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Article title: Hepatitis: NWHIC
Hepatitis is an inflammation of the liver caused by certain viruses and other factors, such as alcohol abuse, some medications, and trauma. Its various forms affect millions of Americans. Although many cases of hepatitis are not a serious threat to health, the disease can become chronic (long-lasting) and can sometimes lead to liver failure and death.
There are four different types of infectious hepatitis viruses, but only three of them can spread to uninfected people: they are HBV, HCV, and HDV and can be spread in the following ways (Delta hepatitis, spread by HDV, is spread only when HBV is present through the same ways listed below):
Having sexual intercourse with an infected person without using a condom.
Sharing drug needles among users of injected street drugs.
Needle-stick accidents among health-care workers.
Mother-to-child transmission of HBV during birth.
Transfusions. Until recently, blood transfusions were the most frequent cause of hepatitis C. Blood banks in the United States now screen donated blood for HBV and HCV and discard any blood that appears to be infected. Therefore, the risk of acquiring hepatitis from these viruses is very low in the U.S. and in other countries where blood is similarly tested. Tests to screen blood for HBV will also screen out HDV.
Personal contact with an infected person. HBV, HCV, and HDV sometimes spread when household members unknowingly come in contact with virus-infected blood or body fluids--most probably through cuts and scrapes or by sharing personal items such as razors and toothbrushes. While it is possible to become infected by contact with saliva, blood and semen remain the major sources of infection.
Many people infected with viral hepatitis have no symptoms. For example, about one-third of people infected with HBV have a completely "silent" disease. When symptoms are present, they may be mild or severe. The most common early symptoms are mild fever, headache, muscle aches, fatigue, loss of appetite, nausea, vomiting, or diarrhea. Later symptoms may include dark and foamy urine and pale feces; abdominal pain; and yellowing of the skin and whites of the eyes (jaundice).
About 15 to 20 percent of patients develop short-term arthritis-like problems as part of a more severe case of hepatitis. Another one-third of those with hepatitis B develop only mild flu-like symptoms without jaundice. Very severe (fulminant) hepatitis B is rare, but life-threatening. Early signs of fulminant hepatitis, such as personality changes and agitated behavior, require immediate medical attention.
Some people infected with HBV or HCV become chronic carriers of the virus, although they may have no symptoms. There are an estimated 1.5 million HBV carriers in the U.S. and 300 million carriers worldwide. Children are at greatest risk. About 90 percent of babies who become infected at birth with HBV, and up to half of youngsters who are infected before age 5, become chronic carriers. It is estimated that there are between 2 and 5 million HCV chronic carriers. At least half of all HCV carriers will develop chronic liver disease, regardless of whether or not they have symptoms.
At present, there are no specific treatments for the acute symptoms of viral hepatitis. Doctors recommend bed rest, a healthy diet, and avoidance of alcoholic beverages and some medications that are metabolized through the liver.
How can I reduce my risks of spreading hepatitis?
The most effective means of preventing viral hepatitis is to avoid contact with the blood, saliva, semen, or vaginal secretions of infected individuals. People who have acute or chronic viral hepatitis should:
Avoid sharing items that could infect others, such as razors or toothbrushes.
Protect sex partners from exposure to their semen, vaginal fluids, or blood. Properly used condoms may be effective in preventing sexual transmission.
There are several vaccines available to prevent hepatitis B. People at high risk of infection should consider vaccination:
Male homosexuals and heterosexuals with multiple partners,
People who receive hemodialysis or blood products,
Household and sexual contacts of HBV carriers, and
Users of intravenous street drugs who share needles.
Regulations now require health care and laboratory workers who handle blood and other body fluids to be vaccinated. People who have come into direct contact with the blood or body fluids of an HBV carrier may receive one or more injections of hepatitis B immune globulin,sometimes in combination with hepatitis B vaccine. Immuoglobulin offers temporary protection, while the vaccine provides a longer-lasting immunity.
In an effort to eliminate chronic carriers, the U.S. Centers for Disease Control recommends that all newborn babies be vaccinated. Other groups have recommended that pregnant women be screened for HBsAg as part of their routine prenatal care. If they are infected, their babies can be given hepatitis B immune globulin as well as vaccine immediately after birth.
No vaccines yet exist for HCV or HDV; however, HBV vaccine will prevent delta hepatitis as well.
American Liver Foundation, 1-800-GO LIVER (465-4837)
Hepatitits Foundation International
30 Sunrise Terrace
Cedar Grove, NJ 07009
This information was abstracted from the National Institute for Allergy and Infectious Diseases Factsheet "Hepatitis" (1992).
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.
Publication date: 1998
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