Beruflich Dokumente
Kultur Dokumente
HCSP GUIDES
A publication of the Hepatitis C Support Project
The information in this guide is
designed to help you understand
and manage viral hepatitis and is
not intended as medical advice. All
persons with viral hepatitis should
consult a medical practitioner for
diagnosis and treatment.
VIRAL HEPATITIS:
THE BASICS
Alan Franciscus
Editor-in-Chief,
HCSP Publications
TABLE OF CONTENTS
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Hepatitis A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Hepatitis B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Hepatitis C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Hepatitis D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Hepatitis E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
FOREWORD
Hepatitis is an inflammation of the liver. “Hepa” refers to the liver
and “titis” means inflammation. Hepatitis can be caused by toxins,
drugs, too much alcohol, or a variety of viruses. Viruses that infect the
liver are called hepatitis viruses. Each virus is unique and is identi-
fied by a letter of the alphabet, in the order of its discovery. This fact
sheet will discuss the basics of hepatitis A, B, and C and will touch on
what we know about hepatitis D and E.
Alan Franciscus
Executive Director, Hepatitis C Support Project
Editor-in-Chief, HCV Advocate
1
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
2
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
international travelers to areas that have Like all types of hepatitis viruses, HAV
substandard drinking water. infects and inflames the liver. If the elderly,
people who have a compromised immune
• HAV Prevention system, or someone with another liver
To prevent transmission of HAV, adults disease such as chronic hepatitis C or
and children must wash hands thoroughly B get infected with HAV, they risk more
(10 to 20 seconds), especially after using damage to the liver due to an additional
the toilet or changing diapers. People virus infecting their liver.
who are acutely infected with HAV should
avoid preparing food for others. Clean up Hepatitis A resolves completely on its
spilled blood or body fluids with a 10:1 own. Symptoms usually last a few weeks,
bleach solution (10 parts cool water to 1 although fatigue may linger for months.
part bleach). Wear gloves when touching About 10-15 percent of people experience
blood, body secretions, or any cuts or a relapse over a 6-9 month period. There
sores. Do not share razors, toothbrushes, is no chronic or carrier state. Rarely,
or needles. Practice safer sex, including a person may develop fulminant (liver
latex condoms and latex or plastic barriers failure) hepatitis A, which is characterized
for oral/anal sex. by severe symptoms and may be fatal;
fulminant hepatitis A is more likely in
Thoroughly wash any fruits and vegetables people who already have chronic hepatitis
especially if grown outside of the United B, hepatitis C or other liver diseases or a
States–some fruits and vegetables may compromised immune system. This is why
become contaminated with unprocessed it is important that anyone at increased risk
sewage accidently, or some growers in for complications should be vaccinated
countries outside of the United States may against hepatitis A if they are not immune.
use human waste as fertilizer.
• HAV Treatment
• HAV Symptoms and Progression Because hepatitis A typically resolves on
Hepatitis A has an incubation period that its own, there is no standard treatment
can be from 15-50 days but averages 28 for HAV. However, if a person has been
days. When symptoms occur in adults, exposed to HAV, an injection of HAV
they appear suddenly and may include immune globulin (antibodies) given
fever, exhaustion, loss of appetite, nausea within 14 days of exposure may prevent
and abdominal discomfort, dark urine and the development of illness or lessen the
jaundice (yellowing of the skin and eyes). severity of symptoms. During the acute
period, general measures such as a
Children younger than age 6, who make healthy diet, plenty of fluids and adequate
up the majority of those who become rest can help make a person feel more
infected with HAV, usually have no comfortable.
symptoms. Because they are symptom-
free, caregivers, parents, and household • The HAV Vaccine
members are at risk of contracting HAV The HAV vaccine is considered safe
from infected children. and effective. The two-dose vaccine is
3
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
administered by injection, with the second velop chronic infection – most experience
dose given 6-12 months after the first. a brief, acute infection. Most people who
Antibody testing after vaccination is not experience acute hepatitis B do not have
recommended since 97-100% of people much liver damage, but people who de-
given two doses of the HAV vaccine velop chronic HBV infection can develop
develop protective anti-bodies within 1 severe liver damage especially after years
month of receiving the first dose and 100% or decades of infection.
have protective levels after the second
dose. Experts believe that the HAV vaccine • What Are the Symptoms?
will provide protection against hepatitis
Up to 70 percent of people infected with
A for 25 years or longer. Some experts
HBV, especially children, experience no
believe that people with compromised
symptoms. The most common symptoms
immune systems (such as people with HIV
are jaundice (yellowing of the skin or
or people taking immunosuppressants)
the whites of the eyes), fatigue, stomach
may require more doses of the HAV
discomfort and abdominal pain, fever, loss
vaccine.
of appetite, nausea and joint pain.
There have been no serious adverse
• What Are the Tests for Hepatitis B?
reactions attributed to the HAV vaccine.
Common side effects may include A health care provider will take a blood
soreness/tenderness at injection site, sample to test for HBV antigens, the
headache, and malaise. proteins that make up the virus, and for
HBV antibodies that the immune system
The HAV vaccine is recommended for creates to attack the antigens. These
anyone at risk of exposure to HAV, include the surface antigen (HBsAg), which
including men who have sex with men, makes up the covering of the virus, and
day care center workers, and certain the “e” antigen (HBeAg). When a person
international travelers. People with does develop surface antibodies, it means
hepatitis B or C or other types of liver he or she has cleared the virus and is no
disease should receive the HAV vaccine to longer infected or able to infect others.
prevent fulminant or severe hepatitis A. Doctors also test blood for HBV DNA, to
assess viral load – the quantity or number
of viruses in the blood – and for certain
liver enzymes that are released into the
HEPATITIS B (HBV) bloodstream when liver cells die as a result
Hepatitis B infection can cause either a of the infection.
short-term (acute) infection or a long-term
or lifelong (chronic) infection. When new- • Transmission and Prevention
borns are born to HBV-infected mothers, HBV is spread mainly through exposure
they face a 90 percent risk of developing to infected blood and bodily fluids,
a chronic HBV infection unless there is especially during childbirth or during sex,
intervention after birth. However, when or when syringes are shared. This virus is
adults are infected, only 5 percent de- very hardy; it can live in dried blood on
4
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
5
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
6
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
transmission route. Needles used for The Centers for Disease Control and
tattooing, body piercing, and acupuncture Prevention recommend that everyone born
may also spread HCV. Sharing personal between 1945 and 1965 should have a
items such as razors, toothbrushes, or one-time HCV antibody test.
nails files is a less likely, but possible,
transmission route. To prevent transmission of hepatitis C
do not share any needles or any other
Sexual transmission between drug paraphernalia. Avoid sharing razors,
monogamous couples in a stable long- toothbrushes, clippers, nail files, or any
term relationship is uncommon (estimated other items that come into contact with
at 0-3%). Healthcare workers and blood. Make sure that instruments used
emergency responders are at risk for HCV for tattooing, body piercing, acupuncture,
infection due to needle stick accidents and and medical procedures are properly
unavoidable situations that may result in sterilized. Cover all cuts and wounds with
direct contact with blood from an infected a bandage.
person.
People who are not in a long-term stable
Mother-to-Child transmission occurs monogamous relationship can practice
about 6% of the time. Transmission may safer sex and take precautions to avoid
depend on the amount of the hepatitis C contact with blood and other body fluids
virus in the mother’s blood; women who during sex. Proper dental hygiene can
are confected with HIV are more likely prevent bleeding gums, another potential
to transmit HCV to their babies. Breast HCV transmission route. Healthcare
feeding is considered safe. workers and emergency personnel should
observe standard universal precautions
People who received blood, blood when dealing with blood. If you are a
products or organ transplants before woman with HCV, talk to your doctor if you
1992 should be tested for hepatitis C. are thinking about becoming pregnant.
People who received clotting factors
before 1987 were at risk for being infected • Acute Infection
with hepatitis C. People who receive After exposure to the hepatitis C virus
hemodialysis are also at risk for being a person will develop antibodies. The
infected with hepatitis C and should be initial stage is called acute infection. Most
tested blood-borne pathogens including people (up to 85%) who become develop
hepatitis C on a regular basis. acute infection will progress to chronic or
long-term infection. But for some people
their body’s immune system will naturally
NOTE fight off the virus.
HCV is not transmitted by hugging,
kissing, sneezing, coughing, sharing • Chronic Infection
eating utensils or glasses, or by casual If a person still has the virus in their body
contact. for longer than six months the person
7
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
8
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
9
G E N E RA L T O P I C S P E C I F I C G U I D E S
VIRAL HEPATITIS: THE BASICS
10
G E N E RA L T O P I C S P E C I F I C G U I D E S
HCSP GUIDES
A publication of the
Hepatitis C Support Project
VIRAL HEPATITIS:
THE BASICS
Executive Director
Editor-in-Chief, HCSP
Publications
Alan Franciscus
Author
Alan Franciscus
Contact Information
Hepatitis C Support Project
PO Box 15144
Sacramento, CA 95813
alanfranciscus@hcvadvocate.org
Permission to reprint this document is granted and encouraged with credit to the author and the Hepatitis C Support Project.