Hepatitis

An Overview of Hepatitis

What do stars of past and present Evil Kenivel and Naomi Judd have in common with hundreds of thousands of people across the United States? Both stars have or have had the hepatitis virus, in particular hepatitis C. There are three types of hepatitis which infect many Americans each year. In order to reduce the risk of contracting the virus, it is necessary to understand what hepatitis is and its effect upon the body.

Hepatitis is a virus that is easily spread and that causes inflammation of the liver. The infection can either be acute, which means the body usually recovers in less than six months. Or, the virus can be chronic, which means the infection lasts in the body for six months or more. There are several viruses that cause the different types of hepatitis and all may respond to medication and treatment differently. Although most people who acquire from the forms of hepatitis recover and the infection is usually preventable, hepatitis is still a major health concern.

Hepatitis remains a major health concern because of the damage it can do to a person’s liver tissue and how easily it is spread among people infected with the virus. Hepatitis can seriously affect the body by weakening the immune system and can even cause liver failure, liver cancer, or death. It is important to realize that one form of hepatitis differs from the next. Hepatitis A, for example, is spread easily through contaminated food or water, but the action by which it is spread is totally different than Hepatitis C, which is spread by body fluids or in the birthing process from mother to child. In order to prevent acquiring the disease, it is equally important to understand how the disease is spread and what measures can be taken to prevent infection.

There are different treatments available to address patients with hepatitis, although again they vary dramatically from one form of hepatitis to another. Patients with hepatitis A, for example, will not find prescription medication to treat their condition, as the condition must run its course. This differs from the medications offered for hepatitis B and C, which even then may vary among the different subtypes of the virus.

Hepatitis A

Hepatitis A is generally the mildest form of hepatitis transmitted in the United States. It is also extremely prevalent in underdeveloped countries and fledgling nations. It is spread very easily and can be acquired more readily than other forms of hepatitis can be.

A Different Disease

Hepatitis A differs significantly from the other two forms of hepatitis –B and C—in that people who contract the illness never experience a chronic infection and in fact, usually have no complications from the condition. People who become infected with hepatitis A generally recover over a period of weeks. There is no treatment for the disease, and the patient’s liver will usually heal itself in about two months. During this time, the patient should maintain a close relationship with his doctor, as the doctor will continue monitoring the patient’s blood levels to check on liver function and health.

However, some patients have died over the years from a hepatitis A infection. This is due to the disease developing into a massive liver infection, which is generally unusual as most patients do make a full recovery. Children who are infected with hepatitis A may show only a few symptoms. The virus can be spread usually about a week before a patient experiences symptoms as well as during the first week of having symptoms. People who do not experience symptoms and are thus unaware they are infected can also spread the virus.

The hepatitis A virus is found in the stools of infected patients. It is therefore most commonly spread through food or water that has been contaminated in some way by an infected stool. The virus is transmitted as well through poor sanitation and poor hygiene, which explains its prevalence in underdeveloped countries. People living with an infected person or having sexual relations with someone infected with hepatitis A can also contract the virus. The virus can also infect people traveling to underdeveloped countries, health care workers, drug users, and day care workers and children, among others.

The virus can cause an acute infection and about 15 percent of people who have had an acute infection will have prolonged infections or experience symptom relapses over a period of six to nine months.

Hepatitis B

Unlike hepatitis A, the hepatitis B virus generally causes liver damage in most people suffering from the disease. While most people who become infected do recover from the virus in about six months or so, other people will sometimes suffer from a life-long, chronic infection that can result in very serious liver damage.

The Middle Ground Virus

Hepatitis B can be considered between hepatitis A and C in terms of severity and the length of illness caused by the virus. Approximately 200,000 to 300,000 people in the United States each year are diagnosed with hepatitis B. These people can spread the disease even if they do not experience symptoms or feel sick; therefore, many people who are infected with the disease are not aware they have it.

Hepatitis B can cause a variety of liver ailments. These include liver scarring, liver cancer, liver failure, and death. Unlike hepatitis A, hepatitis B can be acquired in more conventional ways, through infected blood or body fluids. The disease can also be present in the open sores of infected persons or through breast milk. About 90 to 95 percent of those who become infected will battle a limited infection, and the body can usually fight off the illness within a few months of acquiring it. The body will then develop a lifetime immunity to the virus, meaning these particular people can never become infected with hepatitis B again.

If someone is infected with the disease for longer than six months, though, they become known as a carrier. This person may not have any symptoms but can still spread the disease through the conventional methods as well as deep kissing and sharing food or drinks. Once a person has become known as a carrier, the disease may either go away or cause a chronic infection. About five to 10 percent of people will develop a chronic infection due to hepatitis B, which can then lead to cirrhosis, or severe damage to the liver. There are treatments available for hepatitis B and the patient’s liver function will be continually monitored by a doctor.

Hepatitis C

Hepatitis C is the most serious form of hepatitis infection a person can have. It is one of the most common causes of liver disease in the United States as well as the number one reason for liver transplant in the United States. It is certainly not a disease to be taken lightly and precaution should be taken to avoid acquiring the disease.

More Chronic Infections

Approximately 80 percent of people who become infected with hepatitis C will develop a chronic liver infection, according to statistics. Each year, the disease infects about 2.7 million people in the United States alone. Similar to other forms of hepatitis, the hepatitis C virus often shows no signs of symptoms in its victims. There is also no vaccine available to prevent hepatitis C, so following other methods of prevention is the only way to ensure a person does not acquire the disease.

There are six different subtypes of the virus, with the subtype one being the most common. While there are medications to treat each subtype, as luck would have it most of the available medications do not work to treat subtype one as effectively as the other subtypes. While this form of hepatitis is spread through conventional methods like infected body fluids such as hepatitis B, it is not spread through food, water, or casual contact like hepatitis A.

People who share needles, as well as who require kidney dialysis, are at a higher risk for contracting hepatitis C. Also, blood transfusion and organ transplant recipients prior to 1992 before more effective screening measures were in place are also more likely to have the infection. Approximately 75 to 85 percent of people who become infected with hepatitis C will develop a chronic, long-term infection.

If a patient believes they may have developed the infection or is experiencing symptoms, it is important to be seen and tested by a doctor. The doctor can determine which subtype of hepatitis C the patient has and thus which type of medication and treatment would be most effective. Testing is also important to confirm the diagnosis so patients can confer with their family and friends, or anyone else who may have been exposed to their body fluids.

How is Hepatitis Acquired?

Since hepatitis is a virus, it can be fairly easily spread from person to person. However, how easily it is spread depends on the type of hepatitis as well as whether the person is high risk or not.

Different Mechanisms

Each hepatitis virus has its own mechanisms for how it is spread. Hepatitis A varies from hepatitis B and C in that the virus is present in the stool of infected persons. Thus, the virus is spread by food, water, or contact with an infected person who does not practice good hygiene and sanitation. Trace amounts from the person’s infected stool can contaminate food and water that is not handled properly in a hygienic manner.

All three forms of the virus can be spread by sexual contact, but interestingly enough this is more rare in the case of the hepatitis C virus. On the other hand, body fluids such as blood, semen, and vaginal secretions do carry the virus and thus any sexual activity, including oral sex, should be carried out with protection. People who have sex with many different partners should also be aware that they are at a higher risk for acquiring a hepatitis infection.

Other high risk people and groups include those who consume large amounts of alcohol. People who get poor nutrition, work in hospitals, nursing homes or day care centers, and people who receive kidney dialysis are also at higher risk for developing the infection. Individuals who travel to foreign countries prone to the disease should investigate whether or not a vaccine is a good idea, because traveling in countries prone to the virus such as underdeveloped nations can put a person at higher risk, as well.

In general, people with risky behavior such as drug users –whether intravenous or not—and those who practice risky sexual behavior are at a much higher risk for acquiring the infection. Learning how the virus is spread and taking steps to avoid infection is important to maintaining a healthy and enjoyable lifestyle. Since the virus sometimes does not have symptoms, it is important for people engaging in risky behaviors to get tested frequently to avoid spreading the virus to others if they have it.

How to Prevent Hepatitis

There are several ways in which a person can avoid becoming infected with the hepatitis virus. Although some factors can be incontrollable, for example an infant who has acquired the disease from his mother or a patient who received a blood transfusion or organ transplant prior to 1992, for the most part the disease can be prevented.

Vaccines

Both hepatitis A and B can be prevented simply by enduring a needle stick. The two types of hepatitis have vaccines available to prevent them. There is not a vaccine available for hepatitis C, so other preventative measures must be taken.

Other Measures

Regardless of whether a person has been vaccinated, it is still a beneficial idea to follow good practices in terms of preventing the virus. People who participate in sexual activities should use a latex condom during sex and avoid having sexual relations with someone who is infected with hepatitis. Also avoiding risky sexual behaviors like having unprotected sex or sex with multiple partners can significantly cut one’s risk of becoming infected.

Avoiding other risky behavior like doing drugs is a good way to prevent the disease. This is especially true for people who share needles as injecting drugs intravenously can spread the virus from person to person. Avoiding this behavior all together is best, but if the behavior is continued, a fresh needle should be used each time. This is similar to people who work in high risk environments such as hospitals and nursing homes, where needle sticks can occur. Daycare center workers and restaurant employees should also use caution and good sanitation to avoid spreading the disease.

Do not use the personal items of an infected person, including items like the person’s razor or toothbrush, as these items can carry the virus. Get vaccinated when traveling abroad, especially to underdeveloped nations with a propensity for the disease. People getting tattoos or body piercings should use extra caution as the disease can be spread through needles that have not been properly sanitized. Even patients who are considering therapies like acupuncture should be cautious as the needles must be properly sanitized since they do pierce the skin.

What are the Symptoms of Hepatitis?

Each type of hepatitis can carry its own unique symptoms, but for the most part hepatitis A, B, and C share similar symptoms. If you are experiencing any of these symptoms or a combination of these symptoms, it is important to make an appointment to get tested for hepatitis so treatment can begin if necessary.

Similar Symptoms

Not all of the types of hepatitis share each symptom, but they are similar for the most part. Common symptoms that affect all three types of the virus include dark urine, yellow skin or eye whites –also known as jaundice, low grade fever, loss of appetite, fatigue, and feeling sick to the stomach. The viruses can also cause a lack of nutrition.

Other symptoms are more unique to different types of the hepatitis virus. Stomach pain, for example, affects people suffering from hepatitis B and C. Pale or clay colored stool affects patients infected with hepatitis A or C, and aching joints often strike patients infected with hepatitis B.

Since these symptoms are so similar, patients may be unaware of which type of hepatitis virus they have, or even whether they have hepatitis. That is why making a doctor’s appointment and getting tested for the disease is so profoundly important, especially for people engaging in high risk behaviors. This is especially crucial since the virus can be spread so easily from person to person. Knowing which symptoms are associated with which type of virus can also help patients to learn more about which particular type of hepatitis they have.

Patients with hepatitis A, for example, can learn which type of symptoms to expect and can contact their doctor should they experience a deviation from that expectation, which could mean a more serious infection has potentially developed. Since hepatitis A has no real form of treatment and must be waited out, patients can report any unusual symptoms to their doctors while their liver functioning is being monitored. Recognizing the symptoms is the important first step in seeking help and making a definitive diagnosis, which can be done by blood test.

Pregnancy and the Hepatitis Virus

Pregnancy is a big concern to women who are infected with the hepatitis virus. Women who are pregnant or who are planning to become pregnant must consider the risks of doing so when infected with the virus and also whether they are going to be treated for their infection prior to becoming pregnant or giving birth.

Passing the Infection

Women who are pregnant have approximately a 70 percent chance of passing their infection on to their child in the case of hepatitis B. The virus can be passed during the birth process or during nursing from mother to infant through breast milk. It is thus extremely important that all women who are pregnant or who are planning to become pregnant get tested for the presence of the hepatitis B virus. This is because infants who are born to mothers infected with the virus need to begin treatment for the disease within 12 hours of birth. Fortunately, the hepatitis B virus can be completely eliminated by a vaccination that is successful.

On the other hand, approximately five percent of women infected with hepatitis C will pass the virus to their children through birth or breast milk. It is especially important that women who are infected with hepatitis C do not seek treatment for their disease if they are immediately planning on becoming pregnant or if they are already pregnant. The medications used to treat hepatitis C are strong and can cause miscarriage and birth defects. These drugs include interferon drugs and also those drugs in combination with ribavarin. Hepatitis A usually runs a shorter course of infection in most women and is not as big a concern as women who are infected with B or C, the two types of hepatitis that can cause liver damage.

Women who have hepatitis C must make the decision between becoming pregnant or undergoing treatment, as it is inadvisable to do both. Therefore, women infected with the hepatitis C virus may face a heavier decision than women with the hepatitis B virus, which can be treated in pregnant women and their children.

Diagnosing the Hepatitis Virus

The hepatitis virus in its various forms is diagnosed tentatively through the symptoms of the disease and then definitively through one or more of the several blood tests available. Doctors may choose to perform more than one blood test to ensure the accuracy of the diagnosis.

Blood Testing

Blood testing is the definitive method of diagnosing hepatitis, whether it is A, B, or C. Blood tests for hepatitis are designed to recognize certain substances in the blood that may indicate the presence of hepatitis. There are tests available that can indicate whether the person had hepatitis or whether the virus is still active and how much of the virus is at work within the person. They may determine whether the virus is still active, and if so whether it is chronic. Tests can also detect antigens, antibodies, or genetic material of the viruses.

For hepatitis B, antigen testing is the earliest way to find out if the virus is in an active stage of infection. The surface antibody test, which detects antibodies of the virus, is also a common way to determine whether the virus is present in the body. The surface antibody test for hepatitis indicates that the virus has been present in the body and also that the body now has immunity to the virus.

Hepatitis C may also be detected through antibody tests. These tests can determine if infection has occurred, but they do not distinguish whether the virus is acute or chronic. Genetic material, or RNA testing, is a popular way of testing to determine if the virus is present and active in the body. Generally, the virus can be detected in the body within one to two weeks of exposure. Hepatitis A also necessitates a blood test to make a definitive diagnosis.

Doctors may also perform tests for liver function in conjunction with hepatitis testing and after the hepatitis virus has been indicated. Liver testing is an important part of dealing with the hepatitis virus as it can cause severe liver infections and damage if not properly monitored. If symptoms for hepatitis are present, making an appointment to have a blood test performed is necessary in order to prevent the spread of the virus and to begin successful treatment.

Liver Problems and Hepatitis

The hepatitis virus is one of the most significant causes of liver problems. The virus can result in all types of liver damage and thus should be taken very seriously in its diagnosis and treatment.

Serious Effects

The virus has serious effects on an infected person’s liver. Only hepatitis A does not cause chronic damage to a person’s liver and even then, some deaths have been reported from hepatitis A due to massive liver infection. Hepatitis B and C can cause the destruction of liver tissue, liver cancer, scarring, failure, and even death. Heavy scarring of the liver is known as cirrhosis, a condition that can be caused by hepatitis and one that is the seventh leading cause of death by disease in the country. In the United States, approximately 25,000 people die each year due to cirrhosis.

The liver is an important organ –weighing in at three pounds, it is also the largest solid organ in the body. The liver is responsible for manufacturing blood proteins, storing excess nutrients, manufacturing bile, storing sugar in the form of glycogen, and ridding the body of harmful substances like drugs and alcohol. The liver also helps to break down saturated fat and to produce cholesterol. Cirrhosis is a progressive disease that occurs as healthy liver tissue is replaced by scar tissue. This can eventually impair liver function and cause liver failure or death. Along with fatty liver and alcohol abuse, hepatitis is a leading cause of cirrhosis.

Liver failure occurs when large parts of the organ become too damaged to function properly. Symptoms of liver failure include nausea, fatigue, loss of appetite, diarrhea, jaundice, and easy bleeding. More severe symptoms such as coma can also be a result of liver failure. Fortunately, liver transplants are one of the more successful types of transplant procedures. Approximately 75 percent of people who have a liver transplant survive for more than 10 years. However, careful monitoring of the liver should occur when patients are diagnosed with hepatitis to avoid liver damage and failure. Damage to the liver can be slowed or prevented by diagnosing hepatitis as soon as symptoms appear and by beginning a course of treatment.

Treatment for Hepatitis Patients

Treatment for hepatitis patients depends on the type of hepatitis the patient has. There is no treatment for hepatitis A, for example, although the patient’s doctor will regularly monitor the patient’s liver function to ensure the body is recovering from the disease sufficiently, as it usually does over a period of months.

Hepatitis B and C, however, do have treatments available to address the diseases. When a patient has a chronic case of hepatitis B, it can usually be treated successfully with an interferon medication or a treatment like lamivudine or adefovir. Hepatitis C can also be treated by an interferon medication, but patients generally show better results when the drugs are combined with antiviral medications.

Interferon and Anti-Viral Medications

Interferons are proteins that help to increase the body’s ability to fight disease. In the case of chronic hepatitis C infections, the medications may be injected into the body for as much as three times per week up to one year. Some treatments may be given one time per week, but results show a consistent form of therapy lasting for longer than a few months has a better chance at providing a successful course of treatment. Hepatitis B and C patients usually have a better chance at successful treatment if other factors are considered, as well. These factors include having lower levels of the virus present (which can be determined through antibody or genetic material testing of the blood), and a lower amount of liver damage to begin with. The anti-viral medications like ribavarin can help to prevent the virus from multiplying in the liver and may also help to reduce inflammation and scarring.

Side effects of the medications may vary from drug to drug, but there are more than a few side effects characteristic of these types of drugs. These side effects include headache, fatigue, irritability, fever, depression, and flu-like symptoms. The combination of anti-viral and interferon therapy works best for treatment courses of a year or more, most studies show. Patients should discuss their drug tolerance and medical history, as well as the severity of their infection, with their doctors to determine which type of medication will be most effective for them.

The Prognosis for People with Hepatitis

The prognosis for patients dealing with a hepatitis infection depends on a number of factors. Namely, which type of hepatitis a patient has can make a significant difference as to how long the road to recovery will take and what kind of symptoms the person will be facing.

A Positive Outlook

Still, a guarded prognosis for patients with hepatitis is positive. Most people who become infected with hepatitis do recover from the disease, although in some cases it may take longer than six months for the liver to heal itself. In the case of the most mild form of the disease, hepatitis A, the liver generally takes about two months to heal. How long the liver of a patient with hepatitis B or C takes to heal depends on the amount of damage done to the liver by the disease and how long the patient has maintained a consistent level of treatment.

People with the virus who wish to speed their recovery should take a few things into consideration. One of the most important things a patient diagnosed with hepatitis can do is to avoid alcohol. Alcohol and drugs add an excess burden to the liver, which is attempting to heal itself from a virus at any rate. Also, practicing good nutrition and establishing an exercise program can greatly aid in overall health, as well. Another key element many people neglect is resting when they’re feeling sick, and keeping a consistent course of medicine if prescribed by a doctor.

Regular doctor’s visits to monitor liver function are equally important. The patient plays an important role in determining his overall health, so it is necessary to be active in the doctor-patient relationship and to express any concerns or new symptoms to the doctor. Also, learning as much as possible about the illness can keep the patient better informed as to what kind of symptoms or changes to expect through the course of his illness. Doing so can make the road to recovery a bit less bumpy and can help to speed up the process.