Viral Hepatitis | National Institute on Drug Abuse (NIDA)

Left untreated, hepatitis can lead to cirrhosis, a progressive deterioration and malfunction of the liver. It can also lead to a type of liver cancer called hepatocellular carcinoma. In fact, HBV and HCV infections are related to about 65 percent of liver cancers worldwide. Nearly 50 percent of the cases are caused by HCV alone.² During the next 40 to 50 years, 1 million people with untreated chronic HCV infection will likely die from complications related to their HCV.³

Since 2012, there have been more deaths due to hepatitis C than all 60 of the other reportable infectious diseases combined.

In an effort to fight viral hepatitis in the United States, the U.S. Department of Health and Human Services developed the National Hepatitis Action Plan for 2017-2020. The plan outlines strategies to achieve the following goals:

1. Prevent new viral hepatitis infections.
2. Reduce deaths and improve the health of people living with viral hepatitis.
3. Reduce viral health disparities (differences among ethnicities, race, income, gender, etc.).
4. Coordinate, monitor, and report on implementation of viral hepatitis activities.

What is the relationship between drug use and viral hepatitis?

Drug and alcohol use places people at particular risk for contracting viral hepatitis. Engaging in risky sexual behavior that often accompanies drug use increases the risk of contracting HBV and, less frequently, HCV. People who inject drugs (PWID) are at high risk for contracting HBV and HCV from shared needles and other drug preparation equipment, which exposes them to bodily fluids from other infected people. Because drug use often impairs judgement, PWID repeatedly engage in these unsafe behaviors, which can increase their risk of contracting viral hepatitis. One study reported that each person who injects drugs infected with HCV is likely to infect about 20 others, and that this rapid transmission of the disease occurs within the first 3 years of initial infection. ⁴ Drug and alcohol use can also directly damage the liver, increasing risk for chronic liver disease and cancer among those infected with hepatitis. This underscores that early detection and treatment of hepatitis infections in PWID and other people who use drugs is paramount to protecting both the health of the person and that of the community.

What are the other health challenges for people with hepatitis who inject drugs?

People with hepatitis who inject drugs often have several other health conditions at the same time, including mental illness and HIV/AIDS, thus requiring care from multiple health care providers. This is sometimes referred to as co-occurring disorders. Substance use disorder treatment is critical for PWID, as it can reduce risky behaviors that increase the chance of transmitting hepatitis. Research has shown that patients with hepatitis receiving medication-assisted treatment for their opioid addiction can be safely treated with antiviral medications. ⁵

To enhance HCV care, NIDA is examining coordinated care models that utilize case managers to integrate HCV specialty care with primary care, substance use disorder treatment, and mental health services so that these patients get treatment regimens that address all of their health care needs. The Health Resources and Services Administration’s Ryan White HIV/AIDS Program developed a free, online curriculum about HIV/hepatitis C for healthcare providers and healthcare staff to increase knowledge about co-infection among people of color in the United States.

What treatments are available for viral hepatitis?

Many medications are available for the treatment of chronic HBV and HCV infection. For chronic HBV infection, there are several antiviral drugs. People who are chronically infected with HBV require consistent medical monitoring to ensure that the medications are keeping the virus in check and that the disease is not progressing to liver damage or cancer.

There are also antiviral medications available for HCV treatment and new treatments have been approved in recent years. Many antiviral HCV treatments can cure more than 90 percent of people who take them within 8 to 12 weeks. HCV treatment dramatically reduces deaths, and people who are cured are much less likely to develop cirrhosis or liver cancer. However, not everyone infected with HCV needs or can benefit from treatment. NIDA researchers have identified genes that are associated with spontaneous clearance of HCV. These genes also enable people who are unable to clear HCV on their own to respond more favorably to treatment medications. This new information can be used to determine which patients can benefit most from HCV treatment. More studies must be done, but this is a first step to personalized medicine for the treatment of HCV. 

How do I know if I am infected with viral hepatitis?

The number of new HBV and HCV infections has been declining in recent years, but the number of people living with chronic hepatitis infections is considerable, and deaths associated with untreated, chronic hepatitis infections have been on the rise. This is because most people don’t know they are infected until the disease has begun to damage the liver, highlighting why screening for viral hepatitis is so important. People with a history of drug use are generally at higher risk, and should discuss their substance use with their health care provider.

Initial screening for HBV or HCV involves antibody tests, which show whether you have been exposed to the hepatitis virus, although not necessarily whether you are still infected. A positive antibody test should then be followed up with a test that measures the amount of virus in your blood. If this follow-up test is positive, then you should seek advice from a physician that specializes in viral hepatitis treatment. Because screening for hepatitis is so critical for linking people who test positive to the care they need, NIDA is studying new rapid HCV antibody tests that can be used in drug treatment settings.

The CDC recommends that people who inject drugs be tested for hepatitis B and C as part of routine medical care.  To determine if you are at risk for contracting hepatitis, HHS has created an online assessment tool to help you find out.

• More about HBV testing: https://www.cdc.gov/hepatitis/hbv/bfaq.htm#bFAQ22
• More about HCV testing: https://www.cdc.gov/hepatitis/hcv/cfaq.htm#cFAQ51
• Locate a testing center near you:  https://npin.cdc.gov/search/organization/testing/viral hepatitis

What do I do if I find out I have viral hepatitis?

After learning from your doctor that you have hepatitis, your first step will be to learn more about the virus. Read government resources, like the websites listed below, to find current, scientific information. Adopting a healthy lifestyle is important to prevent the virus from becoming serious. Don’t drink or misuse drugs because they are hard on your liver. Get plenty of rest, eat healthy foods, and exercise. Work to protect others by not donating blood or participating in risky behaviors, including sharing needles when using drugs or having unprotected sex.

References

1. Hardtke-Wolenski, M., et al., Genetic predisposition and environmental danger signals initiate chronic autoimmune hepatitis driven by CD4+ T cells.Hepatology, 2013.
2. Centers for Disease Control and Prevention. Viral Hepatitis and Liver Cancer Fact Sheet. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/viral-hep-liver-cancer.pdf. Accessed April 6, 2018.
3. Rein, D.B., et al., Forecasting the morbidity and mortality associated with prevalent cases of pre-cirrhotic chronic hepatitis C in the United States.Dig Liver Dis, 2011. 43(1): p. 66-72.
4. Magiorkinis, G., et al., Integrating phylodynamics and epidemiology to estimate transmission diversity in viral epidemics.PLoS Comput Biol, 2013. 9(1): p. e1002876.
5. Bruce, R.D., et al., A review of pharmacological interactions between HIV or hepatitis C virus medications and opioid agonist therapy: implications and management for clinical practice. Expert Rev Clin Pharmacol, 2013. 6(3): p. 249-69.
6. Centers for Disease Control and Prevention. Surveillance for Viral Hepatitis – United States, 2017 Report. https://www.cdc.gov/hepatitis/statistics/2017surveillance/index.htm. Accessed July 31, 2020.
7. S. Department of Health and Human Services, Office of Infectious Disease and HIV/AIDS Policy. Viral Hepatitis in the United States: Data and Trends. https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/data-and-trends/index.html. Accessed July 31, 2020.

Hepatitis – NHS

Hepatitis is the term used to describe inflammation of the liver. It’s usually the result of a viral infection or liver damage caused by drinking alcohol.

There are several different types of hepatitis. Some types will pass without any serious problems, while others can be long-lasting (chronic) and cause scarring of the liver (cirrhosis), loss of liver function and, in some cases, liver cancer.

Symptoms of hepatitis

Short-term (acute) hepatitis often has no noticeable symptoms, so you may not realise you have it.

If symptoms do develop, they can include:

• muscle and joint pain
• a high temperature
• feeling and being sick
• feeling unusually tired all the time
• a general sense of feeling unwell
• loss of appetite
• tummy pain
• dark urine
• pale, grey-coloured poo
• itchy skin
• yellowing of the eyes and skin (jaundice)

See your GP if you have any persistent or troublesome symptoms that you think could be caused by hepatitis.

Long-term (chronic) hepatitis also may not have any obvious symptoms until the liver stops working properly (liver failure) and may only be picked up during blood tests.

In the later stages it can cause jaundice, swelling in the legs, ankles and feet, confusion, and blood in your stools or vomit.

Hepatitis A

Hepatitis A is caused by the hepatitis A virus. It’s usually caught by consuming food and drink contaminated with the poo of an infected person, and is most common in countries where sanitation is poor.

Hepatitis A usually passes within a few months, although it can occasionally be severe and even life threatening.

There’s no specific treatment for it, other than to relieve symptoms like pain, nausea and itching.

Vaccination against hepatitis A is recommended if:

• you’re at high risk of infection or severe consequences of infection
• you’re travelling to an area where the virus is common, such as the Indian subcontinent, Africa, Central and South America, the Far East and eastern Europe.

Find out more about hepatitis A

Hepatitis B

Hepatitis B is caused by the hepatitis B virus, which is spread in the blood of an infected person.

It’s a common infection worldwide and is usually spread from infected pregnant women to their babies, or from child-to-child contact.

It can also be spread through unprotected sex and injecting drugs.

Hepatitis B is uncommon in the UK. It most commonly affects people who became infected while growing up in part of the world where the infection is more common, such as southeast Asia and sub-Saharan Africa.

Most adults infected with hepatitis B are able to fight off the virus and fully recover from the infection within a couple of months.

But most people infected as children develop a long-term infection. This is known as chronic hepatitis B, and can lead to cirrhosis and liver cancer. Antiviral medicine can be used to treat it.

In the UK, vaccination against hepatitis B is recommended for people in high-risk groups, such as:

• healthcare workers
• people who inject drugs
• men who have sex with men
• children born to mothers with hepatitis B
• people travelling to parts of the world where the infection is more common

Hepatitis B vaccination is also part of the routine immunisation programme so all children can benefit from protection from this virus.

Find out more about hepatitis B

Hepatitis C

Hepatitis C is caused by the hepatitis C virus.

It’s usually spread through blood-to-blood contact with an infected person.

In the UK, it’s most commonly spread through sharing needles used to inject drugs.

Poor healthcare practices and unsafe medical injections are the main way it’s spread outside the UK.

Hepatitis C often causes no noticeable symptoms, or only flu-like symptoms, so many people are unaware they’re infected.

Some people will fight off the infection and be free of the virus. In other cases, it’ll stay in the body for many years.

This is known as chronic hepatitis C and can cause cirrhosis and liver failure.

Chronic hepatitis C can be treated with very effective antiviral medicines, but there’s currently no vaccine available.

Find out more about hepatitis C

Hepatitis D

Hepatitis D is caused by the hepatitis D virus. It only affects people who are already infected with hepatitis B, as it needs the hepatitis B virus to be able to survive in the body.

Hepatitis D is usually spread through blood-to-blood contact or sexual contact. It’s uncommon in the UK, but is more widespread in other parts of Europe, the Middle East, Africa and South America.

Long-term infection with hepatitis D and hepatitis B can increase your risk of developing serious problems, such as cirrhosis and liver cancer.

There’s no vaccine specifically for hepatitis D, but the hepatitis B vaccine can help protect you from it.

Hepatitis E

Hepatitis E is caused by the hepatitis E virus. The number of cases in Europe has increased in recent years and it’s now the most common cause of short-term (acute) hepatitis in the UK.

The virus has been mainly associated with the consumption of raw or undercooked pork meat or offal, but also with wild boar meat, venison and shellfish.  

Hepatitis E is generally a mild and short-term infection that does not require any treatment, but it can be serious in some people, such as those who have a weakened immune system.

There’s no vaccine for hepatitis E. When travelling to parts of the world with poor sanitation, where epidemic hepatitis E may be common, you can reduce your risk by practising good food and water hygiene measures.

The British Liver Trust has more information about hepatitis E

Alcoholic hepatitis

Alcoholic hepatitis is a type of hepatitis caused by drinking excessive amounts of alcohol over many years.

The condition is common in the UK and many people do not realise they have it.

This is because it does not usually cause any symptoms, although it can cause sudden jaundice and liver failure in some people.

Stopping drinking will usually allow your liver to recover, but there’s a risk you could eventually develop cirrhosis, liver failure or liver cancer if you continue to drink alcohol excessively.

You can reduce your risk of developing alcoholic hepatitis by controlling how much you drink.

It’s recommended that you do not regularly drink more than 14 units of alcohol a week.

Read more about alcohol-related liver disease and the health risks associated with alcohol.

Autoimmune hepatitis

Autoimmune hepatitis is a rare cause of long-term hepatitis where the immune system attacks and damages the liver.

Eventually, the liver can become so damaged that it stops working properly.

Treatment for autoimmune hepatitis involves very effective medicines that suppress the immune system and reduce inflammation.

It’s not clear what causes autoimmune hepatitis and it’s not known whether anything can be done to prevent it.

The British Liver Trust has more information about autoimmune hepatitis

Page last reviewed: 23 August 2022
Next review due: 23 August 2025

Hepatitis B – a dangerous disease

Hepatitis B – an infectious disease of the liver caused by the hepatitis B virus. and disease outcomes .

Chronic hepatitis B – long-term inflammatory liver disease, which can turn into a more severe disease – cirrhosis and primary liver cancer, remain unchanged or regress under the influence of treatment or spontaneously. Diffuse inflammation of the liver lasting more than 6 months – chronic hepatitis B.

How does infection occur?

The hepatitis B virus is transmitted from person to person through blood, semen or other bodily fluids. Hepatitis B is not spread through food or water, eating utensils, hugging, kissing, shaking hands, coughing, sneezing or insect bites.

Hepatitis B virus can survive up to 7 days outside the human body at room temperature on objects, environmental surfaces.

Main virus sources:

• patients with acute hepatitis B 4-6% of cases,
• Chronic hepatitis B patients and virus carriers – the majority of transmission cases.

Carriers are the most dangerous in terms of the spread of infection.

Hepatitis B is transmitted by natural and artificial means:

• through unprotected sex
• at home – sharing of toothbrushes, manicure utensils, razors and other personal hygiene items infected with hepatitis B viruses
• from mother to child – during pregnancy or childbirth
• in medical institutions – during medical procedures in violation of safety regulations
• non-medical invasive procedures – manicure, pedicure, tattooing, body piercing
• Parenteral administration of psychoactive substances.

How long does the infectious period last?

Even before the onset of clinical symptoms, starting from the incubation period, also throughout the disease (acute or chronic form) and the virus carrier.

May be asymptomatic. About a third of people infected with the hepatitis B virus learn about its presence only at the time of blood donation.

Symptoms:

• yellowness of the skin, whites of the eyes
• chair discoloration
• discoloration of urine (intense orange, brown)
• fever
• fatigue that persists for weeks or months
• loss of appetite, nausea and vomiting
• abdominal pain
• joint pains.

The first symptoms may not appear until 1-6 months after infection.

Chronic infection can go unnoticed for decades until serious and life-threatening complications occur.

Complications of hepatitis B:

cirrhosis of the liver – inflammation of the liver, accompanied by irreversible changes in the liver tissue

• liver cancer
• acute liver failure – a condition in which the vital functions of the liver are disabled. When this happens, a liver transplant is needed.
• People with chronic hepatitis B may develop kidney disease or inflammation of the blood vessels

Most adults with hepatitis B recover completely, even if their signs and symptoms are severe. Infants and children are more likely to develop chronic hepatitis B.

The diagnosis of hepatitis B, as well as the virus carrier, is confirmed by laboratory. HBsAg and HBeAg are detected in the blood.

Prevention of hepatitis B

The most effective measure for the prevention of viral hepatitis B is specific prophylaxis – vaccination, which is carried out in accordance with the National immunization schedule and the immunization schedule according to epidemic indications.

Due to vaccination, over the past 10 years (2009-2018), the incidence of acute hepatitis B has decreased by 3.9times.

Vaccination of newborns is carried out according to the scheme:

0 – 1 – 6 months; 0 – 1 – 2 – 6 – 12 months – risk groups.

Revaccination is carried out after 5-7 years.

Hepatitis B vaccination recommended:

• newborns
• children and adolescents not vaccinated at birth
• contacts from hepatitis B foci – living with those who have hepatitis B; those whose sexual partners are infected with hepatitis B
• medical workers
• HIV infected
• people with immunodeficiency conditions
• who use narcotic psychoactive substances
• HBsAg and HBeAg are detected in their blood.

Precautions to avoid hepatitis B infection:

• avoid unprotected sex unless you are sure that your partner is not infected with hepatitis B virus or any other sexually transmitted infection
• use barrier contraception if you do not know your partner’s status
• do not use drugs
• use personal hygiene items
• be careful with manicures, piercings and tattoos. If you are planning to get a manicure, pedicure, piercing or tattooing, do it in a professional salon. Make sure employees use sterile needles and instruments. If you can’t get answers, look elsewhere.

If infection is confirmed:

Patients with viral hepatitis B are subject to hospitalization in the infectious department.

Those who have been ill are under dispensary observation, undergo regular examinations for 6 months.

Current and final disinfection is carried out in the focus of infection.

Persons who have been in contact with the patient are also under medical supervision.

All pregnant women are obligatory tested for the presence of hepatitis B virus in the 1st and 3rd trimesters of pregnancy.

In case of detection of hepatitis B virus, pregnant women are hospitalized in an infectious disease hospital, women in labor – in specialized departments of maternity hospitals with a strict anti-epidemic regime.

Newborns are vaccinated in accordance with the National Immunization Schedule, and are also subject to dispensary observation.

In medical institutions the main measure to prevent the transmission of viral hepatitis B is compliance with the anti-epidemic regimen:

• patient examination
• disinfection, sterilization of medical devices
• vaccination of healthcare workers against hepatitis B
• blood donor screening

Public service organizations (beauty salons, nail salons, hairdressers) must comply with the requirements of the sanitary and anti-epidemic regime in order to prevent the spread of viral hepatitis B. Employees must undergo hygiene training.

If left untreated, the disease is fatal.

If you are infected, taking certain precautions can help prevent the virus from spreading to others.

If you think you are at risk of getting hepatitis B under certain circumstances in your life, or if you think you have signs or symptoms of hepatitis B, call your doctor right away!

Viral hepatitis can be prevented – State Budgetary Institution of the Rostov Region “Dental Polyclinic No.

1″ in Rostov-on-Don

World Hepatitis Day is celebrated every year on July 28, established by WHO at the initiative of the World Hepatitis Alliance.

Viral Hepatitis is a viral disease of the liver that wreaks havoc throughout the body. The viral infection spreads easily and can cause an epidemiological case. Doctors around the world have recognized this disease as a globally dangerous health problem. The source of infection are sick people or virus carriers. Transmission of the virus from a sick person to a healthy person occurs either enterally (through contaminated water and food) – hepatitis A and E , or parenteral (direct introduction of the virus into the blood) – hepatitis B, C, D . Viruses of parenteral hepatitis are found in all secretions of the patient: blood, semen, saliva, vaginal secretions, sweat, tears and can be transmitted by repeated use of non-sterile syringes for injections, blood transfusions, tattooing with raw needles, cosmetic procedures with the removal of moles, papillomas, earlobe piercing, manicure and pedicure procedures, as well as sexually and from mother to fetus .

The seriousness of the situation lies in the fact that one of the main risk groups for infection with hepatitis B and C are adolescents who like tattoos, piercings, earrings, who like to exchange combs, earrings, scissors, razors, etc. First sexual experience and the onset of drug use is often also at this age. But, unfortunately, even a single neglect of the rules of safe sex or a single injection of a narcotic substance with someone else’s syringe can lead to infection with hepatitis B and C. For example, 0.0000001 ml is enough for parenteral infection with hepatitis B. infected blood.

The clinical picture of all viral hepatitis is similar. The most severe course is observed in viral hepatitis B . The disease is accompanied by fever, weakness, loss of appetite to complete aversion to food and gastrointestinal manifestations. Sometimes (more often in children) the disease proceeds as an acute respiratory disease. The diagnostic signs are jaundice, the appearance of dark urine and uncolored stools . A large number of 9 are currently being discovered0003 asymptomatic infections .

Hepatitis C is considered to be the most insidious and dangerous among all viral hepatitis. More than 85% of those infected with the hepatitis C virus do not clear the virus from the body and, as a result, develop chronic hepatitis C , which leads to the development of cirrhosis and primary liver cancer. Treatment at the present stage requires large economic costs and long-term treatment.

Vaccination against viral hepatitis A and B is the main protection and the most effective way to prevent this dangerous infection, including our younger generation. Hepatitis B vaccination was introduced in National Immunization Schedule. In this case, three vaccinations should be performed with an interval of 1 month between the 1st and 2nd vaccinations and 5 months between the 2nd and 3rd. Such a vaccination course ensures the development of immunity for a long time (up to 15-20 years). For children, the first vaccination is carried out in the first 24 hours of life in the maternity hospital .

Effective preventive measures against the disease are hygiene, care in blood transfusion and caution in choosing sexual partners. It is necessary from childhood to instill strict observance of personal hygiene measures, to be an example in consolidating these hygiene skills, in instilling a sense of danger in various kinds of contacts with unknown persons. Young people must make the right choice – a healthy lifestyle, without drugs and serious illnesses, to preserve their healthy gene pool, thereby strengthening the health of the nation.

Rospotrebnadzor informs: Every year on July 28, many countries celebrate World Hepatitis Day (World Hepatitis Day). The date for its establishment was the birthday of the American doctor Baruch Samuel Bloomberg, Nobel Prize winner, who discovered the hepatitis B virus. The application of hygienic knowledge in practice by each person, the recognition of the need for vaccination against hepatitis A and B, as well as participation in vaccination campaigns will preserve the health of the population of not each individual country, but the population of the planet as a whole.

Hepatitis, an inflammation of the liver caused by a viral infection, is one of the most common and serious infectious diseases in the world.

There are five major hepatitis viruses, defined as types A, B, C, D, and E. Depending on the type of hepatitis, people can become infected either from infected body fluids or from contaminated food and water.

Infection with types B, C and D occurs through the blood of an infected person, and in the case of hepatitis B and C, also through unprotected sexual contact. Type D only infects those who already have hepatitis B. Types A and E are usually transmitted through contaminated water or food and are closely associated with poor sanitation and poor personal hygiene.

Acute infection may present with symptoms such as jaundice (yellowing of the skin and eyes), excessive fatigue, nausea, vomiting, and abdominal pain.

Types B and C may be asymptomatic in the early stages of the disease in some cases. A significant proportion of people infected with these viruses may only become aware of their illness when it becomes chronic, sometimes several decades after infection. Without knowing about their infection, they can pass it on to other people. All of these viruses cause acute hepatitis, which is characterized by fatigue, loss of appetite, fever, and jaundice. Most people recover completely, but among a small proportion of people, acute hepatitis can lead to death. In addition, hepatitis B and C infections can become chronic and lead to the development of cirrhosis and liver cancer.

The main preventive measures:

• hepatitis A and E are sanitary and hygienic measures.
• Immunization against viral hepatitis A, in the first place, is subject to groups at high risk of infection.
• One of the most reliable ways to protect against viral hepatitis B, according to WHO, is vaccination.

However, there is currently no vaccine for hepatitis C.

For World Hepatitis Day 2019d. WHO’s mission is to:

1. Call on national and regional policy makers to increase political and financial commitment to support hepatitis response.
2. Draw attention to WHO’s new estimates of the necessary costs of eliminating hepatitis in the context of achieving the health-related Sustainable Development Goals (SDGs) and UHC by 2030.
3. Encourage people to increase their use of hepatitis prevention, testing and treatment services.

According to a new WHO cost analysis, to achieve hepatitis elimination goals between 2016 and 2030 in low- and middle-income countries, an additional $6 billion per year would be required. This analysis is consistent with the 2017 WHO estimate of the cost of achieving the SDGs for health. In 2016, only $0.5 billion was invested, and these funds were mainly received from domestic sources.

Know. Prevent. Test. Treat. Eliminate hepatitis.

Are you at risk? Take the test! Detecting an infection early will allow you to start treatment faster, which can prevent disease and save your life.

Are you protected against hepatitis? Hepatitis B or C is preventable. Each injection must be safe. The hepatitis B vaccine provides lifelong protection. Hepatitis B and C can be sexually transmitted, so use condoms.

Be strong: get treated and be cured of hepatitis. If you test positive, find out if you need treatment and don’t delay getting treatment.

Do you have hepatitis B? Some people need treatment but can stay healthy with lifelong therapy.

Do you have hepatitis C? A 3-month course of treatment may help clear the infection.

Viral hepatitis B or C infects 325 million people worldwide and causes 1.