Understanding Hepatitis and How it Can Impact You

Each year worldwide, viral hepatitis claims a life every 30 seconds. Many of us are unaware of how this disease could impact us, including our personal risk level, symptoms to watch for, and when to have a conversation with our doctor about hepatitis.

The World Health Organization has named July 28 World Hepatitis Day to draw awareness to this health concern, and the U.S. Department of Health and Human Services highlights hepatitis awareness in July as part of its National Health Observances. Let’s take a look at what you should know about hepatitis and its potential to impact your health.

What is viral hepatitis?

Viral hepatitis is a type of infection that affects the liver. Like many infections, it causes inflammation and can cause damage. There are several types of viral hepatitis: hepatitis A, B, C, D, and E. There are some differences between these types of infection:

  • Hepatitis A and E are short-term (acute) infections that your body can heal completely from. They are spread through food or water that has been contaminated by stool containing the virus.
  • Hepatitis B, C, and D can be acute infections, but they can also cause long-term (chronic) infections that your body is not able to fully heal from. They are spread through blood and/or body fluids. For example, this can happen from sexual contact with an infected person, or contaminated needles during drug use.

In the United States, hepatitis B and C are the most common sources of viral hepatitis infection.1 Because of this, they are a common cause of chronic hepatitis. Chronic hepatitis can cause cirrhosis of the liver, liver failure, and liver cancer. There are treatment options for chronic hepatitis that can reduce your risk of serious problems developing- but you must first know that you are infected.

Hepatitis B

Hepatitis B is spread through blood, semen, and other bodily fluids. It can be spread through sexual contact, contaminated needles, and shared personal care items like toothbrushes and razors. Around 2 in 3 people who are infected are not aware they are, and hepatitis B is a leading cause of liver cancer. 2

Hepatitis C

Hepatitis C often becomes a chronic infection and is spread through contact with infected blood- even small amounts. Prior to 1992, blood transfusions and organ transplants were not screened for hepatitis C. Drug use is another risk factor. About 50% of people infected with hepatitis C do not know they are infected, and hepatitis C is also a leading cause of liver cancer, and liver transplants. 3

What are the symptoms of viral hepatitis?

It’s important to remember that not all viral hepatitis infections cause symptoms. As discussed above, as many as half of people who are infected with hepatitis B or C do not have any symptoms. 4

When symptoms are present, it’s often due to liver damage from chronic infection, and they may not appear for decades. Symptoms from acute infections may take anywhere from 2 weeks to 6 months from exposure to appear. The symptoms of any type of viral hepatitis can include the following: 5

  • Fatigue
  • Fever
  • Appetite loss
  • Nausea and/or vomiting
  • Abdominal pain
  • Dark-colored urine
  • Light-colored stools
  • Joint pain
  • Jaundice (yellowing of the skin and eyes)

Can hepatitis be treated?

The ultimate cure for chronic hepatitis is a liver transplant; hepatitis C has been a leading cause of liver transplants, but this has been decreasing with the use of available treatments. 6 These are the treatments available for both hepatitis B and C:

  • Hepatitis B- a vaccine is available for people at high risk of infection, such as healthcare workers and people whose sexual partners are infected with hepatitis B. An injectable drug called pegylated interferon-alpha is used to treat hepatitis B and is successful 25% of the time. 7 Oral antiviral medications may also be used.
  • Hepatitis C- there is no vaccine available for this type of hepatitis. However, there are several treatments available for hepatitis C depending on the specific sub-type, or genotype, of hepatitis C a person is infected with. These treatments can cure hepatitis C in as many as 90% of cases. 8

Hepatitis A, although less common in the US, does occur and can be prevented by vaccination. The vaccine is recommended for certain types of international travel where there is poor sanitation, and for people with liver disease who have not been previously exposed to hepatitis A. There is no treatment for this type of hepatitis.

Should I get tested for hepatitis?

If you have any of the symptoms of chronic hepatitis, it’s important to discuss them with your doctor as soon as possible. Remember, however, that many people do not experience symptoms of chronic hepatitis infection for many years. Because of this, it’s important to consider testing.

Previously, it was recommended that people born between 1945 and 1960 prioritize testing for hepatitis C in particular, as it was more common in that age group. The more recent opioid crisis has increased the number of infections across all age groups. For younger adults, this is especially linked to drug use. 9

Current CDC guidelines recommend: 10

  • Hepatitis C screening for all adults age 18 and above at least once in their lifetime
  • Hepatitis C screening for anyone in a high-risk category, regardless of age:
  • People who are HIV positive
  • Anyone who ever injected drugs and shared equipment, even if it was just once
  • Anyone who has ever received maintenance hemodialysis
  • Anyone with a long-standing abnormal ALT level (a lab value that measures liver function)
  • Anyone who has received an organ transplant or blood transfusion, especially if it was before 1992

The CDC ultimately recommends that “Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons may be reluctant to disclose stigmatizing risks.” 11 There is also current discussion about creating a recommendation that everyone 18 and older have a test for hepatitis B at least once in their lifetime. 12

With this in mind, it may be helpful to ask your doctor whether you have been screened for hepatitis C in the past and discuss testing if you have not.

Being proactive is key

Because it is possible to prevent some types of hepatitis and successfully treat chronic hepatitis infections before they cause serious damage, it’s important to be proactive about this disease. As discussed above, reporting any symptoms to your doctor is crucial. And having a discussion with your healthcare provider about screening for hepatitis can play an important role in early treatment if you’re unaware that you’re infected.

Caregivers can help older adults manage concerns about hepatitis by being an advocate at regular checkups. Questions to ask include whether screening for viral hepatitis has ever been done, and whether any testing should be repeated.

Professional caregivers play an important role in regular health maintenance by helping older adults travel to and from checkups, and relaying any important questions family may want to be sure a physician is aware of. To assist with visits to the doctor that can assess for hepatitis and other health conditions, Caresify provides skilled caregivers that defy the ordinary to offer excellent care when you’re not able to be with your loved one. You can read more here, or call 888-799-5007.

References

  1. https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/index.html
  2. https://www.cdc.gov/hepatitis/abc/index.htm
  3. https://www.cdc.gov/hepatitis/abc/index.htm
  4. https://www.womenshealth.gov/a-z-topics/viral-hepatitis#references
  5. https://www.cdc.gov/hepatitis/abc/index.htm
  6. https://journals.lww.com/transplantationdirect/Fulltext/2019/03000/The_Changing_Face_of_Liver_Transplantation_in_the.2.aspx
  7. https://www.ucsfhealth.org/conditions/viral-hepatitis/treatment
  8. https://www.cdc.gov/nchhstp/newsroom/2021/2014-2020-hepatitis-c-treatment-estimates.html
  9. https://www.yalemedicine.org/news/hepatitis-c-screening
  10. https://www.cdc.gov/hepatitis/hcv/guidelinesc.htm
  11. https://www.cdc.gov/hepatitis/hcv/guidelinesc.htm
  12. https://www.cdc.gov/hepatitis/policy/isireview/HepBFederalRegisterNotice.htm

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