Viral Hepatitis is an infection of the liver that affects people from all walks of life regardless of age, race, gender, or sexual orientation.

A Family of Viruses Affects All People
The Hepatitis A Virus (HAV)
HAV infection can cause an acute, flu-like illness with yellowing of the skin (jaundice), nausea and vomiting, fatigue, loss of appetite, abdominal pain, or diarrhea. It lasts from three to six weeks, but can persist up to six months. Most patients recover with no serious long-term health problems. Symptoms are more severe in adults than in children, who often have no symptoms. HAV is spread when infected human feces is ingested by mouth.

The Hepatitis B Virus (HBV)
HBV infection can cause symptoms similar to HAV. Most adults fight off infection and have no long-term health problems. But in 5% of cases, it becomes chronic (lasting more than six months), and can then cause cirrhosis (scarring of the liver), liver cancer, and liver failure, resulting in 6,000 deaths per year. HBV is spread through contact with infected bodily fluids or blood.

The Hepatitis C Virus (HCV)
HCV infection persists in 85% of cases, and often has no symptoms until liver damage has occurred, many years after infection. It too can cause cirrhosis, liver cancer, and liver failure, and it is responsible for 8,000 to 10,000 deaths per year. HCV is spread through blood-to-blood contact.

Avoid the Risks of Viral Hepatitis
Avoiding the risks can prevent infection.

HAV Infection Risk Factors:
Fecal (Body Waste)/Oral Contamination
 

	Not washing hands after using the bathroom or changing a diaper
	Eating uncooked food prepared by an infected person who did not wash his/her hands after using the bathroom
	Drinking contaminated water
	Having oral/anal sex

HBV Infection Risk Factors:
Blood and Body Fluids
 

	Having unprotected sex with an infected partner
	Using illegal injection drugs, even once
	Using the razor or toothbrush of an infected person
	Exposure as a health care worker to infected blood or body fluids
	Being born to an infected mother

HCV Infection Risk Factors:
Blood-to-Blood Contact

Known to transmit infection
 

	Using illegal injection drugs, even once
	Having a transfusion or organ transplant before July 1992
	Having long-term hemodialysis
	Receiving clotting factor made prior to 1987
	Being injured by a needle or other sharp object that has infected blood on it
	Being born to an infected mother

May transmit infection
 

	Having unprotected sex with multiple partners or a history of sexually transmitted disease
	Tattooing or body piercing in unsanitary conditions
	Using the razor or toothbrush of an infected person
	Other exposure to infected blood

Hepatitis C – An Emerging Epidemic
Over four million people in the U.S. have been infected with the hepatitis C virus. HCV causes 8,000 to 10,000 deaths each year and this number may increase to 30,000 in the next two decades.

As many as 70% of those infected don’t know it, as they have no symptoms or only vague symptoms initially. However, this virus may be causing serious liver damage that will likely not be recognized for several years.

The best way to determine who may be infected is to assess the presence of risk factors for contact with infected blood. Some people may not want to talk about or be able to recall the following risk factors.

Past Drug Use
The most efficient way to become infected with HCV is through injection drug use. Even people who experimented with injection drugs just once many years ago may be infected and should get tested.

Blood Transfusions Prior to 1992
An estimated 300,000 people in the U.S. are infected with HCV as a result of a blood transfusion or organ transplant before July 1992, when a reliable test came into use. As many as one-third to one-half of people infected prior to 1988 contracted HCV this way. Many people may not know that they had a transfusion. People may have been transfused if they:
 

	Had an injury and were unconscious and hospitalized
	Gave birth by cesarean section
	Were a premature or low-birthweight baby
	Had any kind of major surgery
	Were hospitalized as an infant or child
	Were adopted and have no early medical records

Getting Tested and Getting Treated
If you think you may have been exposed to infected blood, you should consider getting tested. Blood tests for HAV, HBV, and HCV are available through a physician and, in some cases, through a public health clinic.

Those who test positive for chronic hepatitis B or C may need a liver biopsy (a small piece of liver tissue is obtained) to determine the existence or extent of liver damage. Early diagnosis and management of hepatitis viruses may have long-term health benefits.

Treatment for hepatitis A involves bed rest, good nutrition, and an intake of extra liquids. HAV infection does not usually lead to long-term health problems and is rarely fatal.

Treatments are available for chronic hepatitis B and C. Therapy with interferon or lamivudine is available to help people with chronic hepatitis B. Therapy with interferon or pegylated interferon, alone or in combination with ribavirin, can help many people with chronic hepatitis C. Additional treatment options are being developed. More research is needed to develop cures for chronic hepatitis.

Many people live with chronic hepatitis (B or C) without experiencing liver damage. Others, however, may develop serious liver disease. People with chronic hepatitis should be monitored by a physician who is knowledgeable about liver disease.


Impact of Viral Hepatitis
Hepatitis A infects up to 200,000 Americans each year. Some communities have cyclical outbreaks every decade and 29 million people travel to places with high rates of HAV infection. Although hepatitis A rarely causes long-term health problems, it can create economic hardship through wages lost during the recovery period.

Hepatitis B is a preventable tragedy. Yet, 128,000 – 320,000 Americans become newly infected every year. Although 95% of infected adults fight the virus successfully, more than one million people have chronic HBV infection, and 5,000 people die each year. We can eradicate this virus. Preteens through young adults are at risk, as the vaccine was not available to them as infants. All pregnant women should be tested so that infection can be prevented in their newborns.

Within the next 20 years, the hepatitis C epidemic is expected to cause more deaths annually than AIDS. Although the rate of new infections is now greatly reduced, most of the almost four million people with HCV were infected years ago and are unaware of their condition. If they are not tested and evaluated for liver damage and the potential to benefit from treatment, many may develop liver damage and liver failure.


Diet and Alcohol
Adoption of a healthy lifestyle with a good diet, plenty of rest, and stress reduction can improve one’s health and well being.

Studies show that the use of alcohol substantially increases the risk of serious liver damage in persons with chronic viral hepatitis, and it should be avoided.


Vaccines Stop the Spread of Some Hepatitis Viruses
Vaccines for hepatitis A and B can provide long-term protection from these diseases. Unfortunately, there is no vaccine for hepatitis C.

Hepatitis A Vaccine
The hepatitis A vaccine is recommended for people over the age of two who:
 

	Travel to countries with high rates of HAV infection (Mexico, the Caribbean, Central and South America, Africa, the Middle East, Eastern Europe, countries bordering the Mediterranean, and some parts of Asia)
	Are children living in communities with high rates of the disease or regular outbreaks
	Have chronic liver diseases, including HBV and HCV infection (HAV can increase liver damage and can be fatal to these patients
	Engage in oral/anal sex

The HAV vaccine is given in two doses, 6 to 18 months apart, and it takes 30 days to take effect. For people already exposed to the virus, immune globulin can reduce the risk of infection if given within 14 days of exposure.

Hepatitis B Vaccine
This vaccine is recommended as part of the routine schedule of childhood immunizations. Many countries  require this vaccination for entry into elementary school.

Because the vaccine was not routinely given to infants until 1991, children born before then may not be protected. Immunization experts recommend vaccination of all children up to age 18 to fill this gap.
Experts also recommend immunization for:
 

	Infants born to HBV-infected mothers
	People with chronic liver diseases, including HCV infection
	People who have unprotected sex with more than one sexual partner
	People who are exposed to blood in the workplace, including health care and emergency service workers