Hepatitis

What is hepatitis?

Hepatitis is an inflammation (swelling and tenderness) of the liver, an organ which is essential to life. If the liver does not function properly, it can cause serious illness. Hepatitis is usually caused by a virus, but other factors like drugs, alcohol and toxins may play a role.

There are several viruses which can cause hepatitis and these are all identified with letters of the alphabet A-G. The 3 most common types of Hepatitis are Hepatitis A, Hepatitis B and Hepatitis C the other forms D-G are very rare. All these viruses cause similar problems and have similar symptoms but are spread in different ways and have different effects on your health.

HEPATITIS A.

What is hepatitis A?

Hepatitis A is a disease of the liver, caused by the hepatitis A virus. Hepatitis A is fortunately quite rare in the U.K. It tends to be more common in countries with poor personal hygiene, the highest risk areas are India, Pakistan, Africa, South and Central America and the Middle East.

What causes hepatitis A?

It is possible to become infected with hepatitis A through eating or drinking contaminated food or water. The virus is highley infectious and can spread easily within families and places where people live in close contact e.g. schools where children may not be so careful about hand washing. The virus is found in faeces and can be passed on even if a tiny amount of virus comes into contact with a person’s mouth. It is therefore always very important to practise good hygiene and wash your hands after going to the toilet and before eating. The virus may also be passed on through sexual activity.

Am I at risk from hepatitis A?

The following are factors that could put you at risk of getting hepatitis A: –

• Poor personal hygiene.
• Close personal contact with someone with hepatitis A.
• Swimming in water that may be contaminated.
• Drinking water that is untreated – only use bottled or treated water if travelling to countries with poor sanitization.
• Eating food that has been washed in contaminated water e.g. fruit.
• Eating shellfish from seawater that is contaminated.
• Unprotected sex.
• Injecting drugs.
• Travelling to countries with a high rate of hepatitis A.

What are the symptoms of hepatitis A?

People with hepatitis A may have no symptoms depending on the severity of infection, but can still pass the virus on to others. It can take 2-6 weeks for symptoms to appear and may include: –

• Flu-like symptoms (fever).
• Nausea and vomiting.
• Diarrhoea.
• Fatigue.
• Loss of appetite and weight loss.
• Abdominal pain.
• Itchy skin.
• Jaundice (a yellow discolouration in the skin and eyes, it also turns your urine dark and your faeces turn pale).

How is hepatitis A diagnosed?

Your doctor may have a feel of your liver from a physical examination and may also carry out a urine test which among other things looks for bilirubin and urobilinogen, if these levels are raised this could indicate the liver is damaged and a sign of liver disease (eg hepatitis,cirrhosis). If these levels are raised and/or the liver feels larger or harder than it should then your doctor may recommend a LFT (Liver Function Test) for more detailed results. A simple blood test is usually carried out to confirm the presence of the hepatitis virus.

Can hepatitis A be prevented?

There is a vaccination available to protect you from hepatitis A for 1 year, a booster can then be given to protect you for up to 10 years. It is important to have the vaccination if you are travelling to parts of the world with a high level of hepatitis A (usually less developed areas such as Africa).
Ask your doctor for advice if you are at all worried about the virus. Once you have had hepatitis A you will develop an immunity to the infection for the rest of your life.

Can hepatitis A be treated?

Hepatitis A usually runs its course within 2-8 weeks, although some people can be ill for up to 6 months. The length of infection is influenced by the age and general health of the affected person. There is no specific treatment for hepatitis A, and it will usually resolve itself. Bed rest, proper nutrition and avoiding alcohol are usually recommended to relieve the symptoms.

What are the long-term effects of hepatitis A?

Most patients make a full recovery from hepatitis A, this type of hepatitis virus is not a serious long-term health problem. There is however, a small chance that hepatitis A will cause long-term damage to your liver, but this is very rare. Once you have had hepatitis A you will not be able to donate blood.

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HEPATITIS B

What is hepatitis B?

Hepatitis B is very common worldwide and is a very infectious virus, that causes inflammation of the liver.

What causes hepatitis B?

Hepatitis B is very infectious, unlike HIV it is able to survive outside the body for about a week, which means objects contaminated with dry blood can still pose a risk. Hepatitis B is usually passed on through unprotected penetrative sex, (where the penis enters the vagina, anus or mouth) or through sex which draws blood. It can also be passed on through sharing sex toys or sharing contaminated needles, from an infected mother to her baby or from a blood transfusion.

What are the symptoms of hepatitis B?

Hepatitis B can be a silent infection with no symptoms, or it can result in  acute hepatitis or chronic hepatitis. Acute means the illness usually only lasts a few weeks, and the liver normally returns to normal. Chronic hepatitis B is a more serious illness and it may last for the rest of your life and cause permanent liver damage. Hepatitis B is called chronic when the illness has lasted longer than 6 months.

The symptoms of acute hepatitis may include: –

• Fatigue.
• Loss of appetite.
• Flu like symptoms (headache and fever).
• Nausea and vomiting.
• Diarrhoea.
• Weight loss.
• Jaundice (a yellow discolouration in the skin and eyes, it also turns your urine dark and your faeces turn pale).
• Itchy skin.

Only a small percentage of people will go on to develop chronic hepatitis and it can have a broad range of symptoms or remain asymptomatic, while other people may become extremely ill. Symptoms of chronic hepatitis B may include: –

• Fatigue.
• Jaundice.
• Gastrointestinal bleeding (stomach and intestines).

How is hepatitis B diagnosed?

Your doctor may have a feel of your liver from a physical examination and may also carry out a urine test which among other things looks for bilirubin and urobilinogen, if these levels are raised this could indicate the liver is damaged and a sign of liver disease (eg hepatitis,cirrhosis). If these levels are raised and/or the liver feels larger or harder than it should then your doctor may recommend a LFT (Liver Function Test) for more detailed results. Hepatitis B can be diagnosed with a simple blood test. The blood test looks for the presence of the hepatitis B virus. If the result of your blood test is positive, you may be referred to a specialist for further tests. These tests are to find out how much hepatitis is affecting your liver.

Can hepatitis B be prevented?

If your partner has hepatitis B a condom should always be used when having sex to prevent them passing the virus on. There is a vaccine available for people who are at a high risk of catching hepatitis B.

Can hepatitis B be treated?

If you have acute hepatitis B then most people will recover and will require no specific treatment, though bed rest and a good diet is recommended.

If you go on to develop chronic hepatitis then you should see a liver specialist who will discuss treatment options with you, this area of medicine is developing fast and new treatments have become available. Your specialist might recommend an antiviral drug such as interferon that can help prevent further complications. You will also need to be monitored regularly to detect if any damage is occurring to their liver. If you have signs of severe liver damage you may need to have a liver transplant.

If you are diagnosed as having hepatitis B you should try to limit the amount of alcohol you drink and avoid fatty foods. Most adults once recovered from the hepatitis B virus will develop a life long immunity.

What are the long-term effects of hepatitis B?

In severe cases if a person remains infected with the hepatitis B virus (chronic hepatitis) they may develop complications such as liver cirrhosis(scarring, damage of the liver) or liver cancer.

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HEPATITIS C

What is hepatitis C?

Hepatitis C as the other 2 viruses is inflammation of the liver and is the most serious type. Symptoms of hepatitis C can be easily confused with less serious illnesses. Unfortunately the signs of liver damage may not occur for a couple of decades and by the time the disease becomes apparent liver damage can be considerable and even irreversible.

What causes hepatitis C?

Hepatitis C is present in the blood of an infected person. If infected blood enters another person’s blood stream, that person may then catch the virus. The most common spread of hepatitis C is through sharing needles and syringes. It may also be passed on through sharing razor blades or from an infected person’s blood coming into contact with open cuts on another person. There is a very small risk of catching hepatitis C during sex, the risk is greater during menstruation. Another way of catching hepatitis C is through a blood transfusion in a country where blood is not tested for the hepatitis C virus. All blood in the U.K. is tested. On rare occasions hepatitis C can be passed on from a infected mother to her baby at the time of birth.

What are the symptoms of hepatitis C?

Ther are 2 phases of hepatitis C infection, known as acute and chronic. In many cases people infected with acute hepatitis C may not become ill, others may experience the following symptoms: –

• Flu like symptoms (fever).
• Poor appetite.
• Diarrhoea.
• Mild jaundice (dark urine,yellow skin).

When liver inflammation lasts more than 6 months the illness is called chronic hepatitis C. The symptoms of chronic hepatitis C may include: –

• Fatigue.
• Loss of appetite.
• Nausea and vomiting.
• Soreness in the abdomen (under the ribs).
• Pain in the joints.
• Fever.

How is hepatitis C diagnosed?

A simple blood test will confirm if you are infected with the hepatitis C virus. If the blood test is positive you may be referred to a specialist for further tests. These tests are to find out how the hepatitis virus is affecting your liver and could include, a liver scan or liver biopsy.

Can hepatitis C be prevented?

At present there is no vaccine available to stop infection with hepatitis C, though research is being carried out to develop one. However, you can prevent infection with hepatitis C in the following ways:-

• If you inject drugs, always use clean, sterile needles and never share.
• Never share personal items, such as toothbrushes, razors and nail scissors as these can all punture the skin and become contaminated.
• Always clean blood up with bleach and using waterproof gloves.
• Practice safe sex – always use condoms.

Can hepatitis C be treated?

The treatment of Hepatitis C has greatly improved and is now aimed at clearing the virus from the body. The usual treatement is with a combination drug. The treatment you receive and when will vary and you should be referred to a specialist to give you information. The drugs can have some not very nice side effects, such as depression, vomiting, fever and fatigue so the specialist might monitor you to see if your body is able to fight the infection on its own. The doctor will closely monitor your symptoms and the amount of virus in your body.

What are the long-term effects of hepatitis C?

People who have been infected may continue to carry the virus in their blood and become long term or chronic carriers. It is believed a low percentage of people will develop cirrhosis, which is scarring of the liver, then after a few years some people with cirrhosis may then go on to develop liver cancer.

It is believed that carriers of hepatitis C remain infectious throughout their lives and may be capable of spreading the virus to others.

Because drinking makes hepatitis C worse, people with hepatitis C should either seriously cut down on drinking alcohol or avoid alcohol entirely.

IF YOU ARE WORRIED THAT YOU MAY HAVE A HEPATITIS VIRUS YOU SHOULD VISIT YOUR LOCAL G.U.M. CLINIC OR DOCTOR FOR ADVICE AND IF NECESSARY FOR TREATMENT

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