The ABC's of Viral Hepatitis A, B & C

Q. What is viral hepatitis?

Viral hepatitis is a disease caused by viruses that damage your liver. This damage can make your liver inflamed, swollen and tender.

• Serious cases can lead to life-threatening liver cirrhosis (or scarring), liver failure and eventually liver cancer.
• The most common forms of viral hepatitis include hepatitis A, hepatitis B and hepatitis C.

Q. What is the liver and how is it affected by viral hepatitis?

The liver, your body’s largest organ, is…

• dark red
• wedge-shaped
• three to four pounds
• located behind the right-hand side of your rib cage.

Your liver performs many important functions. When viral hepatitis damages your liver, the organ may become scarred. This scarring is known as cirrhosis. Cirrhosis can lead to problems with digesting food, fighting infection, storing energy, clotting blood and getting rid of poisonous waste.

Q. How many people have viral hepatitis?

Hepatitis A does not cause long-lasting infections. One-third of all Americans have been infected with hepatitis A at some time in the past.

Centers for Disease Control and Prevention, 1997

* Estimated annual acute infections, 1984-95 (adjusted to include infections without symptoms).

Q. How do you get viral hepatitis?

There are a number of ways to develop viral hepatitis. Each virus is unique and spread in different ways.

The hepatitis A virus is found in the stool, or bowel movement, of people infected with the virus. The virus is transmitted when a person eats food or drinks water contaminated with infected human waste. This happens most often when people don’t wash their hands after using the bathroom and then prepare or serve food or water. This can occur in places where there is poor water purification.

Hepatitis B is transmitted through direct contact with the blood or body fluids of an infected person, such as…

• having unprotected sex with an infected person
• injecting drugs (even once)
• receiving blood transfusions before 1972 (when hepatitis B blood screening procedures began)
• during childbirth from mother to baby

The most common causes of hepatitis C are…

• snorting or injecting drugs (even once)
• receiving blood transfusions before 1992 (when more accurate hepatitis C blood screening procedures began)
• having unprotected sex with multiple partners
• during childbirth from mother to baby (rare)

It is important to note that many people don’t know how they got infected.

Q. Who is at risk for getting viral hepatitis?

*Less than five percent of reported cases are contracted this way.

Q. What are the symptoms of viral hepatitis?

A viral hepatitis infection can be hard to detect because there often are no visible signs or symptoms. In some people, the virus causes flu-like symptoms: fatigue, loss of appetite, weakness, fever, nausea and vomiting. In more severe cases, infected people experience abdominal pain, skin rashes, dark urine and jaundice (yellowing of the eyes and skin). It is possible to carry the hepatitis B and hepatitis C virus for many years and have no symptoms.

Q. How is viral hepatitis diagnosed?

Because there may be no obvious symptoms, many times the disease goes unnoticed. Most often, viral hepatitis is discovered through routine blood tests conducted during an evaluation. You can ask your doctor about testing. Sometimes a procedure known as a biopsy, in which a sample of liver tissue is removed and tested, is performed to confirm a diagnosis.

Q. Is viral hepatitis preventable?

Yes, most forms of viral hepatitis are preventable. Vaccines are available to protect you from hepatitis A and hepatitis B.

Hepatitis A vaccines are recommended for people who travel to places such as Mexico, the Caribbean, Southeast Asia, South and Central America and Africa; children living in communities that have high rates of the disease; those in high-risk groups; and patients with liver disease.

The hepatitis B vaccine is part of the standard series of shots, known as the childhood immunization program, recommended for all infants. In addition, the hepatitis B vaccine is recommended for pre-teenagers and high-risk adults.

There isn’t a vaccine for hepatitis C yet.

You can protect yourself from contracting all three viruses by avoiding the risky behaviors mentioned above:

• not washing your hands after using the bathroom
• injecting or snorting drugs (even once)

having unprotected sex with an infected person or multiple partners

Q. What are the treatments for viral hepatitis?

There are several prescription drugs available to treat and manage viral hepatitis. You should discuss the treatment options with your doctor.

To protect against the disease, people traveling to countries where hepatitis A is common should take the hepatitis A vaccine four weeks before leaving for their trip. For most people there is no need to treat the disease. Once you get hepatitis A, the body builds a natural resistance to it. After the disease runs its course, a person is unlikely to get hepatitis A again.

The approved treatment for hepatitis B consists of a drug called alfa interferon. It works for many people. New treatments are being tested.

A lot of progress has been made in recent years to improve the treatment of hepatitis C. Again, interferons are the only currently available drugs that work against the disease. New drugs are being tested.

Q. What are the long term effects of the hepatitis viruses?

Hepatitis A causes no long-term liver damage and is rarely fatal. Having the disease usually produces lifelong resistance to future infection.

Hepatitis B and hepatitis C are the most dangerous forms of viral hepatitis. They can last a lifetime and cause liver failure, liver cancer and even death. Liver damage due to hepatitis C is the leading cause of liver transplants in the United States.

Q. When should you consult a doctor?

If you think you have hepatitis or may have come in contact with an infected person or contaminated object (like a dirty needle), call your doctor as soon as possible.

Q. Will you be referred to a specialist?

Usually, a primary care physician will perform the initial blood tests. If the tests are positive, you may be referred to a specialist, usually a gastroenterologist or a hepatologist, for a full examination. A gastroenterologist is a doctor who specializes in diseases of the digestive tract. A hepatologist is a doctor who specializes in diseases of the liver.

Q. How can you learn more about digestive health?

Contact the Foundation for Digestive Health and Nutrition at 1-866-337-FDHN.

The FDHN Viral Hepatitis Education Campaign is made possible by unrestricted educational grants from Amgen Inc., Chiron Corporation, GlaxoSmithKline and Schering-Plough Corporation.