Hepatitis is an infection of the liver, the organ that removes bacteria and toxins from the blood, processes nutrients, hormones and medications, and prevents infections in the body. Hepatitis can infect the liver and cause it to function abnormally or not function at all. While hepatitis is a general term, there are five known subsets of the condition that are currently known, and vaccines exist for a few of them. While Hepatitis A, B, C, D, and E all have different ways of entering the body or treatment methods, they can be characterized by the same general symptoms: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, gray-colored bowel movements, joint pain, and jaundice (an obstruction of the bowel duct that can cause yellowing of the skin and eyes.)
Hepatitis A is not the most common hepatitis in the United States—in fact, it has seen a sharp downward turn since the introduction of the hepatitis A vaccine in 1995. Hepatitis A is transmitted by consuming food or water that has been contaminated with fecal matter, even in microscopic amounts. Hepatitis A can also be transmitted by sexual contact with a person infected with hepatitis A, or even close person-to-person contact with an infected individual.
Everyone is at risk for hepatitis A if they ingest food or water that has been contaminated, but those most at risk for being infected are travelers that have recently returned from regions known to have high rates of hepatitis A, people working with primates, sexual partners of infected individuals, household members or caregivers of infected individuals, and users of illegal drugs. Hepatitis A is rarely fatal and does not normally become a chronic condition. Preventing hepatitis A is fairly simple; a two-dose vaccination given early in life is the best way to prevent hepatitis A. For individuals who have not been vaccinated against this specific virus can count on their antibodies to protect them against future infections of hepatitis A.
While the rates of Hepatitis B have declined in the United States, they have not dropped as quickly as hepatitis A. In 2014, there were an estimated 2.2 million people living with a chronic hepatitis B infection. Hepatitis B is transmitted by contact with infectious blood, semen and other body fluids. Being born to a mother infected with hepatitis B, sexual partners of infected individuals, sharing contaminated needles and accidentally becoming injured with a needle can all lead to the transmitting of hepatitis B.
Drug users, individuals with multiple sexual partners, individuals with STDs, healthcare workers who are exposed to blood during their job, hemodialysis patients and travelers to regions that have a high rate of hepatitis B are all at risk for contracting the virus. While some hepatitis B sufferers recover within six months with no lasting damage to their liver, around 25% of those infected suffer chronic liver problems like liver disease, liver failure, and liver cancer. Hepatitis B can survive outside the body for up to seven days and still cause infection, to those at risk for the virus are encouraged to receive a hepatitis B vaccine, usually given to all infants at birth but can be given to those adults with risk factors.
More people contract Hepatitis C than hepatitis B—an estimated 4 million Americans have the chronic infection. Hepatitis C is the virus that is most likely become chronic, meaning that people who contract the virus and then develop an immune response can be cured for a short time, but the virus replication can change. This can cause the virus to adapt to the body’s immune response and develop new infections that can continue to infect the individual. Hepatitis C is transmitted through infected blood, usually from birth to an infected mother, needle stick injuries, receiving infected blood or injectable drug use. Those individuals who have these risk factors are more likely to contract the virus. Hepatitis C can also spread the same way that the other hepatitis viruses can: through sexual contact with an infected individual, sharing needles during injection drug use, and other methods. Because hepatitis C is mostly considered a chronic condition (85% of newly infected people develop a chronic infection,) long-term effects can be serious. Most people who develop chronic hepatitis C also develop chronic liver disease, and others develop cirrhosis of the liver. Those who develop an acute illness from hepatitis C will be given antivirals, and those who deal with chronic hepatitis C will have regular liver supervision for the rest of their lives. There is no vaccine for hepatitis C.
While most people know of hepatitis A, B and C, Hepatitis D is an uncommon version of the hepatitis virus. It’s not popular in the United States because it only occurs in individuals who are already infected with hepatitis B. Hepatitis B is an “incomplete” virus that requires hepatitis D to reproduce. The individuals who are at risk for hepatitis D are individuals who are already infected with hepatitis B or individuals who contract hepatitis B and hepatitis D simultaneously.
Hepatitis E is also uncommon in the United States, but people who have traveled to countries that have high rates of hepatitis E are more likely to contract the virus. Hepatitis E is common in countries with inadequate water supplies and poor sanitation practices. It is spread through fecal matter, as its common source is contaminated drinking water. In developed countries, some genotypes of hepatitis E can be found in undercooked pork and deer meat.
Vaccinations play an important role in preventing the types of viruses that can cause long-term chronic illnesses. It’s important to take action before becoming at risk for developing any of the hepatitis viruses. If you plan to travel to any area of the world where hepatitis viruses are riskiest, visit your doctor to ensure you’re up to date on all possible protections.
Dr. Gildardo Ceballos
OakBend Medical Group
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.