How do hepatitis A, B, and C differ in transmission, severity, and long-term effects. What are the key similarities and differences between hepatitis B and C. How does hepatitis impact liver health and overall wellbeing. What treatment options are available for different types of hepatitis.

The Basics of Hepatitis: Inflammation of the Liver

Hepatitis, a term meaning “inflammation of the liver,” can be caused by various factors including alcohol consumption, physical injury, autoimmune responses, or viral infections. The five most common hepatitis viruses are A, B, C, D, and E. These viruses can lead to serious liver complications such as fibrosis, cirrhosis, liver failure, and even liver cancer. When the liver becomes damaged, its ability to filter toxins from the body is compromised, leading to a cascade of health issues.

What causes hepatitis?

• Excessive alcohol consumption
• Physical injury to the liver
• Autoimmune responses
• Viral infections (Hepatitis A, B, C, D, E)
• Bacterial infections

Hepatitis B: The World’s Most Common Liver Infection

Despite the availability of an effective vaccine, hepatitis B remains the most prevalent liver infection globally. An estimated 292 million people worldwide are living with chronic hepatitis B. This blood-borne pathogen is primarily transmitted through direct blood-to-blood contact with an infected individual. The most common mode of transmission is from mother to child during birth.

Key facts about hepatitis B:

• Affects over 292 million people globally
• Can cause chronic, lifelong infections
• More infectious than hepatitis C (5-10 times)
• Can survive outside the body for up to 7 days
• Unique ability to integrate into host cell DNA

Is hepatitis B curable? Unlike hepatitis C, there is currently no cure for hepatitis B. The virus’s ability to integrate into the host cell’s DNA through covalently closed circular DNA (cccDNA) makes it particularly challenging to eradicate. This unique feature of hepatitis B contributes to the risk of reactivation even in patients with undetectable surface antigen levels.

Hepatitis C: A Curable but Serious Liver Infection

Hepatitis C, while less common than hepatitis B, has gained significant attention due to recent advancements in treatment. Like hepatitis B, it is a blood-borne pathogen that can cause chronic, lifelong infections. Hepatitis C is most commonly spread through the use of unclean needles for drug injection.

Treatment breakthrough for hepatitis C

Can hepatitis C be cured? Yes, a major breakthrough in hepatitis C treatment occurred in 2013 when the FDA approved a cure in the form of antiviral pills. This treatment, taken once daily for 8-12 weeks, has revolutionized the management of hepatitis C. A cure is defined as a sustained virologic response (SVR), meaning the virus is undetectable in the blood three months after completing treatment.

Comparing Hepatitis B and C: Similarities and Differences

While both hepatitis B and C are blood-borne pathogens that can lead to chronic liver infections, they have several key differences in terms of prevalence, transmission, and impact on liver health.

Prevalence and mortality

How do hepatitis B and C compare in terms of global impact? Hepatitis B is more prevalent worldwide and causes more liver-related cancer and death than hepatitis C. Together, chronic hepatitis B and C account for approximately 80% of the world’s liver cancer cases. However, studies indicate that individuals with chronic hepatitis B are more likely to die from liver-related complications compared to those infected with hepatitis C.

Liver cancer development

In hepatitis C infections, liver cancer typically develops after cirrhosis has occurred. However, in certain cases of hepatitis B, liver cancer can develop without any signs of cirrhosis. This characteristic makes it more challenging to predict the virus’s impact on the body and complicates liver cancer screening protocols for hepatitis B patients.

Virus stability and infectiousness

How long can hepatitis viruses survive outside the body? The hepatitis B virus is remarkably stable and can remain highly contagious on surfaces outside the body for up to 7 days if not properly disinfected. Recent studies suggest it may even survive in extreme temperatures. In contrast, the hepatitis C virus is known to survive outside the body for only a short period on room-temperature surfaces.

The Unique Nature of Hepatitis B: Covalently Closed Circular DNA

A major distinguishing factor between hepatitis B and C lies in how the viruses attack host cells. While both viruses reproduce by entering healthy cells and producing copies of themselves, hepatitis B employs a unique mechanism involving covalently closed circular DNA (cccDNA).

What is cccDNA and why is it significant?

Covalently closed circular DNA is a structure unique to only a few viruses, including hepatitis B. This DNA permanently integrates itself into a healthy cell’s DNA, residing within the cell nucleus. The presence of cccDNA means that even if a person’s hepatitis B surface antigen (HBsAg) levels are undetectable, there’s still a risk of viral reactivation.

Why is cccDNA challenging for treatment? The integration of cccDNA into the host cell’s nucleus makes it extremely difficult to isolate and destroy without harming the rest of the cell. This complexity contributes significantly to the challenges in finding a cure for hepatitis B.

Hepatitis A: The Often Overlooked Viral Liver Infection

While hepatitis B and C often dominate discussions about viral liver infections, hepatitis A is another important form of the disease that deserves attention. Unlike hepatitis B and C, hepatitis A is typically acute and does not lead to chronic infection.

Transmission and prevention of hepatitis A

How is hepatitis A transmitted? Hepatitis A is primarily spread through the fecal-oral route, often through contaminated food or water. It can also be transmitted through close personal contact with an infected individual. Proper hygiene practices and vaccination are key to preventing hepatitis A infections.

Is there a vaccine for hepatitis A? Yes, an effective vaccine is available for hepatitis A. The vaccine is typically given in two doses and provides long-lasting protection against the virus. It is recommended for travelers to high-risk areas, men who have sex with men, people with chronic liver diseases, and those at occupational risk of exposure.

Symptoms and course of hepatitis A infection

What are the symptoms of hepatitis A? Symptoms of hepatitis A can include:

• Fatigue
• Nausea and vomiting
• Abdominal pain
• Loss of appetite
• Low-grade fever
• Dark urine
• Jaundice (yellowing of the skin and eyes)

How long does hepatitis A last? In most cases, hepatitis A is a self-limiting disease that resolves on its own within a few weeks to months. Unlike hepatitis B and C, it does not cause chronic liver disease and is rarely fatal. However, it can cause debilitating symptoms and, in rare cases, acute liver failure.

The Global Impact of Viral Hepatitis

Viral hepatitis, particularly hepatitis B and C, poses a significant global health challenge. These infections contribute to a substantial burden of liver disease, including cirrhosis and hepatocellular carcinoma, worldwide.

Hepatitis and liver cancer

What percentage of liver cancer cases are caused by viral hepatitis? Chronic hepatitis B and C infections account for approximately 80% of the world’s liver cancer cases. This statistic underscores the critical importance of prevention, early detection, and treatment of these viral infections in reducing the global burden of liver cancer.

Economic impact of viral hepatitis

How does viral hepatitis affect global economics? The economic burden of viral hepatitis is substantial, encompassing direct medical costs, lost productivity, and the long-term impacts of chronic liver disease. In many countries, the cost of treating hepatitis C has been a significant challenge, though the advent of more affordable generic treatments is helping to address this issue.

Prevention and Treatment Strategies for Viral Hepatitis

Preventing and treating viral hepatitis requires a multifaceted approach, involving vaccination, screening, and antiviral therapies. Each type of viral hepatitis has its own specific prevention and treatment strategies.

Vaccination: A key tool in hepatitis prevention

Which types of hepatitis have vaccines? Effective vaccines are available for hepatitis A and B. The hepatitis B vaccine is particularly important, as it can prevent both acute and chronic infections. Vaccination programs have significantly reduced the incidence of these infections in many countries.

Is there a vaccine for hepatitis C? Currently, there is no vaccine available for hepatitis C. Prevention efforts for hepatitis C focus on reducing risk behaviors and implementing screening programs to identify and treat infections early.

Treatment options for chronic hepatitis

What treatments are available for chronic hepatitis B? While there is no cure for chronic hepatitis B, several antiviral medications can help suppress the virus and reduce the risk of liver damage. These include drugs such as entecavir, tenofovir, and pegylated interferon.

How effective is the cure for hepatitis C? The direct-acting antiviral drugs used to treat hepatitis C have revolutionized treatment, with cure rates exceeding 95% for most genotypes of the virus. Treatment duration is typically 8-12 weeks, with minimal side effects compared to older interferon-based therapies.

Living with Chronic Hepatitis: Management and Quality of Life

For individuals living with chronic hepatitis B or C, proper management is crucial for maintaining liver health and overall quality of life. This includes regular medical check-ups, lifestyle modifications, and in some cases, ongoing antiviral therapy.

Monitoring liver health

How often should individuals with chronic hepatitis have their liver checked? Regular monitoring of liver function and viral load is essential for people with chronic hepatitis. The frequency of check-ups may vary depending on the individual’s condition, but typically includes blood tests every 3-6 months and periodic imaging studies to screen for liver cancer.

Lifestyle considerations

What lifestyle changes can help manage chronic hepatitis? People living with chronic hepatitis can take several steps to support their liver health:

• Avoiding alcohol consumption
• Maintaining a healthy diet and exercise regimen
• Avoiding medications or supplements that may be toxic to the liver
• Getting vaccinated against other forms of hepatitis (if applicable)
• Practicing safe sex and avoiding sharing personal items that may come into contact with blood

By understanding the differences between hepatitis A, B, and C, individuals can take appropriate steps to protect themselves and seek proper treatment if infected. While hepatitis B remains a significant global health challenge due to its prevalence and the lack of a cure, advancements in hepatitis C treatment offer hope for those affected by this form of the virus. Continued research, education, and public health efforts are crucial in the ongoing fight against viral hepatitis and its impact on liver health worldwide.

What’s the Difference: Hepatitis B vs Hepatitis C?

About Hepatitis B, Living with Hepatitis B

January 9, 2019 hepbtalk

With five different types of viral hepatitis, it can be difficult to understand the differences between them. Some forms of hepatitis get more attention than others, but it is still important to know how they are transmitted, what they do, and the steps that you can take to protect yourself and your liver!

This is part one in a three-part series.

What is Hepatitis?

Hepatitis means “inflammation of the liver”. A liver can become inflamed for many reasons, such as too much alcohol, physical injury, autoimmune response, or a reaction to bacteria or a virus. The five most common hepatitis viruses are A, B, C, D, and E. Some hepatitis viruses can lead to fibrosis, cirrhosis, liver failure, or even liver cancer. Damage to the liver reduces its ability to function and makes it harder for your body to filter out toxins.

Both hepatitis B and C are blood-borne pathogens, which means that their primary mode of transmission is through direct blood-to-blood contact with an infected person. Also, both hepatitis B and C can cause chronic, lifelong infections that can lead to serious liver disease. Hepatitis B is most commonly spread from mother-to-child during birth while hepatitis C is more commonly spread through the use of unclean needles used to inject drugs.

Hepatitis B vs. Hepatitis C

Despite having an effective vaccine, hepatitis B is the world’s most common liver infection; over 292 million people around the world are estimated to be living with chronic hepatitis B. While hepatitis C tends to get more attention and research funding, hepatitis B is considerably more common and causes more liver-related cancer and death worldwide than hepatitis C. Combined, chronic hepatitis B and C account for approximately 80% of the world’s liver cancer cases. However, studies show that those with chronic hepatitis B are more likely to die from liver-related complications than those who are infected with hepatitis C. With hepatitis C, most people develop cirrhosis, or scarring of the liver, before liver cancer. In certain cases of hepatitis B, liver cancer can develop without any signs of cirrhosis, which makes it extremely difficult to predict the virus’ impacts on the body, and makes screening for liver cancer more complicated.

The hepatitis B virus is also approximately 5-10 times more infectious than hepatitis C, and far more stable. It can survive – and remain highly contagious – on surfaces outside of the body for up to 7 days if it is not properly cleaned with a disinfectant or a simple bleach solution. A new study suggests that the hepatitis B virus has the ability to survive in extreme temperatures, whereas the hepatitis C virus has been known to survive outside of the body for a short period of time on room-temperature surfaces. However, more research will need to be done on the topic.

Another major difference between the two forms of hepatitis is how the virus attacks a cell. The hepatitis C virus operates like other viruses; it enters a healthy cell and produces copies of itself that

Hepatitis C Virus
Courtesy of Google Images

go on to infect other healthy cells. The hepatitis B virus reproduces in a similar fashion, but with one large difference – covalently closed circular DNA. Covalently closed circular DNA (cccDNA) is a structure that is unique to only a few viruses. Unlike a typical virus, hepatitis B’s cccDNA permanently integrates itself into a healthy cell’s DNA – a component of the cell that allows it to function properly and produce more healthy cells. The cccDNA resides within an essential area of the cell called the nucleus and can remain there even if an infected person’s hepatitis B surface antigen (HBsAg) levels are undetectable. Its presence means that a person with chronic hepatitis B may have a risk of reactivation even if the HBsAg levels have been undetectable for a long period of time. The complex nature and integration process of cccDNA contributes to the difficulties of finding a cure for hepatitis B. The cccDNA’s location inside of the nucleus is especially troublesome because it makes it difficult to isolate and destroy the cccDNA without harming the rest of the cell.

Hepatitis C, on the other hand, has a cure! Approved by the FDA in 2013, the cure is in the form of an antiviral pill that is taken once a day over the course of 8-12 weeks. For hepatitis C, a cure is defined as a sustained virologic response (SVR), which means that the virus is not detected in a person’s blood 3 months after treatment has been completed. In the United States, an affordable, generic version of the hepatitis C cure is set to be released by Gilead Sciences, Inc. in January 2019.

People living with chronic hepatitis B are susceptible to hepatitis Delta. Only people with hepatitis B can contract hepatitis D as well. Hepatitis Delta is considered to be the most severe form of hepatitis because of its potential to quickly lead to more serious liver disease than hepatitis B alone. Of the 292 million people living with chronic hepatitis B, approximately 15-20 million are also living with hepatitis D. Unlike HIV and hepatitis C coinfections, there are currently no FDA approved treatments for hepatitis Delta. However, there are ongoing clinical trials that are researching potential treatments!

Hepatitis B/C Coinfection

It is possible to have both hepatitis B and C at the same time. The hepatitis C virus may appear more dominant and reduce hepatitis B to low or undetectable levels in the bloodstream. Prior to curative treatment for hepatitis C, it is important for people to get tested for hepatitis B using the three-part blood test (HBsAg, anti-HBc total and anti-HBs). People currently infected with hepatitis B (HBsAg positive) or those who have recovered from past infection (HBsAg negative and anti-HBc positive) should be carefully managed according to the American Association for the Study of Liver Diseases (AASLD) treatment guidelines in order to avoid dangerous elevation of liver enzymes resulting in liver damage.

How to Protect Yourself   

The hepatitis B vaccine is the best way to protect yourself and your family against hepatitis B. Although there is no vaccine for hepatitis C, you can protect yourself from both liver infections by following simple precautions! Simple steps such as not sharing personal items such as razors or toothbrushes, thoroughly washing your hands, and disinfecting surfaces that have been in contact with blood, can keep your liver healthy!

AASLDAmerican Association for the Study of Liver DiseaseCoinfectionHBVHCVHDVhepatitis Chepatitis D

Comments on this blog are closed. These blogs are not regularly reviewed or updated, and information, data, or practice recommendations/guidelines may have changed. If you have questions about hepatitis B or this blog post, please email [email protected] or call 215-489-4900.

Types of Viral Hepatitis: Hepatitis A, B, C

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on December 15, 2021

• What Is Viral Hepatitis?
• How Do You Get Hepatitis A?
• How Do You Get Hepatitis B?
• How Do You Get Hepatitis C?
• How Do I Know If I Have Viral Hepatitis?
• How Long Before I Have Symptoms?
• Should I Get Tested?
• Is There a Vaccine to Protect Me From Hepatitis?
• How Long Do the Viruses That Cause Hepatitis Survive Outside the Body?
• If I Have Hepatitis, How Can I Avoid Giving It to Someone Else?
• More

Viral hepatitis is an inflammation of your liver that’s caused by a virus. There are five types, but the most common ones in the U.S. are hepatitis A, B, and C. All of them affect your liver. Some of the symptoms are similar, but they have different treatments.

Hepatitis A. This type won’t lead to long-term infection and usually doesn’t cause any complications. Your liver heals in about 2 months. You can prevent it with a vaccine.

Hepatitis B. Most people recover from this type in 6 months. Sometimes, though, it causes a long-term infection that could lead to liver damage. Once you’ve got the disease, you can spread the virus even if you don’t feel sick. You won’t catch it if you get a vaccine.

Hepatitis C. Many people with this type don’t have symptoms. About 80% of those with the disease get a long-term infection. It can sometimes lead to cirrhosis, a scarring of the liver. There’s no vaccine to prevent it.

The main way you get hepatitis A is when you eat or drink something that has the hep A virus in it. A lot of times this happens in a restaurant. If an infected worker there doesn’t wash their hands well after using the bathroom, and then touches food, they could pass the disease to you.

Food or drinks you buy at the supermarket can sometimes cause the disease, too. The ones most likely to get contaminated are:

• Fruits and vegetables
• Shellfish
• Ice and water

You could catch or spread it if you’re taking care of a baby and you don’t wash your hands after changing their diaper. This can happen, for example, at a day care center.

Another way you can get hep A is when you have sex with someone who has it.

The virus that causes hepatitis B lives in blood, semen, and other fluids in your body. You usually get it by having sex with someone who’s infected.

You also can get it if you:

• Share dirty needles when using illegal drugs
• Have direct contact with infected blood or the body fluids of someone who’s got the disease, for instance by using the same razor or toothbrush as someone who has hepatitis B, or touching the open sores of somebody who’s infected.
• If you’re pregnant and you’ve got hepatitis B, you could give the disease to your unborn child. If you deliver a baby who’s got it, they need to get treatment in the first 12 hours after birth.   

Just like hepatitis B, you can get this type by sharing needles or having contact with infected blood. You can also catch it by having sex with somebody who’s infected, but that’s less common.

If you had a blood transfusion before new screening rules were put in place in 1992, you are at risk for hepatitis C. If not, the blood used in transfusions today is safe. It gets checked beforehand to make sure it’s free of the virus that causes hepatitis B and C.

It’s rare, but if you’re pregnant and have the disease, it’s possible to pass it to your newborn.

There are some myths out there about how you get hepatitis C, so let’s set the record straight. It’s not spread by food and water (like hep A). And you can’t spread it by doing any of these things:

• Kissing
• Hugging
• Sneezing or coughing
• Sharing forks, knives, or spoons

The best-known symptom is jaundice, which can make your skin or the whites of your eyes turn yellow.

But not everyone who has hepatitis gets jaundice. You might just feel like you have the flu — weak, tired, and sick to your stomach. These symptoms are common for many types of hepatitis:

• Fever
• Loss of appetite
• Nausea and vomiting
• Stomach pain
• Diarrhea
• Dark-colored urine
• Light-colored bowel movements
• Joint pain

See your doctor as soon as possible if you have any of these symptoms.

Sometimes, people have no symptoms. To be sure you have hepatitis, you’ll need to get tested.

Many people have mild symptoms or no symptoms, which is why hepatitis is sometimes called a “silent” disease.

Hepatitis A. The symptoms usually show up 2 to 6 weeks after the virus enters your body. They usually last for less than 2 months, though sometimes you can be sick for as long as 6 months.

Some warning signs that you may have hepatitis A are:

• Fever
• Fatigue
• Nausea, vomiting, or pain in your belly
• Dark urine or clay-colored bowel movements
• Pain in your joints
• Yellowing of your skin or eyes (jaundice)

Hepatitis B. The symptoms are the same as hepatitis A, and you usually get them 3 months after you’re infected. They could show up, though, anywhere from 6 weeks to 6 months later.

Sometimes the symptoms are mild and last just a few weeks. For some people, the hep B virus stays in the body and leads to long-term liver problems.

Hepatitis C. The early symptoms are the same as hepatitis A and B, and they usually happen 6 to 7 weeks after the virus gets in your body. But you could notice them anywhere from 2 weeks to 6 months later.

For about 25% of people who get hep C, the virus goes away on its own without treatment. In other cases, it sticks around for years. When that happens, your liver might get damaged.

Remember, it’s possible to spread all the types of hepatitis even if you don’t show any signs of being sick.

If your doctor thinks you have hepatitis, there are blood tests to tell if you have type A, B, C, or another type called D. You should get lab results back within a few days.

Some types of hepatitis get better on their own. Others turn into chronic cases and can damage the liver and cause liver cancer. If your doctor thinks you could have chronic hepatitis B or C, they may perform a liver biopsy. That means they’ll remove a very tiny piece of your liver with a needle, then send it to a lab to check for liver damage.

The sooner you’re tested for a chronic form of hepatitis, the sooner you can take medicine to reduce or stop the damage the virus can cause to your liver.

Many people with hepatitis C don’t have symptoms, so they don’t know they’re infected. That’s why it’s so important to see a doctor and get tested. Chronic hepatitis C testing is recommended for anyone who:

• Was born from 1945 through 1965
• Received blood-clotting factor drugs before 1987
• Received blood transfusions or an organ transplant before 1992
• Has been on dialysis for many years
• Injected illegal drugs, even once
• Has HIV
• Has a known exposure to hepatitis C (such as a health care worker stuck by a needle with blood that is hepatitis C-positive or received an organ or blood transfusion from a donor who has hepatitis C)
• Was born to a mother who had hepatitis C

Can Hepatitis Be Treated?

If you have hepatitis A, your doctor will carefully see how well your liver is working, but there aren’t any treatments.

There are several drugs that treat long-term hepatitis B, such as:

• Adefovir (Hepsera)
• Entecavir (Baraclude)
• Interferon
• Lamivudine (Epivir HBV)
• Pegylated Interferon (Pegasys) 
• Telbivudine (Tyzeka)
• Tenofovir (Viread)

If you have long-term hepatitis B, you might be a “carrier,” which means you can infect others.

Medications called direct-acting antiviral (DAA) treatments can cure many people with hepatitis C. If you haven’t been treated before, your doctor may suggest these drugs for hepatitis C:

• Elbasvir-grazoprevir (Zepatier)
• Glecaprevir-pibrentasivir (Mavyret)
• Ledipasvir-sofosbuvir (Harvoni)
• Ombitasvir-paritaprevir-ritonavir-dasabuvir (Viekira Pak)
• Simeprevir (Olysio)
• Sofosbuvir (Sovaldi)
• Sofosbuvir-velpatasvir (Epclusa)

There are vaccines that prevent hepatitis A and B. There isn’t one for hepatitis C.

The CDC recommends that all children get hepatitis A and B vaccines. Adults should get vaccinated if they travel to a country where there are outbreaks or if they’re at high risk for the disease.

The hepatitis A virus can live outside the body for months.

Hepatitis B survives for at least 7 days while still being able to cause an infection.

Hepatitis C can live on household and clinic surfaces for up to 6 weeks at room temperature. In open air, it can survive for at least 4 days.

For hepatitis A, one of the best things you can do is wash your hands a lot. That will keep the virus out of food and drinks.

If you have hepatitis B and C, you need to find ways to keep others from making contact with your blood. Follow these tips:

• Cover your cuts or blisters.
• Carefully throw away used bandages, tissues, tampons, and sanitary napkins.
• Don’t share your razor, nail clippers, or toothbrush.
• If your blood gets on objects, clean them with household bleach and water.
• Don’t breastfeed if your nipples are cracked or bleeding.
• Don’t donate blood, organs, or sperm.
• If you inject drugs, don’t share needles or other equipment.

Top Picks

What is hepatitis – Pro Palliative

Contents

Not all types of hepatitis are dangerous

Hepatitis B

Hepatitis C

There are a lot of myths around hepatitis. Unfortunately, sometimes even people with medical education believe in them. Doctors, nurses and volunteers in hospices often fear contracting viral hepatitis, but the risk of getting the virus in a hospice is no greater than at a dentist’s appointment, in a nail or tattoo parlor.

Hepatitis patients are often treated with neglect. One of the most striking cases that I know of was that of a young HIV-positive man who was diagnosed with liver cancer while also diagnosed with hepatitis C. The tumor was only a few centimeters long, and after it was removed, there was not even a need for chemotherapy. This focus was discovered in August, and the patient was operated on only in January. The young man was sentenced. He was denied operations even in large cancer centers: “We will not operate on you because you have hepatitis C and HIV.”

How can I get palliative care for a patient with HIV? Doctors, social workers, palliative experts — about the present and future of palliative care for HIV-positive patients in Russia

The story ended happily because there were doctors who operated on him. They understood that if all the rules are observed, there is no risk of infection of medical personnel. These rules are simple, but in Russia they are neglected, and then they loudly shout about the danger of those infected with hepatitis and HIV. The simplest thing in surgical interventions is not to transfer sharp instruments to a colleague, but to place them on a sterile table so that the other surgeon can take them as safely as possible.

Doctors in Europe and the United States treat HIV and hepatitis C with no fear. Restriction in access to medical care due to the presence of an infection in a person can be punished very seriously – fines, dismissals, up to criminal liability.

People with hepatitis or HIV infection in Russia, especially in the regions, are alone in their problems. There is no one even to support them psychologically, because they are considered the most insignificant elements of society. Doctors and medical staff are extremely negative and very wary of such patients, many are denied medical care (especially in dentistry, dermatology, etc.). Unfortunately, this is due to the huge ignorance of medical workers and there is no justification for such behavior.

Among infectious disease doctors there are professors who talk about the cure for hepatitis C at lectures, but when they come down from the podium, they say: “Does anyone really believe in this? Hepatitis lives in the nerve ganglia. ” In fact, this is far from being the case, and currently viral hepatitis C is cured in 100% of cases, but this does not always happen on time. Treatment is becoming more and more affordable and occurs in 8-12 weeks.

Not all types of hepatitis are dangerous

There are many types of hepatitis viruses: A, B, C, D, E, G, F, TTV. Nature does not stand still, perhaps in the future a new hepatotropic virus will appear, with which we will fight. Hepatitis D only appears when the patient has a B infection. With these two types of hepatitis, an avalanche-like progression of liver disease begins up to the development of cirrhosis, patients very often die and it is almost impossible to treat them. Hepatitis E is now becoming more relevant due to the mass migration of people from Africa to Europe. According to WHO, up to 33 million new cases of infection are recorded in the world per year.

Not all types of hepatitis are dangerous. G, F, TTV are viruses that live in the liver but do not carry any consequences. However, there are some private clinics that actively treat these types of hepatitis, although they are recognized worldwide as not active viruses.

Hepatitis A is called “dirty hands disease”. It almost always resolves in an acute form and is not chronic. The virus does not carry serious consequences and almost never ends lethally. It is clear that in a sparsely populated area in a remote area, a patient with hepatitis A may develop a fulminant form of the disease (acute liver failure), and doctors will not always be able to save such a patient. But this is an extremely rare case.

To protect yourself from hepatitis A, it is enough to get vaccinated. All people entering the health facility should be vaccinated or tested for antibodies to the virus, including non-medical personnel. If your mother says that you definitely “did not turn yellow” from hepatitis as a child, this does not guarantee that you did not get sick with it. Perhaps you suffered it in a subclinical form, for example, you thought that these were signs of poisoning. If antibodies are detected, vaccination against hepatitis A is not needed.

Wash your hands before eating, do not drink unboiled water, always wash vegetables and fruits and do not neglect the heat treatment of food. Hepatitis A is not transmitted by airborne droplets, but by the fecal-oral route.

Hands should be washed with soap and water when caring for the sick, especially after using the restroom and cleaning the room. After changing a patient’s diaper, wash your hands thoroughly. This is a non-specific prophylaxis that people must follow, regardless of which category of patients they work with.

In Russia, the presence of hepatitis A implies hospitalization for 21 days. In this case, the diagnosis occurs already in the “icteric” period, when the patient is not dangerous and practically does not release the virus into the environment. In my opinion, this category of patients needs the usual home bed rest with careful care and supervision of a family doctor.

In terms of infecting other people, the patient is dangerous during the “preicteric” period. The disease manifests itself, like any rotavirus infection: high fever, loose stools, weakness, so it is quite difficult to identify hepatitis A before jaundice appears. Persons who have been in contact with a patient with hepatitis should be under the supervision of a doctor for 45 days. There is no emergency vaccination in the recommendations, but theoretically, in the first 72 hours from the moment of contact, it is possible to vaccinate.

In contrast to hepatitis A with a minimal number of deaths, according to WHO, 44 thousand people die from hepatitis E per year out of 3.5 million infected people. The virus is most dangerous for pregnant women in the second and third trimesters. The hepatitis E virus is present in the feces of an infected person. It enters the body more often through water, poorly processed meat, raw shellfish, blood transfusion, or from mother to fetus. Symptoms of this disease are jaundice, nausea, fever, weakness.

Weakness, changes in body temperature, sleep problems – how to help? Why these symptoms appear and how they can be controlled

Most patients recover from hepatitis E, but some of them remain chronic and no doctor knows how to treat. China has developed a vaccine against the hepatitis E virus, but it has not yet been approved by the WHO.

Hepatitis B is the most dangerous type of hepatitis virus

Hepatitis B is the most dangerous type of hepatitis virus. According to WHO, 257 million people are chronically infected with it, 686 thousand die from it every year. The Asia-Pacific region is home to about 90% of all infected in the world. It is expected that in the next generation among the inhabitants of this region the number of infected people will decrease, as they began to vaccinate against hepatitis B. The vaccine was invented in 1982, and its effectiveness is 95%.

There are no drugs for a complete functional cure yet – antiviral therapy does not destroy the virus, but slows down the development of cirrhosis and liver cancer. The virus can exist outside of humans for up to seven days. It is transmitted through blood and other body fluids (saliva, urine, semen, menstrual fluid, etc.), through sexual contact, from mother to fetus in utero or during childbirth. If a drop of an infected person’s blood enters a pool, there is a risk that the pool water will become infected. A person can get an infection in this pool through cuts on the skin, through microtrauma. People with psoriasis and xerosis who have dry and damaged skin are also at risk of infection.

All hepatitis in the acute phase are manifested by the same symptoms – jaundice, nausea, fever. If a person with hepatitis A gets better after turning yellow, then a person with hepatitis B gets even worse. Jaundice in hepatitis B is an indicator that the immune system saw the virus and began to fight it: the body’s immune cells went to the liver and began to destroy the virus. Therefore, the patient is ill, he has a fever, he is all yellow. In this battle, the body will win with a probability of 90%. And if a person does not turn yellow and does not understand how and when he became infected, most likely, his body did not notice the virus.

Non-specific prophylaxis against hepatitis B virus – no contact with infected people. If you work with patients who may be infected with this type of hepatitis, follow the requirements for working with used disposable medical instruments, wear personal protective equipment (rubber gloves, goggles) when working with open wounds and body fluids, wash your hands before handling and immediately after them, use modern methods of blood sampling (vacutainers).

You don’t have to wear a “plague suit” every time you enter a patient’s room. You are fully protected if you are vaccinated.

Hepatitis B consists of three antigens: surface antigen, cardiac antigen and intermediate antigen. In order for our body to reject hepatitis B, it must have a defense against the surface antigen. The vaccine against this type of hepatitis is an artificially created piece of surface antigen. It stimulates the immune system so that a person does not get sick.

Hepatitis B vaccination is recommended for people requiring blood transfusions, dialysis patients, family members and sexual partners of people with chronic hepatitis B, health care workers and other people who work with blood, women planning pregnancy, people who have unprotected sex, people who inject drugs. Also, hepatitis B vaccination is needed for everyone who has not been vaccinated before and does not have the necessary protection against hepatitis B (sufficient level of antibodies to HBsAg).

If you are under 35, you can go to your local health center and get vaccinated against hepatitis A and B free of charge. You can get vaccinated against two hepatitis at once. Vaccinations are carried out according to the plan: from hepatitis B – three times at intervals of a month and six months, from hepatitis A – twice.

Hepatitis C is a gentle killer

Tuberculosis: ways of transmission, symptoms, prevention How to protect yourself from tuberculosis

According to WHO, about 72 million people in the world are infected with hepatitis C. Approximately 399,000 infected people die each year, mostly from cirrhosis and liver cancer. The hepatitis C virus is called the “gentle killer”. It is transmitted in the blood through unsafe injection, through the transfusion of blood and its products. Sexual transmission and infection from mother to fetus are extremely rare.

Hepatitis C can be transmitted by household means through razors, toothbrushes. There is a risk of getting a virus during a manicure, during dental procedures and examinations of internal organs with non-sterile equipment.

One day I asked an endoscopist friend of mine from a very prestigious clinic to examine patients with hepatitis C and HIV. It turned out that in this clinic there is a very large flow of patients, and endoscopes do not have time to sterilize – they are simply wiped with a disinfectant.

So both children and pensioners can get hepatitis C, not just injection drug users. If you notice that the medical facility has not processed the instruments, and you are offered to look at a certificate from a previous patient that he is not infected, you should not worry about this. Firstly, his certificate may be fake, and secondly, he may be in a phase when the virus has not yet been detected.

If hepatitis B has the ability to “sleep” (a person became infected 20-30 years ago and carried it in an inactive form), then hepatitis C cannot “sleep”. It reproduces at a tremendous rate, synthesizing a billion viral particles every day. There are doctors who dissuade patients with a low concentration of the virus from being treated, but this should never be done, as a person puts both himself and others at risk.

For prevention, hand hygiene is required, the use of gloves when working with body fluids. The danger of hepatitis B and C is that you can get infected from one viral particle in the blood, a drop of which is not visible to the eye. Unlike hepatitis B, in hepatitis C there is no emergency prevention in the form of a vaccine or a specific immunoglobulin – only the treatment of the wound surface with an antiseptic and blood donation for antibodies to hepatitis 4-12 weeks after contact with the blood of an infected person.

Recorded by Diana Karliner

The most aggressive hepatitis leading to cirrhosis of the liver can now be cured

Fresh issue

WG-Week

Rodina

Thematic applications

Union

Fresh issue

Society

04.08. 2020 21:07

Share

Irina Nevinnaya

Now that everyone is focused on the new coronavirus, other infections are somehow out of the question. But no one has canceled them, and tens, hundreds of thousands of people are infected with them every year.

lemono / iStock

On World Hepatitis Day, experts warned that the incidence of especially dangerous hepatitis C is on the rise, and that of hepatitis B is improving thanks to vaccination. More good news: the most aggressive hepatitis D, which leads to cirrhosis of the liver in just a few years after infection, is now curable.

– Every year in Russia there are 45-50 thousand more patients with chronic hepatitis C – these are those who are under the supervision of doctors, – said the chief freelance infectious disease specialist of the Russian Ministry of Health Vladimir Chulanov. – The incidence of hepatitis B has decreased to 0.6 cases per 100 thousand of the population – this is already the level of prosperous European countries. This happened solely due to widespread vaccination: in total, more than 100 million people have already been vaccinated against hepatitis B in Russia.

The rarest, but also the most aggressive is hepatitis D, which accompanies hepatitis B. This is such a feature of this virus – it cannot enter the body itself, but it easily “attaches” to the conductor, which is the hepatitis B virus.

” For hepatitis D, we usually give the most unfavorable prognosis. It has a rapid progression, and of those who are diagnosed with this for the first time, 60-70 percent already have cirrhosis of the liver,” the chief infectious disease specialist explained.

The trouble is that all hepatitis only sometimes proceed in an acute form, more often they attack imperceptibly – the liver does not hurt, and a person attributes other possible symptoms to fatigue, a cold, and other insignificant causes.

Here are the signs of hepatitis B, C, D:

– fatigue;

– poor appetite, nausea;

– subfebrile temperature;

– pain in the joints;

– dark color of urine;

– yellowing of the skin and eyeballs.

Today, the only sure way to prevent infection with hepatitis D is vaccination against hepatitis B. There is no vaccine yet for hepatitis C. But unlike hepatitis B (there is no cure for it), hepatitis C, and now D, have become curable. A few years ago, an effective antiviral drug was created that acts on the C virus. Moreover, it does not stop its destructive effect (as, for example, in the case of HIV therapy – it is lifelong), but actually completely destroys it. There was also a breakthrough in the treatment of hepatitis D: the new drug, as experts say, is effective even at the stage of liver cirrhosis that has already begun. The drug molecule, originally developed in Germany, was brought to the status of a drug in Russia. And since May 2020, our drug has become available for treatment in hospitals.