Hepatitis A And B: Diseases Of The Liver
Hepatitis is an inflammation of the liver, most often caused by a viral infection. There are three common types of hepatitis caused by viruses: hepatitis A, hepatitis B, and hepatitis C. Vaccines have been developed that protect people from contracting hepatitis A and B. There is no vaccine for hepatitis C.
Hepatitis A and hepatitis B can be spread from person to person, although in different ways. They have similar symptoms, which include abdominal pain, fever, fatigue, joint pain, and jaundice .
Over the last 20 years, there has been a 90% decrease in cases of hepatitis A and an 80% decrease in hepatitis B cases in the U.S. Health experts believe that immunization efforts have led to this drop in rates of infection.
What Medications Are Available To Treat Hepatitis C
Many medications can treat and cure hepatitis C. The first medication for hepatitis C was interferon alfa-2b, but other medications are now available too.
Oral antiviral medications called direct acting antivirals were first introduced in 2011. Theyre now first-choice medications to treat hepatitis C, but the best DAA to treat hepatitis C depends on the person. Before choosing and starting a DAA, your healthcare provider will consider your medical history, take blood work, and assess how well your liver and kidneys are working.
Choosing a DAA can depend on the HCV genotype that you have. While determining if you have hepatitis C, your healthcare provider may run tests to determine your HCV genotype. But, this isnt necessary for all people some DAAs can treat many identified genotypes. The CDC recommends that people should be tested for their HCV genotype if they have cirrhosis or were previously treated unsuccessfully for hepatitis C.
DAA medications are often taken for 8 to 12 weeks when treating an acute infection, but this timeframe can vary. Recommended DAAs available to treat hepatitis C include:
If DAA medications cant be used, other medications are available. Medications like pegylated interferon , interferon , and ribavirin may be considered. The best medication to treat hepatitis C varies by person, so your healthcare provider can talk with you about which medication may be best for you.
Managing Fever After Immunisation
Common side effects following immunisation are usually mild and temporary . Specific treatment is not usually required.There are a number of treatment options that can reduce the side effects of the vaccine including:
- Drinking extra fluids to drink and not overdressing if there is a fever.
- Although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be taken check the label for the correct dose or speak with your pharmacist .
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How Is Hepatitis Contracted
There are various ways of contracting hepatitis, depending on the type. Contracting a viral form of hepatitis depends on the mode of transmission, which the table above shows.
A person may sometimes contract hepatitis nonvirally. In autoimmune hepatitis, the immune system attacks the liver cells. Ingesting substances that contain toxins, such as alcohol, can also induce some types of hepatitis.
A doctor may use a blood test to diagnose viral hepatitis.
A healthcare professional will check a persons blood for:
- HAV-specific immunoglobulin G antibodies to diagnose HAV
- the surface antigen HBsAg to diagnose HBV
- anti-HCV antibodies to diagnose HCV
- high immunoglobulin G and anti-HDV immunoglobulin M levels to diagnose HDV
- virusspecific IgM antibodies to identify HEV
To autoimmune hepatitis, a doctor may consider:
- symptoms
Liver Anatomy And Function
Main Function of the Liver
The liver is an essential organ that has many functions in the body. The liver plays an important role in detoxifying the body by converting ammonia, a byproduct of metabolism in the body, into urea that is excreted in the urine by the kidneys. The liver also breaks down medications and drugs, including alcohol, and is responsible for breaking down insulin and other hormones in the body. The liver also stores vitamins and chemicals that the body requires as building blocks.
Many different disease processes can occur in the liver, including infections such as hepatitis, cirrhosis , cancers, and damage by medications or toxins.
Symptoms of liver disease can include:
- Jaundice
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How Can I Contract Hepatitis B
You can contract hepatitis B by coming into contact with the bodily fluids of an infected person.
Resort activities that may put you at risk for hepatitis B include:
Getting a manicure, pedicure, tattoo, piercing, or acupuncture with improperly sterilized tools
Having sexual contact with an infected partner
Giving first aid to, or receiving it from, an infected person
Receiving a medical or dental procedure with contaminated equipment
Sharing personal grooming items with an infected person
Who Should Be Vaccinated With Hepatitis A
- Any person who desires protection from hepatitis A
- Men who have sex with men
- People who use injection or non-injection illegal drugs
- People traveling to areas with a high or intermediate occurrence of hepatitis A
- People with chronic liver disease
- People who receive clotting factor concentrates
- People working with HAV-infected primates or with HAV in a research laboratory
- People who will have close personal contact with an international adoptee during the first 60 days after arriving in the US from a country with a high or intermediate occurrence of hepatitis A
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Who Should Not Receive Hepatitis A Vaccine
There are a very few situations where the hepatitis A vaccine is not recommended. They include:
- If you have an illness causing a high temperature. In this situation, it is best to postpone vaccination until after you have fully recovered from the illness.
- If you have had an allergic reaction to the vaccine or to any of its components in the past.
- One type of vaccine should not be given to anyone who is known to be allergic to eggs.
- Children under the age of 1 year. However, the risk of hepatitis A in children under the age of 1 year is very low. The hepatitis A vaccine is not licensed for this age group.
The vaccine may be given if you are pregnant or breastfeeding and vaccination against hepatitis A is thought to be necessary.
People Whose Lifestyle Increases Their Risk Of Acquiring Hepatitis A
Serological testing for hepatitis A immunity is not routinely recommended, but may be appropriate for some people
Serological testing for immunity to hepatitis A is not routinely recommended before receiving hepatitis A vaccine.
It is also inappropriate to test people who cannot remember whether they have ever had a hepatitis A vaccine. If a person is recommended for vaccination and has no records of previous vaccination, they should receive a vaccine.
However, certain groups of people should be screened for natural immunity to hepatitis A to avoid unnecessary vaccination:
- people who were born before 1950
- people who spent their early childhood in hepatitis Aendemic areas
- people with an unexplained previous episode of hepatitis or jaundice
People with unexplained jaundice should also be tested for other causes of hepatitis, including hepatitis B.
These people may need to be tested for total hepatitis A antibodies or IgG antibodies against hepatitis A virus. A positive test indicates immunity to hepatitis A. People who are immune do not need hepatitis A vaccination.
To better interpret serological testing results, discuss them with the laboratory that performed the test. Ensure that the laboratory receives the relevant clinical information.
See also Vaccine information and Variations from product information for more details.
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Concurrent Administration With Other Vaccines
The administration of oral cholera and travellers diarrhea vaccine and Typh-O vaccine capsules should be separated by at least 8 hours Typh-O vaccine can be given concomitantly with or at any time before or after any parenteral vaccine. There is no known interaction between Typh-I vaccine and other travel vaccines, such as hepatitis A vaccine, yellow fever vaccine and hepatitis B vaccine.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
Where Can I Get Vaccinated
The best place to go for vaccinations is your family medical clinic. They have your medical records and can check to see if youve already had a particular vaccination. Either your doctor or a nurse can give the vaccination.If you dont have a family doctor, you can go to one of the after-hour medical clinics. Ring them first to make sure they can help you with the vaccination you need.You can find a clinic near you on the Healthpoint website. Put in your address and region, and under Select a service, click on GPs/Accident & Urgent Medical Care.Vaccines on the National Immunisation Schedule are free. Other vaccines are funded only for people at particular risk of disease. You can choose to pay for vaccines that you are not eligible to receive for free.
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What Are The Symptoms Of Hepatitis A And B
Not all infected adults will experience symptoms. That means you could contract hepatitis A or B, and spread the viruses to others, without realizing it.
Symptoms of hepatitis A may include*:
Fever
Jaundice
Loss of appetite
Dark urine
Fatigue
* TWINRIX is not indicated to treat the symptoms of, or reduce serious consequences associated with hepatitis A and B.
Possible consequences of hepatitis A.*Hepatitis A infection can have mild to severe consequences on infected individuals that can last from a few weeks to several months.
Chronic hepatitis and carrier states are not linked with hepatitis A infection.
However, relapsing hepatitis, a condition where a person gets worse again after a period of improvement, can last up to a year in 15% of cases.
While most infected people recover, the older you are, the more severe hepatitis A can be.
Approximately 25% of infected adults are hospitalized.
The overall case fatality rate, which is the proportion of deaths among the number of hepatitis A cases, is approximately 0.5%, but can reach 2.6% in adults over 60 years of age.
* TWINRIX is not indicated to treat the symptoms of, or reduce serious consequences associated with hepatitis A and B.
Symptoms of hepatitis B may include*:
Fatigue
Jaundice
Loss of appetite
Dark urine
Clay-coloured stool
* TWINRIX is not indicated to treat the symptoms of, or reduce serious consequences associated with hepatitis A and B.
Safety Of Hepatitis Vaccines
Hepatitis vaccines have been given to millions of people all across the world without any evidence of serious side effects. “They’re very safe, and they’re extremely effective,” says Poland.
If you are not sure whether you should have hepatitis vaccines, talk with your doctor about your specific concerns.
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When To Talk To Your Doctor
You may not realize that you’ve come in contact with hepatitis B or C because oftentimes there aren’t any symptoms. You should get tested if you’ve been in any situation that presents a risk of infection, like sharing needles. The CDC also recommends that all pregnant women get tested for hepatitis C.
Some people can be allergic to the hepatitis B vaccine, so you should also see your doctor if you experience any bad reactions after getting one of the doses.
How Great Is The Risk For Hepatitis A
In 2016, the CDC reported there were an estimated 4,000 hepatitis A cases in the United States. The number of cases has declined by more than 95 percent since the Hepatitis A vaccine became available in 1995.
While anyone can get hepatitis A, in the United States, the CDC cautions the follow groups of people are at a higher risk:
- People who have direct contact with someone who has hepatitis A
- Travelers to countries where hepatitis A is common
- Men who have sexual contact with men
- People who use drugs, both injection and non-injection drugs
- Household members or caregivers of a recent adoptee from countries where hepatitis is common
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Concerns About Immunisation Side Effects
If a side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your childs condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.
Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety and central reporting service. Adverse events in other states or territories can be reported through SAEFVAC.
It is important to seek medical advice if you are unwell, as this may be due to other illness rather than because of the vaccination.
Who Is At Risk For Infection
Anyone who is not immune to hepatitis A can get hepatitis A infection. Food-borne outbreaks occur sporadically throughout the USA. Certain groups of people do have a higher risk of developing HAV infection and should be vaccinated:
- Persons experiencing homelessness
- People who eat raw or under-cooked shellfish
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What Is Hepatitis A Vaccine
Hepatitis A vaccine gives protection against infection from the hepatitis A virus. The vaccine works by causing your body to produce antibodies against the virus responsible for hepatitis A infection and in this way protects against the disease. The hepatitis A virus is carried in the faeces of an infected person. You can come into contact with this when you drink contaminated water, eat food prepared by someone with hepatitis A virus who did not wash their hands after going to the toilet or have sexual contact with someone with the virus. Read more about hepatitis A.
Efficacy Of Hepatitis A Vaccines
Randomised controlled trials show that the vaccines have protective efficacy of nearly 100%.28,29 This is supported by the apparent eradication of hepatitis A from Aboriginal and Torres Strait Islander communities in north Queensland and the Northern Territory since the vaccination program started in these regions.15,17,30
A single dose of Hepatitis A vaccine can confer protection for several years. There is evidence to suggest that a single dose of HAV hepatitis A vaccine can be 100% efficacious in preventing hepatitis A infection in seronegative young children in the study period from 6 weeks to 15 months post vaccination.31 Other studies have demonstrated effectiveness of a single dose in preventing hepatitis A infection up to 7 years after vaccination.25,32
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Symptoms And Causative Agent
Hepatitis is a general term for inflammation of the liver, which may result from infectious or non-infectious causes. Viruses responsible for many cases of infectious hepatitis include hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. Hepatitis A and B are the only hepatitis viruses for which vaccines are currently available in the United States .
The hepatitis B virus is a partly double-stranded DNA virus in the hepadnavirus family. The hepatitis A virus is a single-stranded RNA virus in the picornavirus family. Both viruses, though they are structurally unrelated to one another, infect and replicate primarily in liver cells.
The symptoms of acute hepatitis A infection are identical to those of hepatitis B infection. Early symptoms are headache, nausea, vomiting, abdominal pain, fever, rash, body aches and pains, and dark colored urine. Following this phase, jaundice , light stools, and liver pain may appear.
What If You Have Hepatitis A
There are no specific treatments once a person gets hepatitis A. Doctors usually recommend rest, adequate nutrition and fluids to treat symptoms, although some people will need additional medical care at a hospital.
The disease can range from a mild illness lasting a few weeks to a severe illness lasting several months. According to the Centers for Disease Control and Prevention, although rare, hepatitis A can cause liver failure and death in some people. This is more common in people who are at least 50 years old and in people with other liver diseases.
Once you recover from hepatitis A, you develop antibodies that protect you from the virus for life.
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Immunisation Against Hepatitis A
Immunisation is the best protection against hepatitis A infection and is recommended for people in high-risk groups, and for unvaccinated people who have been in close contact with someone who has hepatitis A.
Immunisation against hepatitis A includes a course of injections over a 6 to 12-month period. Healthy people 12 months of age and over receive 2 doses of hepatitis A vaccine, or 3 doses if the hepatitis A and hepatitis B vaccines are given as a combination.
You can complete any missed vaccine doses, even if the recommended time frame has passed. You do not need to start the vaccine course again.
If you are in close contact with someone who has hepatitis A be sure to have the hepatitis A vaccine if you have not already completed a vaccine course.
Babies under 12 months of age and people who have a weakened immune system who are also in close contact with a person with hepatitis A can have an injection of normal human immunoglobulin instead of the hepatitis A vaccine.
Protection against hepatitis A is available free of charge under the National Immunisation Program Schedule for Aboriginal and Torres Strait Islander children who live in high-risk areas .
Who Should Be Vaccinated With Hepatitis B
- Any person who desires protection from hepatitis B
- Sexually active people who are not in a long-term, mutually monogamous relationship like a person with more than 1 sex partner during the last six months
- Men who have sex with men
- People seeking testing or therapy for a sexually transmitted infection like HIV
- Recent or current injection drug users
- Healthcare and public safety workers who are potentially exposed to blood or other infectious body fluids
- People with diabetes who are younger than age 60 years and consider after age 60
- People with end-stage kidney disease, including people undergoing hemodialysis, people with HIV, and people with chronic liver disease
- Household contacts and sex partners of people who have hepatitis B
- Clients and staff members of institutions and daycare facilities for persons with developmental disabilities
- International travelers to countries with a high or intermediate prevalence of chronic HBV infection
- All adults in sexually transmitted infection treatment facilities like HIV testing and treatment facilities,
- All adults in facilities providing drug abuse treatment and prevention services or providing services to injection drug users
- All adults in healthcare settings providing services to men who have sex with men
- All adults in correctional facilities
- All adults working in end-stage kidney disease facilities for patients on chronic hemodialysis
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