Understanding Hepatitis

Extracted from “The Star – 19 May 2013”

Understanding the different forms of hepatitis, who is at risk, and how it can be prevented and treated can be confusing. Mayo Clinic infectious diseases expert Dr Stacey Rizza offers the following primer:

 

Hepatitis A – A highly contagious viral condition that causes inflammation affecting the liver’s ability to function, hepatitis A is most likely contracted from contaminated food, water or someone already infected.

Mild cases don’t require treatment, and most have the infection recover completely with no permanent liver damage.

Effective vaccines are available and recommended for children at age one; for older children who didn’t get the vaccine at age one; and for people travelling to areas with high rates of the illness, among others.

Practising good hand hygiene is one of the best ways to protect against hepatitis A.

Hepatitis B – For some people, hepatitis B infection becomes chronic, leading to liver failure, liver cancer or cirrhosis – a condition that causes permanent scarring of the liver. It is spread through bodily fluids.

Most people infected as adults recover fully, even if their signs and symptoms are severe. Infants and children are much more likely to develop a chronic hepatitis B infection.

Although no cure exists for hepatitis B, treatment options are available and vaccine can prevent the disease. Vaccination is recommended for infants; children who weren’t vaccinated in infancy; people being treated for sexually transmitted infection; healthcare workers and others who come in contact with blood on the job; people with end-stage kidney disease; and people travelling to areas with high rates of hepatitis B, among others.

If a person is already infected, taking certain precautions can help prevent the spread of hepatitis B to others.

There are vaccines to protect against hepatitis A and B. The CDC recommends hepatitis A vaccination for all children ages 12 to 23 months  and for adults who plan to travel or work in areas with hepatitis A outbreaks. People with chronic hepatitis B or C should also get the hepatitis A vaccine if they don't already have immunity to hepatitis A. The hepatitis B vaccine is recommended for all infants at birth and for adults who have any of the risk factors we discussed earlier. There is no vaccine for hepatitis C.

Hepatitis C – Most people infected with the hepatitis C virus have no symptoms. And most don’t know they have the hepatitis C infection until liver damage shows up decades later during routine medical tests.

Generally considered to be among the most serious of the three viruses, hepatitis C is passed through contact with contaminated blood – most commonly through needles shared during illegal drug use. Hepatitis C infection is treated with antiviral medications intended to clear the virus from the body.

“Hepatitis C infection can be asymptomatic for decades but typically appears as liver problems over time,” Dr Rizza says. “This can happen faster if people’s immune systems decline due to other conditions as they age. It’s a good idea to ask your physician about testing for it during your regular check-up. All forms of hepatitis should be taken seriously as the risks for them have increased in recent years.

The most common treatment for chronic hepatitis C is a combination of antiviral medications called interferon and ribavirin. Interferon is given as a shot and ribavirin is a pill. Studies suggest this combination can cure or control hepatitis C in about half of patients. But it can cause serious side effects. In addition, not everyone needs treatment. Your doctor will explain your options based on how active the virus is.