Viral Hepatitis

Hepatitis A

Hepatitis A is a virus which gets into the liver and causes acute illness with symptoms of diarrhea, fatigue and loss of appetite. This virus is spread when people eat raw foods or drink water that has been contaminated with stool (“poop”) from an infected person. This happens if food is sprayed with water with fecal contamination or, in the case of shellfish the food is grown in water that is contaminated with raw sewage.

The hepatitis A virus can also be transmitted by a cook or food handler who is ill and does not wash his or her hands thoroughly before handling food. The truth is that people who get hepatitis A have somehow gotten an infected person’s “poop” into their mouth. From there the virus has moved into the gut and liver and has made the person sick.

Almost everyone gets over this infection. People who get hepatitis A sometimes will feel sick and tired for a week or two and then they get better. If you have had hepatitis A once you will never get it again because you develop antibodies that protect you against the virus.

There is also a vaccine to protect us from hepatitis A. So if you have never had hepatitis A you can be protection against the virus with a series of two shots.

Hepatitis B

Hepatitis B is a contagious liver disease that results from infection with the hepatitis B virus.  It can range in severity and duration – some will only have a short-term, mild form of the virus, while others will develop long-term, chronic infection.  Hepatitis B is transmitted when blood, semen, or another body fluid from a person infected with the hepatitis B virus enters the body of someone who is not infected.  This can happen through sexual contact with an infected person or sharing needles, syringes, or other drug-injection equipment.  Hepatitis B can also be passed from an infected mother to her baby at birth but is not tranmitted through breastmilk.

Hepatitis B can be either acute or chronic.  Acute Hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis B virus. Acute infection can — but does not always — lead to chronic infection.  Chronic Hepatitis B virus infection is a long-term illness that occurs when the hepatitis B virus remains in a person’s body.  Chronic hepatitis B is a serious disease that can result in long-term health problems, and even death.  Those with chonic hepatitis B should maintain regular contact with a medical provider to monitor their liver health over time and consider treatment.

The best way to prevent Hepatitis B is by getting vaccinated.

Hepatitis C

Hepatitis C is a blood-borne viral infection which can, over decades, lead to liver fibrosis (scarring), cirrhosis, and in some patients liver cancer and death. It is transmitted through blood-to-blood contact, and in rare cases, sexual transmission.  Approximately 4 million Americans have chronic hepatitis C; however, only 25 to 30% have been diagnosed.  The diagnosis is made by specific laboratory (blood) testing.  Liver biopsy may be recommended to assess the degree of fibrosis and need for treatment.

Hepatitis C is curable and treatment for most people is 12 weeks, although some people can acheive cure with only 8 weeks of treatment and others may require 24 weeks.  Cure rates for almost all patients range from 90-100%, depending on the hepatitis C genotype (strain) and severity of liver disease.  Previously, treatment consisted of pegylated interferon and ribavirin, which resulted in viral clearance in approximately 50% of those patients treated.  Fortuntately for patients, none of regimens used to cure hepatitis C today include interferon.

HIV/HCV Co-Infection

HIV and Hepatitis C (HCV) coinfection has become an increasing concern in the medical field.  As improvements in HIV treatment have reduced the rate of death due to acute opportunistic infections (i.e pneumonia), liver disease has emerged as a leading cause of hospitalization and death among persons living with HIV and AIDS.  It is estimated that prevalence rates of HCV among people living with HIV/AIDS may be as high as 30%*.

HIV and HCV share many characteristics – both are RNA viruses and have blood to blood transmission methods.  The effects of coinfection on the body are still poorly understood, but it is generally accepted that coinfection accelerates the progression of HCV, leading to higher viral load counts and increased risk of severe liver damage; however and most studies indicate that HCV does not accelerate the progression of HIV.