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How are the different types of hepatitis transmitted?

Picture
News
Sept 2012
HBV or HCV Infection: Which Is Worse?

May 2012
Risk  of Liver-Related Deaths Twice as High With Chronic Hep  B
Versus Hep C


April 2012
Discussing Hepatitis


New  challenges in viral hepatitis
Although liver  inflammation or ‘hepatitis’ can be caused by many infectious and non-infectious  conditions, there are at  least five viruses for which hepatitis is the primary (or only) clinical  manifestation and are thus named: hepatitis A virus (HAV),hepatitis B virus  (HBV), hepatitis C virus (HCV), hepatitis D (or delta) virus (HDV) and hepatitis  E virus (HEV).

Oct-Dec 2011
Related- Hepatitis A infection in high risk subjects

Aug 2011
What Factors Determine the Severity of Hepatitis A-related Acute Liver Failure?

How are the different types of hepatitis transmitted?

First let me explain what hepatitis is, for those who don’t know. Hepatitis is a disease of the liver. Your liver is an organ located in your abdomen, on the right side, under your lower rib cage. It has several very important roles in digestion and metabolism.

When you eat, stuff gets absorbed from your intestines into your bloodstream. The first place the blood carries the stuff is through your liver. The liver filters the blood, hanging on to the garbage and letting the good stuff through. The liver also produces bile, a green liquid that helps your body absorb fat. This super organ also serves as a breakdown and storage facility for important vitamins, minerals, immune cells and energy sources and a production facility for blood-clotting substances, not to mention a site for metabolism of many fats, carbohydrates and proteins.

You can’t live without your liver, although if you lose part of it, like in an accident or as a donation to someone who needs it, that part will grow back. It seems like even the ancient Greeks knew this. You might have heard of the myth of Prometheus. He was the Greek god who liked humans so much he gave them the gift of fire, without checking with Zeus first. This infuriated Zeus, so he tied Prometheus to a rock and sent a vulture to eat his liver on a regular basis. Ouch! Between vulture visits, Prometheus’ liver regenerated. Prometheus was eventually rescued, by the way, courtesy of Hercules.

Hepatitis means inflammation of the liver. “Hepa” is from a Greek word meaning “liver” and the “itis” is Latin for “inflammation.” You have heard that Latin suffix in words like appendicitis and laryngitis. Hepatitis is a general term that can describe liver inflammation from various causes, including drugs, alcohol and viruses. I’ll limit my discussion to viral hepatitis.

Viral hepatitis comes in 5 varieties: A, B, C, D and E. The first three are by far the most common in our country. Hepatitis A is passed through what is called the fecal-oral route. Someone who has Hepatitis A excretes it in their feces, and someone else takes it in orally. How? If the excreter didn’t wash their hands carefully after using the bathroom and then prepared food for you or shared food with you, that could do it. Oral sex on someone who has it could do it. Hepatitis A occurs in the U.S. but is more common in developing countries. There is a vaccination for it that we recommend for travelers to areas with a high incidence. Hepatitis A is not a pleasant disease — it causes nausea, vomiting and jaundice, but most people in this country recover from it without incident.

Hepatitis B is passed through blood and bodily fluids. This can happen at birth, from mother to child, if the mother has it, or during sex, or during intravenous drug use if needles are shared. It can also be passed in occupational accidents during health care procedures on infected patients. Hepatitis B is a much more serious disease than Hepatitis A. Some people recover fully, but Hepatitis B can become chronic, meaning it can last a long time and damage your liver. It can also cause cancer of the liver. Vaccination for Hepatitis B has become routine for babies in this country, but that happened relatively recently. If you didn’t get one, I recommend you do so. It is a three-shot series and you can get it at SHAC.

Hepatitis C is the up-and-coming liver monster of the millennium, according to experts. About 3.2 million Americans have Hepatitis C, and many of them don’t know it because it usually has no symptoms to begin with. Like Hepatitis B, it is passed through blood and bodily fluids, although sexual transmission of Hepatitis C is not as efficient as it is for Hepatitis B. Many people with Hepatitis C get it through intravenous drug use. There is no vaccine for Hepatitis C, and a high percentage of people who get this one go on to develop chronic liver disease, cirrhosis and cancer. Hepatitis C is the number one reason for liver transplants.

Hepatitis D is like B, and E is like A. Both are rare and neither has a vaccine.
You can minimize your chances of getting viral hepatitis by getting immunized against B, making sure you see a travel clinic before you travel in case you need a Hepatitis A shot, avoiding intravenous drug use and practicing standard safety procedures if you work in the health fields.

For more info, go to Goaskalice.columbia.edu or Cdc.gov. To get immunized, come to SHAC and see the highly skilled nurses in our Allergy and Immunization Clinic.

Dr. Peggy Spencer has been a UNM Student Health physician for 17 years and a Daily Lobo contributing columnist for three years. She is co-author of the book 50 Ways to Leave Your 40s. E-mail your questions to her at Pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health provider.

http://www.dailylobo.com/index.php/article/2009/11/hepatitis_know_risks_how_to_protect_yourself

HEPATITIS VACCINATIONS

Individuals infected with hepatitis C virus infection should be protected against all forms of viral hepatitis to avoid liver disease complications.

Hepatitis A Vaccination

Is the hepatitis A vaccine safe and effective?
The HAV vaccine, made from inactive hepatitis A virus (synthetic), is highly effective in preventing the hepatitis A infection when given prior to exposure. However, its safety when given during pregnancy has not been determined.  Currently, the hepatitis A vaccine is NOT licensed for children less than 1 year of age in the U.S.

Who should be vaccinated against hepatitis A?
just about anyone is a candidate to get hepatitis A; however, those at higher risk for hepatitis A include: users of illegal drugs; individuals who have chronic liver disease or blood clotting disorders (e.g., hemophilia); those who have close physical contact with people who live in areas with poor sanitary conditions; men who have sex with men;  those who travel or work in developing countries; and children in populations that have repeated epidemics of hepatitis A (e.g., Alaska natives, American Indians, and certain closed religious communities).

What is the dosage regimen?
Recommended dosages and schedules vary with the patient's age and which specific vaccine is used. Whether you are a child over 1 or an adult, more than one shot is needed for long-term protection. Check with your doctor or nurse to determine how many shots are needed and when to return for the next dose. The vaccine provides protection  about four weeks after the first injection; a second injection protects you longer, possibly up to 20 years. Twinrix, a combined hepatitis A and B vaccine may be given to those over 18 years of age.


Hepatitis B Vaccination

Is the hepatitis B vaccine safe and effective?
Yes. The hepatitis B vaccine has been available since 1982. Use of hepatitis B vaccine and other vaccines is strongly endorsed by the medical, scientific and public health communities as a safe and effective way to prevent disease and death. Hepatitis B vaccines have been shown to be very safe when given to infants, children and adults.



Could vaccinations eradicate hepatitis B?
Eradication of hepatitis B is possible through a comprehensive vaccination program. The way to do this is to make sure all newborns, children under 19, and adults at risk are vaccinated against HBV.

Who should be vaccinated?
All newborns and children up to the age of 19, especially adoptees; all individuals living in the same household with a chronically infected individual; those who are in positions where they are exposed to blood at work, through drug use, or who have multiple sex partners; and individuals with hepatitis C and other chronic liver diseases should be vaccinated for hepatitis B.

Why is it so important to vaccinate children against hepatitis B?
Parents and guardians are encouraged to have their children vaccinated at an early age to prevent the serious complications that can occur when youngsters under the age of five are infected. HBV, a sexually transmitted disease, is100 times more infectious than HIV (the virus that causes AIDS).

What is the Vaccines for Children program?
The Vaccines for Children Program provides free hepatitis B vaccines to young people under the age of 19 years who are on Medicaid, have no insurance or whose insurance does not cover immunizations.

Can the babies of infected mothers be vaccinated?
Yes. All newborns, especially those whose mothers are HBV-infected, should get three vaccination shots for hepatitis B – the first within 12 hours of birth, the second at 1-2 months, and the third at 6 months. In addition, babies born to infected mothers should receive a shot called HBIG (hepatitis B immune globulin) within 12 hours of delivery.  All women should be screened for hepatitis B surface antigen  during pregnancy to determine if they are a carrier (chronically infected) of HBV. Without the above intervention, 90% of babies born to infected mothers will become chronically infected, reducing their life expectancy. It is safe to vaccinate pregnant women.

What is the dosage regimen?
HBV vaccines require three injections to obtain long-lasting immunity. Hepatitis B vaccine is given as an intramuscular injection, and can be given to children at the same time as other vaccinations. It can be given in a number of schedules, each of which provides excellent protection. For infants, vaccination should begin at birth. A second dose at 1 month of age and the third dose at 6 months of age may be given.

http://www.hepfi.org/living/liv_preventing.html#hep_vaccination



Sept 2011

Dr. Ron Warner answers viewers questions about Hepatitis A

Ron Warner, Ph.D., is an Infectious Disease Specialist and Professor at the Texas Tech Health Sciences Center. He has provided this information to our viewers in addition to the questions he answered in our segment on NewsChannel 11 at Ten.
-Karin McCay


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