk of hepatitis include:

• Hemophilia or other blood coagulation disorders
• Kidney disease requiring hemodialysis
• Receiving a blood transfusion, especially before 1992 when better examinations were developed review (Even today, the review is not 100% effective in eliminating hepatitis, although it is dramatically safer than in the past).
• Receive multiple transfusions of blood or blood products
• Receive a solid organ transplant, especially before 1992 when better review examinations were developed
• Persistent elevation of some liver function tests (found in people with undiagnosed liver problems)
• Having had a sexually transmitted disease

Symptoms of Viral Hepatitis

Hepatitis A – This infection may or may not cause symptoms. Adults are more likely to have symptoms than children. Incubation takes 15 to 45 days. Hepatitis A does not progress to chronic liver disease.

Hepatitis B – With this form of hepatitis, symptoms usually appear within 25 to 180 days after exposure to the virus. Hepatitis B could progress to a carrier state or chronic liver disease.

Hepatitis C – Approximately 80% of people with hepatitis C have no symptoms. However, with the passage of time, the disease can cause serious liver damage. Hepatitis C could progress to chronic hepatitis. Incubation takes 15 to 60 days.

Common symptoms of all types of viral hepatitis include:

• Fatigue
• Loss of appetite
• Fever
• Nausea and vomiting
• Diarrhea
• Weight loss
• Pain or abdominal discomfort
• Pain and discomfort
• Headache
• Jaundice (yellowing of the eyes and skin)
• Urine darker color
• Fecal stool lighter color
• Itching
• Rash

Diagnosis of Viral Hepatitis

The doctor will ask about your symptoms and medical history and perform a physical exam. 

Tests to diagnose hepatitis may include the following: 

Blood Tests – Your blood is checked for the presence of hepatitis antigens and antibodies. Antigens are external proteins that are part of the hepatitis viruses. Antibodies are proteins that your body has produced to fight off infectious agents. 

Hepatic Function Studies – The levels of various liver enzymes, bilirubin, and coagulation factors in your body are measured to determine how your liver is functioning. 

Hepatic Biopsy – Removal of a tissue sample from the liver to be examined under a microscope. Needle Placement for Liver Biopsy

Treatments for Viral Hepatitis

There are no specific treatments for hepatitis A. The goals of treatment for hepatitis A are:

• Keep it as comfortable as possible
• Prevent the infection from being transmitted to other people

Prevent further liver damage by helping you avoid substances that could alter your liver (eg, medications, alcohol) while you are healing.

Treatment for other types of hepatitis involves the following:

• Changes in lifestyle
• Medications

Alternative and complementary therapies

There are currently no surgical procedures to treat viral hepatitis.

Review for Viral Hepatitis

The purpose of the review is early diagnosis and treatment. Screening tests are usually administered to people without symptoms present, but who may be at high risk for certain diseases or conditions. During the review, invasive tests such as biopsies are not performed.

The review is a method to find out if you have hepatitis before you start having symptoms. The review involves:

• Assessing your medical history and lifestyle habits that may increase or reduce your risk of hepatitis
• Undergo tests to identify early signs of hepatitis, including blood tests to detect hepatitis antigens and antibodies

Screening Exams

Blood tests may be checked or routinely checked for hepatitis in people who are at increased risk of infection. These tests involve checking the presence or absence of hepatitis antigens and antibodies. The antigens are external proteins; Antibodies are proteins that your body has produced to fight off infectious agents.

Revision Guidelines

The Centers for Disease Control and Prevention recommend screening for hepatitis in people at high risk of the disease. Common risk factors for hepatitis B and C include:

• Previous or current IV drug users (or a sex partner who injects illegal drugs, previous or current)
• Blood coagulation product receptors (especially older types that do not they have undergone modern methods of purification and production). Blood receptors, especially before 1992
• Receptors of a solid organ transplant, especially before 1992 when improved revision examinations were developed
• Persistent elevation of certain liver function tests
• Chronic hemodialysis
• People who have ever shared an article personal (toothbrush, razor, or other item that had blood on it, even if it was not visible) with someone who has hepatitis C
• Having a sexual partner who has hepatitis C
• Having a sexual partner who has or has had a medical condition sexual transmission (STD)
• Anyone with an STD
• Liver problems undiagnosed
• Health workers exposed to blood or body fluids
• Babies of mothers with hepatitis C

Reducing Your Risk of Viral Hepatitis

Hepatitis is a contagious disease that is preventable. The basic principles of prevention include avoiding contact with body fluids or other people's blood and practicing good hygiene. In addition, there are vaccines available to prevent some types of hepatitis. These are administered to people at high risk of contracting the disease.

Avoid Contact with Body and Blood Liquids

Blood and infected body fluids can spread hepatitis. To avoid contact:

1. Do not inject illicit drugs, especially with shared needles. Seek help to stop using drugs.
2. Do not have sex with partners who have hepatitis or other sexually transmitted diseases.
3. Practice safe sex (using latex condoms) or abstain from having sex.
4. Limit your number of sexual partners. A mutually monogamous relationship is the best.
5. Avoid sharing personal hygiene products (eg, toothbrushes, rakes).
6. Avoid handling objects that may be contaminated with blood infected with hepatitis.
7. Donate your own blood before elective surgery so it can be used in case you need a blood transfusion.
8. It is better that you avoid tattooing or body piercing. If you are performing a tattoo or a piercing, make sure that the artist or the person performing the piercing properly sterilizes the equipment before using it. You can get infected if the utensils have someone else's blood.
9. Health care professionals should always follow routine precautions to avoid infection and carefully handle needles and other sharp instruments and dispose of them properly.

Wear gloves when touching or cleaning the body fluids of personal items, such as:

• Bandages
• Band-Aids
• Tampons
• Coatings
• Cover wounds or open cuts.

Use only sterilized needles for injected medications, blood draw, ear piercings and for tattoos.
If you are pregnant, get tested for hepatitis B. Babies born to mothers with hepatitis B should be treated within 12 hours after birth.

Practice Good Hygiene

Good hygiene can prevent the transmission of some forms of hepatitis.

• Wash your hands with soap and water after going to the bathroom or changing a diaper.
• Wash your hands with soap and water before eating or preparing food.
• Clean all household utensils carefully after use.

Get vaccinated, if it is recommended

If you belong to a group at high risk, ask your doctor about the possibility of getting vaccinated against hepatitis. There are vaccines available for hepatitis A and B.

• The vaccine for hepatitis A is produced from the inactive hepatitis A virus and is highly effective in preventing infection. Generally (but not always) a series of two injections provides lasting protection.
• The hepatitis vaccine takes a month to become fully effective, so plan to get vaccinated in advance if you need to travel. For a single trip and for a short time or if you need immediate protection, the Centers for Disease
• Control and Prevention continue to recommend an injection of gamma globulin.

Hepatitis A vaccine is usually recommended for:

• People who have a chronic liver disease or a disorder in the coagulation factor
• People who live in areas with poor health conditions or for those who have close physical contact with people of those areas
• People traveling to countries where there are poor health conditions
• Children living in areas that have high rates of hepatitis A or of repetitive epidemics of hepatitis A
• People who are at risk of contracting hepatitis A due to their work (for example, that involves working with primates, in research laboratories)
• People who use illicit drugs (whether or not they are injected)
• Men who have sex with other men

Check with your doctor to see if you should get the vaccine, and if so, how many injections should be given.
Hepatitis B can be prevented through vaccination. Anyone who is at increased risk for hepatitis B should be vaccinated. The series of vaccines, which consists of three injections over a period of six months, is generally recommended for:

• Health workers
• Public safety workers
• People who provide direct services to those with developmental disabilities
• Internal to long-term correctional facilities
• People with multiple sexual partners
• Men who have sex with other men
• People who inject illegal drugs
• People who live with someone who has hepatitis B
• People who have a sexual partner with hepatitis B
• People who have have a blood disorder that requires treatment with blood products
• People who undergo renal dialysis
• People who travel or live in areas where hepatitis B is common
• People migrate, or children of immigrants, from parts of the world with moderate rates or high hepatitis B
• People diagnosed with a sexually transmitted disease
• Babies born to infected mothers

Take Immuno Globulin (Range), If Recommended

This is an injection containing antibodies that help provide protection from hepatitis A for about 1-3 months. It is usually administered:

• Before being exposed to the virus, or
• Within two weeks after being exposed to the virus

Talking to Your Doctor About Viral Hepatitis

You have a unique medical history. Therefore, it is essential that you talk with your doctor or health professional about your personal risk factors and / or experience with hepatitis. By speaking openly and regularly with your doctor, you can play an active role in your care.

General Tips for Gathering Information

Here are some tips that will make it easier for you to talk to your doctor:

• Take someone else with you. It is helpful for another person to listen to what is said and think of questions to ask.
• Write your questions in advance, so you do not forget them.
• Write down the answers you get, and make sure you understand what you are listening to. Ask for clarification, if necessary.
• Do not be afraid to ask your questions or ask where you can find more information about what you are discussing. You have the right to know.

Specific Questions to Ask Your Doctor

About Hepatitis

• What type of hepatitis do I have?
  Is it possible to have more than one type of hepatitis?
• How could I have contracted hepatitis?
• What other medications, food supplements, or herbal preparations should you avoid that could make hepatitis worse?
• Are there other substances that I should avoid (such as alcohol)?
• What can I do to avoid transmitting hepatitis to other people?
• What are some of the short-term and long-term complications of hepatitis?
• What symptoms should I monitor and report?

About Your Risk of Developing Hepatitis

• Based on my medical history, lifestyle, and family history, am I at risk for hepatitis?
• How do I better prevent hepatitis?
• Does my work put me at risk for hepatitis?
• What can I do to reduce my risk of hepatitis?
• Should I be vaccinated?
• Should it be checked for hepatitis?
• How often should I be checked if I do not have any symptoms?

About Treatment Options

• How do I treat hepatitis better?
• What medication options are available to help me?
• What are the benefits and side effects of these medications?
• Will these medications interact with other medications, over-the-counter products, or dietary or herbal supplements that I am already taking for other conditions?
• Is there any alternative or complementary therapy to help me?

About Changes in Lifestyle

• Is it safe for me to have a baby?
• What kind of protection should my sexual partner (s) and I use?
• Are there habits that I should develop to avoid transmitting hepatitis to people with whom I live?
• Why do I need to avoid alcohol?
• How do I get help to stop drinking?
• Should I exercise?

About the Overview

• When will I stop feeling so tired?
• Will my hepatitis go away?
• Will it become a chronic problem?
• Will I develop liver problems in the long term?
• Will I develop liver cancer?
• Will I need a liver transplant?
• How will I know that my treatment program is effective?
• Now I'm immune to hepatitis viruses?
• What types of hepatitis viruses are I immune to now (A, B, C, D, or E)?

How to Prevent Hepatitis A

Adequate hygiene habits

• Wash your hands with soap and water, especially after going to the bathroom or changing a diaper.
• Wash your hands with soap and water before eating or preparing food
• Avoid using household utensils that a person with hepatitis A may have touched.
• Be sure to carefully clean all household utensils.
• Avoid sexual contact with a person with hepatitis A.
• Avoid the use of injectable drugs. If it is injected, do not share the needles.

If you are traveling to a high-risk region, take the following precautions:

• Drink bottled water
• Avoid consuming crushed ice
• Wash fruits well
• Eat well-cooked food

Vaccination or immunoglobulin

Contains antibodies that provide temporary protection against hepatitis A. It can last between one and three months. It must be administered before exposure to the virus or within two weeks after exposure.

Vaccine against hepatitis A

This vaccine is made with inactive hepatitis A virus. It is very effective in preventing infection and provides total protection four weeks after the first injection. The second injection offers protection up to 20 years later.

The vaccine is also used after contact with the virus. If it is administered within two weeks, it can prevent the disease.

This vaccine is recommended for:

• All children 12-23 months
• Children 24 months or older who are at high risk and who have not been previously vaccinated
• People traveling to areas where hepatitis A is prevalent (The CDC Traveler's Health website indicates which areas have a high prevalence of hepatitis A).
• Men who have sex with other men
• People who use injectable drugs
• People who are at risk because of their jobs (eg, those who work in research laboratories)
• People with chronic liver disease
• People with bleeding disorders blood, as hemophilia
• People who have direct contact with an adopted child from a high or medium risk area
• People who want to be immune to hepatitis A

Talk to your doctor to find out if you should get the vaccine.

How to Prevent Hepatitis B

Hepatitis B Vaccine

There is a vaccine to prevent hepatitis B. This vaccine, a series of three injections, is routinely given to newborns. Children and adolescents who were not vaccinated when they were babies can still receive the injections.

It is also recommended that adults at high risk (eg, having several sexual partners, injecting illicit drugs, working in the health care field or being diabetic) receive the vaccine.

How to Prevent Hepatitis C

To prevent becoming infected with hepatitis C:

1. Do not inject drugs. Sharing needles represents the highest risk. Ask for help to stop using drugs.
2. Not having sex with couples who have STDs.
3. Practice safe sex (with latex condoms) or abstain from sex.
4. Limit the number of people you have sex with.

Do not share personal items that may have blood on them, such as:

• Shavers
• Toothbrushes
• Manicure Tools
• Earrings

Avoid handling items that may be contaminated with HCV infected blood.
Donate your own blood before an elective surgery to be used in case a transfusion is required.

To prevent the spread of hepatitis C to others if you are infected:

• Tell your dentist or doctor before getting checked or treated.
• Apply hepatitis A and hepatitis B vaccines.
• Do not donate blood or organs for transplant.