Fear and anxiety often follow a diagnosis of Hepatitis. It’s an infectious disease of the liver, which means it causes infection, often serious and sometimes fatal, in the livers of those who have it. But not all types of hepatitis are equally severe.
If you’re trying to steer clear of it, have possible symptoms, or even have received that diagnosis, make sure you’re fully informed about ways the disease is contracted, how it can be avoided, and which treatments are available for those who have hepatitis.
What is Hepatitis?
Hepatitis is a general term for disease of the liver that results in inflammation. Inflammation can cause scarring and in some cases will eventually lead to liver failure.
Hepatitis is usually caused by viruses, but liver problems can also be caused by physical injury, damage to the liver from a bacterial infection, certain medications or adverse drug interactions, autoimmune disease, heavy use of alcohol, and some toxins.
In one type of hepatitis (A) it’s not only infectious – it can be contagious too (passed directly from person to person.) But for other forms, exposure mainly occurs when participating in risky behavior (sharing drug needles, alcohol dependence, or unprotected sex) or when hygiene is poor.
Five types of viruses are associated with hepatitis liver disease. The fifth is the most recently uncovered; for years only four strains of hepatitis were referred to. This is why you’ll see 5 different names given to the disease – Hepatitis A, B, C, D, and E. Of those, Hep A, B and C are the most common types.
What are the symptoms of Hepatitis?
The Immunization Action Coalition, who work in conjunction with the World Health Organization, explains that viral hepatitis symptoms are similar no matter which type of hepatitis you have.
“If symptoms occur, you might experience any or all of the following: jaundice (yellowing of skin and whites of eyes), fever, loss of appetite, fatigue, dark urine, joint pain, abdominal pain, diarrhea, nausea, and vomiting. For all types of viral hepatitis, symptoms are less common in children than in adults. For people of any age with HCV (the C form of hepatitis), they are less likely to experience symptoms.”
What are the five types of Hepatitis?
It’s important to understand the five types. They’re not at all the same. Recommended treatments differ, and every type has a particular level of risk. Let’s look at them individually:
- Contagious, so it can pass from person to person.
- Usually contracted by eating contaminated food or drinking water (referred to as the fecal oral route), or having close contact with a person or object already infected.
- Generally a short-term liver infection, resolving within weeks or a few months.
- Most recover completely but in some cases can be serious or require hospitalization.
- No specific treatment for Hep A. Symptom relief may be needed for pain, itching, and nausea.
- Good hygiene is one of the best protections against hepatitis A.
- Vaccines are available/recommended for people with risk factors.
- Vaccines recommended if traveling to areas where the virus is prevalent. Central America, South America, the Indian subcontinent, Africa, the Far East and eastern Europe.
- Occurs through contact with infected blood, semen, or other body fluids.
- Exposure occurs from sexual relations, sharing needles/drug-injection equipment, or other exposure to contaminated blood (like needlesticks on the job for tech, lab or nursing personnel)
- Mothers can pass to newborns at birth or soon after.
- Most adults contracting it recover, but some are carriers. Can spread it to others after their own symptoms disappear.
- People infected as children develop long-term infection: chronic hepatitis B. Antiviral medication is a treatment. Can lead to cirrhosis/liver cancer.
- Blood-borne virus chiefly spread by contact with contaminated blood, needles for illegal drug injection, contaminated needles for tattoos.
- Sometimes no symptoms or just mild ones, but can lead to cirrhosis (scarring of liver.)
- Can become chronic.
- Differs from Hep B in that usually only spread through blood-to-blood contact, not other body fluids.
- Occurs only if already infected with hepatitis B; tends to make that disease more severe.
- Spreads through sexual relations and from mother to child.
- Four strains of Hep E have been identified.
- Diagnosed when a doctor does blood tests for antibodies to the virus. Diagnosis can be difficult; distinguishing between various forms of hepatitis is challenging.
- Usually clears up on its own. Rarely, can lead to acute liver failure.
- Mainly in Asia, Mexico, India, and Africa; considered poor sanitation diseases.
- Cases in the U.S. are mainly because of those returning from countries where there are outbreaks.
- Usually contracted by eating/drinking what’s been contaminated by fecal matter, similar to Hep A.
- Mortality rates for this are low. Pregnant women most at risk, and those with suppressed immune systems are at risk for developing a chronic version.
What are the four strains of the Hepatitis E virus (HEV)?
The World Health Organization describes the symptomatic HEV infection as involving at least 4 different hepatitis genotypes – Genotypes 1, 2, 3 and 4:
Genotypes 1 and 2 have been found only in humans. Genotype 3 and 4 viruses circulate in several animals (including pigs, wild boars, and deer) without causing any disease, and occasionally infect humans.
The virus is transmitted via the faecal-oral route. It’s shed in the stools of infected persons and contaminates water. Usually the infection is self-limiting and resolves within 2–6 weeks. Occasionally a serious disease, known as fulminant hepatitis (acute liver failure) develops and a proportion of people with this disease can die.
Resource-poor areas with frequent water contamination disease is common in resource-limited countries with limited access to essential water, sanitation, hygiene and health services. In these areas, the disease occurs both as outbreaks and as sporadic cases.
The outbreaks usually follow periods of faecal contamination of drinking water supplies and may affect several hundred to several thousand persons, but some areas with safe drinking water supplies have had some cases of Hep E. When it occurs where there is better sanitation and water supply, hepatitis E disease is infrequent with only occasional sporadic cases.
How do you avoid being infected with hepatitis? What are treatments and are there any cures?
There are best practices to avoid the various types of hepatitis:
Hep A – Wash your hands thoroughly after using the restroom or if you come in contact with an infected person’s blood, stools, or other bodily fluid. Avoid any food or water that you aren’t confident is clean and uncontaminated. Don’t take chances. Using a personal water filtration system like this one that removes bacteria and lowers the risk of viruses is a safe bet.
Hep B – There are vaccines for Hep B. The vaccine is usually given as 2, 3, or 4 shots over a 1 to 6 month period. The list of those who the CDC says should get the vaccine is long.
Infants should get their first dose of hepatitis B vaccine at birth and will usually complete the series at 6 months of age.
All children and adolescents younger than 19 years of age who have not yet gotten the vaccine should also be vaccinated.
Hepatitis B vaccine is recommended for unvaccinated adults who are at risk for hepatitis B virus infection, including:
People whose sex partners have hepatitis B
Sexually active persons who are not in a long-term monogamous relationship
Persons seeking evaluation or treatment for a sexually transmitted disease
Men who have sexual contact with other men
People who share needles, syringes, or other drug-injection equipment
People who have household contact with someone infected with the hepatitis B virus
Health care and public safety workers at risk for exposure to blood or body fluids
Residents and staff of facilities for developmentally disabled persons
Persons in correctional facilities
Victims of sexual assault or abuse
Travelers to regions with increased rates of hepatitis B
People with chronic liver disease, kidney disease, HIV infection, or diabetes
Anyone who wants to be protected from hepatitis B
The risk of contracting this type with illegal injected drug use is high when equipment is shared. Practice only safe sex. Use condoms correctly and consistently, and know your partner’s history. Donated blood and organs must be pre-screened for the virus. If required to handle blood/body fluids for your job, always take precautions.
Hep C – No vaccine to prevent hepatitis C virus infection. Avoiding risky sexual behavior. Use a latex condom and know your partner’s sexual history.
Hep D – Since it only occurs in those with Hep B, detection and treatment of B as soon as possible can help to help prevent Hep D. Avoid intravenous drug abuse. Never share needles. Get vaccinated against hepatitis B.
Hep E – Currently no vaccine available. Like Hep A it’s often a contaminated water disease. Always be cautious about the condition of water, especially in developing countries. Drink only purified water, like that which flows through a filter like this one, even for brushing teeth. Don’t add ice. Avoid uncooked or unpeeled foods in these areas, i.e. vegetables, fruit and shellfish, or other items rinsed in water. Hot, cooked food that is served hot is usually OK.
When hepatitis E is suspected and your liver immune system is normal, you might not need medications. Rest, plenty of fluids, and avoiding alcohol is the recommended approach. In some studies, treatment with ribavirin for 3 weeks resulted in improved liver function (only for those who have severe acute illness, and who aren’t pregnant.)
What is the outlook for hepatitis sufferers?
No hepatitis is without risk. You can see that some forms that are much less severe than others. Even those that are serious can be avoided by making wise decisions to protect yourself.
If you have the misfortune of being diagnosed with hepatitis, arm yourself with all the information needed to either regain your health, or get the right treatment to live the fullest life possible. Ongoing research and new treatments provide hope that living with hepatitis doesn’t have to define who you are.