
Hepatitis
What is Hepatitis A?
Hepatitis A is a liver disease caused by the hepatitis A virus. The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the feces of an infected person. The disease is closely associated with unsafe water or food, inadequate sanitation, and poor personal hygiene.
Who is impacted?
Anyone who has not been vaccinated or previously infected can become infected with the hepatitis A virus. In areas where the virus is widespread, most hepatitis A infections occur during early childhood. Risk factors in these areas include:
- Poor sanitation
- Lack of safe water
- Use of recreational drugs
- Living with an infected individual
- Sexually active with an individual who has an acute hepatitis A infection
- Travelling to areas where the hepatitis A virus is widespread
How is Hepatitis A diagnosed?
Cases of hepatitis A are not clinically distinguishable from other types of acute viral hepatitis. Specific diagnosis is made by the detection of HAV-specific Immunoglobulin G (IgM) antibodies in the blood. Additional tests include reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA, and may require specialized laboratory facilities.
How is Hepatitis A treated?
There is no specific treatment for hepatitis A. Recovery from symptoms following infection may be slow and may take several weeks or months. Most important is the avoidance of unnecessary medications. Acetaminophen / Paracetamol and medication against vomiting should not be given.
Hospitalization is unnecessary in the absence of acute liver failure. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhea.
What is Hepatitis B?
Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus. It is a major global health problem. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.
Who is impacted?
Hepatitis B is typically spread through contact with blood semen or other bodily fluids from an infected person.
- Risk of contracting hepatitis B is increased if you:
- Have unprotected sex with multiple sex partners or with someone who’s infected with HBV
- Share needles during IV drug use
- Are a man who has sex with other men
- Live with someone who has a chronic HBV infection
- Are an infant born to an infected mother
- Have a job that exposes you to human blood
- Travel to regions with high infection rates of HBV, such as Asia, the Pacific Islands, Africa and Eastern Europe
How is Hepatitis B diagnosed?
It is difficult to differentiate hepatitis B from hepatitis caused by other viral agents and laboratory confirmation of the diagnosis is very important. A number of blood tests are available to diagnose and monitor people with hepatitis B. They can be used to differentiate between acute and chronic infections.
Laboratory diagnosis of hepatitis B infection focuses on the detection of the hepatitis B surface antigen HBsAg. WHO recommends that all blood donations be tested for hepatitis B to ensure blood safety and avoid accidental transmission to people who receive blood products.
Acute HBV infection is characterized by the presence of HBsAg and immunoglobulin M (IgM) antibody to the core antigen, HBcAg. During the initial phase of infection, patients are also seropositive for hepatitis B e antigen (HBeAg). HBeAg is usually a marker of high levels of replication of the virus. The presence of HBeAg indicates that the blood and body fluids of the infected individual are highly contagious.
Chronic infection is characterized by the persistence of HBsAg for at least 6 months (with or without concurrent HBeAg). Persistence of HBsAg is the principal marker of risk for developing chronic liver disease and liver cancer (hepatocellular carcinoma) later in life.
How is Hepatitis B treated?
Chronic hepatitis B infection can be treated with drugs, including oral antiviral agents. Treatment can slow the progression of cirrhosis, reduce incidence of liver cancer and improve long term survival.
WHO recommends the use of oral treatments – tenofovir or entecavir, because these are the most potent drugs to suppress hepatitis B virus. They rarely lead to drug resistance as compared with other drugs, are simple to take (1 pill a day), have fewer adverse effects and require minimal monitoring.
What is Hepatitis C?
Hepatitis C is a viral infection that causes liver inflammation that can possibly lead to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.
Who is impacted?
Health officials recommend that anyone at high risk of exposure to HCV should receive a blood test to screen for hepatitis C infection. People who may want to talk to their doctors about screening for hepatitis C include:
- Anyone who has ever injected or inhaled illicit drugs
- Anyone who has abnormal liver function test results with no identified cause
- Babies born to mothers with hepatitis C
- Health care and emergency workers who have been exposed to blood or accidental needle sticks
- People with hemophilia who were treated with clotting factors before 1987
- People who have ever undergone long-term hemodialysis treatments
- People who received blood transfusions or organ transplants before 1992
- Sexual partners of anyone diagnosed with hepatitis C infection
- People with HIV infection
- Anyone born from 1945 to 1965
- Anyone who has been in prison
How is Hepatitis C diagnosed?
If an initial blood test shows that you have hepatitis C, additional blood tests will:
- Measure the quantity of the hepatitis C virus in your blood (viral load)
- Identify the genotype of the virus.
How is Hepatitis C treated?
- Antiviral Medications
- Liver Transplantation