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Hepatitis Information
 
Hepatitis means diseases of the liver and is used to reference many different diseases. Presently the following hepatitis diseases have been identified: A, B, C, D, E, F, and two G´s. This page only discusses Hepatitis A, B, and C.
 
The information contained on this page is designed to assist in providing additional information on hepatitis. This information is not intended to substitute for informed medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. You are strongly encouraged to consult your health care provider with any questions or concerns you may have.
 
HEPATITIS A (HAV) - A blood test showing the presence of IgM anti-HAV in serum confirms the diagnosis of acute hepatitis A infection. Symptoms of this virus strain include nausea, vomiting, and diarrhea. Once infected and recovered, the antibodies to the virus provide protection from future infections with HAV. Following this, HAV blood tests will always return a positive result.
 
Treatment of Hepatitis A- 99% of those infected will recover without treatment.
 
Prevention of Hepatitis A- Hands should be washed with soap and water following bowel movements and before food preparation. Vaccines to prevent HAV infection prior to exposure provide protection against the virus as early as 2 - 4 weeks after vaccination. Immunization of children (2-18 years of age) consists of 2 or 3 doses of the vaccine. Adults need a booster dose 6-12 months following the initial dose of vaccine. There has been no determination as to the effective time of the vaccine.
 
Other individuals who should be vaccinated include: persons engaging in anal/oral sex; users of illegal injectable drugs; children living in communities that have high rates of hepatitis; certain institutional workers; workers in day-care centers; and laboratory workers who handle live hepatitis A virus. Patients with chronic liver disease should be vaccinated against hepatitis A as well.
 
HEPATITIS B (HBV) - Acute HBV infection is diagnosed by the presence of hepatitis B surface antigen (HBsAg) and IgM antibody to hepatitis B core antigen (anti-HBc IgM).
 
Treatment for Hepatitis B- While there is no treatment for acute hepatitis B, there are two approved treatments for chronic hepatitis B: interferon alfa-2b and lamivudine. Only patients with active HBV replication are candidates. The drugs should not be given together. About 35% of patients treated with injections of interferon for 4 to 6 months will have a long-term response. The response to oral lamivudine, given for at least one year, may be somewhat lower. Lamivudine is very well tolerated but viral resistance to treatment may occur. Interferon therapy often results in a number of side effects including flu-like symptoms, fatigue, headache, nausea and vomiting, loss of appetite, depression, and hair thinning. Because interferon may depress the bone marrow, blood tests are needed to monitor white blood cells, platelets. Liver enzymes are monitored during treatment with both drugs. Patients with chronic hepatitis B should be vaccinated against hepatitis A.
 
Prevention of Hepatitis B- Safe and effective vaccines provide protection against hepatitis B for 15 years and possibly much longer. Current thinking is that the vaccine may provide protection for life. Two or three injections over a 6-12 month period are required to provide full protection. All children and adolescents should be vaccinated since most cases of HBV occur in sexually active young adults. Those who engage in high-risk behaviors should be vaccinated as well.
 
Infected individuals should practice safe sex. Avoid contact with infected blood or other body fluids directly or on objects such as needles, razors, toothbrushes, etc. Sores and rashes should be covered with bandages and blood on any surface should be cleaned up with household bleach.
 
The best way to prevent HBV infection is to decrease chances of exposure and to receive the hepatitis B vaccine series. This vaccine is produced in yeast using recombinant DNA technology, contains no human plasma, and has no possibility of being infectious for HIV or other bloodborne infections. The vaccine is used worldwide, has been tested extensively, and has been shown to be safe and effective. It has also been added to the list of recommended childhood immunizations. The vaccine has been shown to induce protective antibody levels in 85% to 97% of healthy adults.
 
The hepatitis B vaccine is free to all identified staff in the exposure control plan and is given in a series of three intramuscular injections over six months. All DOC employees with potential occupational exposure to blood or other potentially infectious materials should be immunized; those electing not to receive the vaccine must sign a declination statement, which is filed in their medical record. Health care workers who have ongoing contact with blood or other potentially infectious materials should be tested for antibody one to two months after the completion of the three-dose vaccination series.
 
HEPATITIS C (HCV) - Infection by the hepatitis C virus can be determined by a blood test that detects HCV antibodies in the blood. This test is not a part of a routine physical, and people must ask their doctor for hepatitis C test. If the initial test is positive, a second test should be done to confirm the diagnosis and liver enzymes (a blood test) should be measured. Anti-HCV may not be present in the first four weeks of infection in about 30% of patients. HCV infection may be identified by the presence of anti-HCV in approximately 60% of people as early as 5-8 weeks after exposure. In some individuals HCV antibodies may not be detected for 5-12 months. This disease may gradually progress over a period of 10-40 years.
 
Treatment for Hepatitis C- Currently, there are three types of interferon and a combination of interferon and ribavirin used to treat hepatitis C. Selection of patients for treatment may be determined by biochemical, virologic, and when necessary, liver biopsy findings, rather than presence or absence of symptoms. Interferon is given by injection, and may have a number of side effects including flu-like symptoms including headaches, fever, fatigue, loss of appetite, nausea, vomiting, depression and thinning of hair. It may also interfere with the production of white blood cells and platelets by depressing the bone marrow. Periodic blood tests are required to monitor blood cells and platelets. Ribavirin can cause sudden, severe anemia and birth defects so women should avoid pregnancy while taking it and for 6 months following treatment. The severity and type of side effects differ for each individual. Treatment of children with HCV is not currently approved but is under investigation.
 
While 50-60% of patients respond to treatment initially, lasting clearance of the virus occurs in about 10-40% of patients.
 
Currently, almost one half of all liver transplants in the U.S. are performed for end-stage hepatitis C. However, reinfection of the transplanted liver by HCV occurs at a high rate. Fortunately, this infrequently requires a second transplant.
 
Anyone with hepatitis C should be vaccinated against hepatitis A and B and should not drink alcohol. Try to maintain as normal a life as possible by eating a well balanced diet, exercising and keeping a positive attitude. Avoid depressing or overwhelming tasks and learn how to pace yourself, rest when you feel tired. Plan physically exhausting tasks in the morning when your energy level is at its peak.
 
Vaccination Possibility - There is no vaccine for Hepatitis C.