What is Hepatitis?
Hepatitis is inflammation of the liver, which is swelling that occurs when tissues are injured or infected. Liver inflammation can be caused by chemicals, drugs, alcohol, certain genetic disorders or an overactive immune system, but the most common reason is from an infection by a virus, also known as viral hepatitis.
There are five viruses that cause viral hepatitis: hepatitis A, B, C, D and E. In the United States, A, B and C are the most common. Hepatitis A is usually a food-borne illness spread through contaminated water and unwashed food. Hepatitis B and C, on the other hand, are common blood-borne viral infections. Hepatitis B affects about 1.2 million Americans, while hepatitis C affects about 2.4 million and both are serious and can lead to chronic liver disease.
What causes hepatitis B and C?
Both types of hepatitis are caused by contact with the particular virus (hepatitis B virus or hepatitis C virus). Hepatitis B is transmitted by contact with bodily fluids from an infected person. Hepatitis B can be transmitted by having sex with an infected person, sharing drug needles with an infected person, using infected tools for tattoos, acupuncture or piercings and even sharing toothbrushes, razors and other personal items with an infected person.
Hepatitis C is transmitted by contact with blood from someone infected with the virus. The most common way to get hepatitis C is by sharing needles and syringes. Like hepatitis B, it is also possible to get hepatitis C by exposure to infected tools used for tattoos, acupuncture, piercings or even razors as they all could contain blood residue. Anyone who may have had a blood transfusion prior to 1990 is also at risk for hepatitis C as blood banks did not screen for the virus prior to that time.
Both types of hepatitis can be spread at birth from an infected mother and are a risk for healthcare workers through needle stick injury. It is important to note that neither hepatitis B nor C can spread through sneezing, coughing, hugging or sharing food.
Who is at risk for hepatitis B and C?
Because of how hepatitis B and C spreads, individuals at an increased risk include anyone who has unprotected sex with multiple partners, shares needles during drug use, men who have sex with other men, and those who have a job that exposes them to human blood.
What are the symptoms?
Hepatitis B and C are called silent killers because they usually develop slowly over many years, and many patients might not have symptoms and may not even know they are infected. Patients who do have symptoms may experience any of the following:
- Dark yellow urine
- Fatigue
- Fever
- Joint pain
- Nausea
- Pale or gray stools
- Vomiting
- Yellowing of the skin or eyes
Can hepatitis B and C be prevented?
There is no vaccine for hepatitis C, but hepatitis B is preventable through immunization. The CDC recommends the hepatitis B vaccine be administered as part of the routine vaccination schedule for all infants. It also recommends the vaccine for all individuals under the age of 59 who were not vaccinated as children, as well as adults 60 years of age or older with risk factors for hepatitis B. Because there is no vaccine for hepatitis C, the U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for the virus especially if they have risk factors for exposure.
Ensuring good hygiene and avoiding contact with contaminated objects or bodily fluids can help prevent infection from any of the hepatitis viruses.
What are the treatment options?
There are two types of hepatitis B: acute and chronic. Acute hepatitis B is more common and typically lasts less than six months. Most cases of hepatitis B do not require treatment and resolve on their own. While infected with acute hepatitis B, it is important to practice good hygiene to avoid passing to others.
"In situations where the virus lingers after six months, the infection is referred to as chronic hepatitis B. Some cases of chronic hepatitis B may not need treatment, but others do and medications called antivirals are used," said Purvi Parekh, DO, a board-certified physician who practices internal medicine with Penn Highlands Healthcare. "Chronic hepatitis B is a condition that requires close monitoring by a doctor since there is risk of developing worsening liver disease. In some people, the infection can last a lifetime. Avoiding alcohol and over the counter supplements and medications can help to prevent further damage to the liver," she added.
Hepatitis C is generally treated with antiviral medications that attempt to clear the virus from the body in about 12 weeks. There are newer antiviral medicines called direct-acting that typically have better outcomes, fewer side effects and shorter treatment times. If taken correctly, hepatitis C is curable with treatment, although there is a chance of getting it again if exposed, so prevention is critical.
If you have concerns about hepatitis exposure or want to be tested, start with your primary care team. The primary care providers at Penn Highlands Healthcare can diagnose hepatitis A, B and C, and can also arrange for the appropriate testing and referrals if treatment is required. They also can provide the hepatitis B vaccine. To find a physician near you, visit www.phhealthcare.org/findadoc.