Hepatitis: A Silent Health Danger

Hepatitis is a silent epidemic spreading worldwide, affecting 290 million unsuspecting people of all ages globally, or 9 out of 10 people. July is World Hepatitis Month, with July 28 officially designated as World Hepatitis Day, placing emphasis on finding the missing millions having undiagnosed hepatitis.

Your Capital Women’s Care team wants to share important information to raise your awareness and understanding of the different forms of viral hepatitis; their causes and treatments; and how you can protect yourself and your family from its many health dangers.

What is Hepatitis?

Hepatitis affects the liver, the body’s largest internal organ. The liver aids in digesting food, storing energy and removing toxins from within your body. Hepatitis is an inflammation of the liver, often caused by viruses. Each type of hepatitis (A, B, C, D, and E) is named for the virus causing it.

In addition to viruses, drug or alcohol use can cause hepatitis, especially if those unknowingly infected share drug needles. Other cases of hepatitis occur when the body mistakenly sends signals to attack healthy liver cells.

Hepatitis Statistics

Viral hepatitis is a global health burden with sobering statistics:

1.4 million deaths a year can be attributed to Hepatitis B and Hepatitis C, more than the number deaths caused by tuberculosis, HIV/AIDS and malaria combined.
Together, Hepatitis B and Hepatitis C cause 2 of every 3 liver cancer deaths worldwide.
90% of those with Hepatitis B are unaware they have it.
80% of those with Hepatitis C are unaware they have it.
Eliminating viral hepatitis is achievable. There are effective vaccines and treatment for Hepatitis B and a cure for Hepatitis C. Birth-dose vaccine costs as little as $.20/dose, yet vaccine isn’t used in 48% of countries worldwide.
Elimination of Hepatitis B and Hepatitis C as threats to public health by 2030 would prevent approximately 36 million infections and save 10 million lives worldwide.

Hepatitis Symptoms

Oftentimes, hepatitis infection has no noticeable symptoms, leading those unaware of their illness to spread it unwittingly to others, and is potentially deadly if left untreated.

Some with hepatitis may experience these symptoms:

loss of appetite
weight loss
joint pain
fever
nausea and vomiting
diarrhea
dark-colored urine and pale bowel movements
abdominal pain
and yellowing of skin and eyes (jaundice)

Hepatitis forms can range in severity from mild to serious. Some can lead to scarring of the liver (cirrhosis) or to liver cancer.

Sometimes the infection may go away on its own or it may be treated with drugs if it continues. Hepatitis can last a lifetime. Vaccines can offer protection from some viral hepatitis forms, but they must be received before infection occurs to be effective.

It’s important to talk with your doctor immediately if you suspect hepatitis so you can begin immediate treatment, eliminate further liver damage, avoid spread of the disease to others and regain your health.

Forms of Hepatitis

There are 5 forms, or strains, of viral hepatitis. The hepatitis A and E viruses typically cause acute or short-term infections. The hepatitis B, C, and D viruses can cause acute and chronic (long term) infections.

Here is an overview of causes, prevention and risk factors and treatment associated with each strain:

hepatitis A - Primarily spreads through consuming food or water contaminated with an infected person’s stool.

Countries lacking safe drinking water supplies and using poor hygiene and sanitation practices usually have many cases.

Vaccine prevention for hepatitis A exists. If treatment occurs within a few weeks of viral exposure it can bring short-term immunity. Once you experience hepatitis A, you gain immunity from the strain, although you are not immune to other hepatitis forms.

Risk of hepatitis A can be greatly reduced through vaccination, practicing good hygiene and sanitation (washing hands thoroughly after urination and defecation) and avoiding drinking from unsafe water sources.

In rare cases, hepatitis A may lead to liver failure. Liver failure due to hepatitis A is more common in adults age 50+ and in people who have another liver disease.

Hepatitis A diagnosis is based on symptoms and a blood test, which detects antibodies to the hepatitis A virus called immunoglobulin M (IgM) antibodies. If the blood test finds antibodies to the hepatitis A virus that are not IgM antibodies, then you have immunity from hepatitis A, due to either a past infection or vaccination. Blood screening is done similarly for other hepatitis strains.

hepatitis B – Many people who have hepatitis B don’t have symptoms and don’t know they have hepatitis B. Screening tests can help doctors diagnose and treat hepatitis B, which can lower your chances of developing serious health problems.

This form spreads through contact with blood or other bodily fluids of an infected person. Some scenarios in which virus transmission may occur:

from mother to child during childbirth
through sharing razors, nail scissors or toothbrushes
having unprotected sex
getting tattoos or body piercings from unlicensed facilities
and sharing needles and syringes to inject drugs.

There are two types of hepatitis B:

acute hepatitis B - is a short-term infection. If you have symptoms, they may last several weeks. In some cases, symptoms last up to 6 months. Sometimes your body can fight the infection and it goes away. Most healthy adults and children older than age 5 who have hepatitis B get better without treatment.
chronic hepatitis B - is a long-lasting infection and occurs when your body can’t fight the virus and it does not go away.

Chances of developing chronic hepatitis B are greater if you are infected with the virus as a young child. About 90% of infants infected with hepatitis B develop a chronic infection. About 25-50% of children infected between 1 and 5 years develop chronic infections. However, among people infected during adulthood, only about 5% develop chronic hepatitis B.

Certain populations are at increased risk, including those who are:

receiving kidney dialysis
taking medications that weaken the immune system (steroids or chemotherapy)
within specific working environments (healthcare, prisons)
or had either a blood transfusion or organ transplant prior to the mid-1980s.

Vaccination is effective to prevent infection.

Blood tests for hepatitis B indicate if you have acute or chronic type, if liver damage occurred or you have an increased liver damage risk. Additional monitoring of liver function and damage includes transient elastography ultrasound and liver biopsy.

Chronic hepatitis B complications include cirrhosis of the liver, liver cancer or liver failure, resulting in a liver transplant to sustain life.

Although there is currently no true cure, drugs like alpha interferon and peginterferon and a variety of antiviral drugs are available. These drugs slow virus replication within the body and occasionally result in its clearance. Most importantly, these drugs greatly reduce complications risks caused by hepatitis B, like liver cirrhosis (scarring) and liver cancer.

hepatitis C – Many people who have hepatitis C don’t have symptoms and don’t know they have it.

In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with infected blood. Injecting drugs is the most common way people within the U.S. become infected with hepatitis C.

Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.

Hepatitis C can occur either as an acute or chronic infection. About 75-85% of people with acute hepatitis C will develop chronic hepatitis C.

Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver cancer and liver failure, resulting in requiring a liver transplant.

Common ways hepatitis C spreads include:

unsafe injection practices
inadequate medical equipment sterilization
unscreened blood or blood products (platelets and plasma)
and through certain sexual practices.

There is currently no vaccine available. To reduce exposure risk, it is necessary to:

avoid sharing needles, toothbrushes, razors or nail scissors
and avoid getting tattoos or body piercings from unlicensed facilities.

Your doctor may recommend screening you for hepatitis C if you have a high chance of being infected or were born between 1945 and 1965. Other at-risk populations more likely to get hepatitis C are those who

have injected drugs
had blood transfusion or organ transplant before July 1992
have hemophilia and received clotting factor before 1987
had kidney dialysis
have been in contact with blood or infected needles at work (healthcare and prison)
have had tattoos or body piercings
were born to a mother with hepatitis C
have HIV infection
or have had more than one sex partner in the last 6 months or a history of sexually transmitted diseases (STDs.)

Doctors usually recommend one-time screening of all adults age 18 to 79. Blood screening tests for disease in those without symptoms. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems like liver damage.

Treatment can cure hepatitis C infection. Until recently treatment involved combining interferon, generally pegylated, long-lasting interferon, and ribavirin, but there is increasing use of potent direct acting anti-viral drugs. People with different hepatitis C genotypes respond differently to treatment, some more successfully than others; however, differences between genotypes is disappearing as cure rates using newer drugs now approach 100%.

hepatitis D – can only occur in people already infected with hepatitis B virus. A coinfection occurs when you get both hepatitis D and hepatitis B infections at the same time. A superinfection occurs if you already have chronic hepatitis B and then become infected with hepatitis D.

Hepatitis D can occur as an acute or chronic infection with acute infections becoming chronic in some cases. Those with acute infection are more likely to display symptoms. In contrast, most people with chronic hepatitis D have few symptoms until complications develop, which could be several years after they were infected.

Like hepatitis B, the D strain spreads through contact with infected blood.

Exposure risks are the same as the C strain – avoid sharing needles, getting body piercings and tattoos from unlicensed facilities and avoid sharing personal hygiene tools (toothbrushes, razors and nail scissors.)

Doctors determine infection through blood tests and can monitor liver function and condition through ultrasound and biopsy.

There is no vaccine for hepatitis D; however, vaccination against hepatitis B can prevent hepatitis D infection.

Hepatitis D treatment utilizes interferon; researchers are investigating new treatments. Because hepatitis D occurs only in those with hepatitis B, oral medications may be required.

Complications from chronic hepatitis D include cirrhosis of the liver, which increases chance of liver cancer. Liver failure is another complication of both acute and chronic hepatitis D infections, requiring liver transplant to sustain life.

hepatitis E – like the A strain, hepatitis E is primarily transmitted through consuming contaminated food or drinking water, with outbreaks occurring where good hygiene practices and safe drinking water sources aren’t instituted.

Hepatitis E is typically an acute infection that gets better without treatment after several weeks. Some types of hepatitis E virus are spread by drinking water contaminated by an infected person’s feces. Other types are spread by eating undercooked pork or wild game.

Those with other liver diseases face higher risk of acute liver failure.

Vaccine exists but is not widely available. Preventative measures include good hygiene and sanitation practices and avoid drinking water from unsafe sources or consuming undercooked wild game or pork.

Once someone is infected and they haven’t been previously immunized, there is no treatment. While people usually recover even without the availability of medical treatment, the E form can be fatal in very rare instances.

Hepatitis’ Effects on Pregnancy and Babies

Hepatitis can be a detriment not only to pregnant women, but also to their babies’ health.

The Centers for Disease Control (CDC) guidelines for hepatitis A vaccination for babies and children are:

all children at age 12–23 months
unvaccinated children and adolescents aged 2 to 18 years
healthy travelers from ages 1 to 40 years who are going to a country with high or intermediate risk of contracting hepatitis A
and infants ages 6 to 11 months who are traveling internationally where hepatitis A vaccine is recommended.

Your doctor may recommend screening you for hepatitis B if you are pregnant or have a high chance of being infected. The hepatitis B vaccine is safe for pregnant women. Your doctor may recommend screening you for hepatitis B if you are pregnant or have a high chance of being infected.

All newborns should get a vaccine to protect against hepatitis B before leaving the hospital. Sadly, 1 in 5 babies at risk of hepatitis B infection leaves the hospital without receiving the vaccine and treatment shown to protect newborns, even if exposed to hepatitis B at birth. Hepatitis B can cause a lifelong infection, serious liver damage, and even death.

The hepatitis B vaccine for babies is a series of three different shots. The American Academy of Pediatrics and the CDC recommend all newborns receive the first hepatitis B shot before leaving the hospital. If the mother has hepatitis B, her baby should also get a hepatitis B shot within 12 hours of birth. The second hepatitis B shot should be given to baby 1 to 2 months after birth. The third hepatitis B shot should be given to baby no earlier than age 24 weeks, but before age 18 months.

If a woman infected with hepatitis C is pregnant, she increases her baby’s chance of hepatitis C infection. Since hepatitis C is passed through infected blood, an infected breastfeeding mother whose nipples become cracked and bleeding should not breastfeed her baby until fully healed to avoid infecting baby. A baby cannot contract hepatitis C from breast milk.

Acute hepatitis E can be especially dangerous for pregnant women in developing countries, causing acute liver failure in mother and stillbirth, premature birth or low birthweight in babies.

Risk Prevention

There are several ways to reduce your risk of contracting hepatitis:

Check with your doctor for appropriate hepatitis vaccination, especially if traveling to countries with moderate to high hepatitis risk.
Wash hands thoroughly after urination or defecation.
Wash hands before and after food preparation, especially if handling uncooked meat or wild game.
Avoid sharing personal hygiene items like razors, nail scissors or toothbrushes.
Avoid illicit injected drug use or sharing of needles.
Avoid unlicensed tattoo and body piercing businesses.
Protect against accidental needle punctures and others’ bodily fluids if working in the healthcare field.
Use condoms during sex.

Your local Capital Women’s Care team is here for you and your family should you have questions or concerns relating to hepatitis, its vaccines and screenings, treatments or care. Your health and that of your family are top priority here at Capital Women’s Care.