THE ABC'S OF HEPATITIS

By:  Kathleen Speicher, MD, MPH

Do you understand the differences of the various forms of hepatitis? In order to clarify the differences, the following outline presents the routes of transmission, their commons sources, the incubation periods, when a person is contagious, the severity of the illnesses, and prevention treatments for each.

HEPATITIS A

Route of transmission: Fecal-oral

Common sources: Poor sanitation, contaminated food and water

Incubation period: 2-6 weeks

Contagious: 2 weeks before symptoms to 1 week after symptoms

Severity: Death is uncommon, does not cause chronic hepatitis chronic    hepatitis or carrier state

Prevention: a 2 dose vaccine is 96% effective

HEPATITIS B

Route of transmission:  Blood and bodily fluids

Common sources:  Sharing needles with IV drug use, blood contaminated injuries (needlestick), mother to baby at delivery, unprotected sexual contact (especially anal intercourse)

Incubation period:  6 weeks to 6 months

Contagious:  As long as test positive usually <3 months, but may be lifetime

Severity:  <1% die from acute hepatitis, but chronic hepatitis occurs in 1-2% adults & 90% infant with 25-40% becoming carriers with increased risk of cirrhosis or liver cancer

Prevention:  a 3 dose vaccine is 97% effective

HEPATITIS C

Route of transmission:  Blood and bodily fluids

Common sources:  50% from IV drug use now, prior to 1991 was from blood transfusions, now only 1 in 200,000 transfusions, blood contaminated injuries, mother to baby at delivery, tattooing (sharing of needles)

Incubation period:  6 weeks to 6 months

Contagious:  15% - <3 months, 85% - lifetime

Severity:  50+% develop chronic hepatitis, with 30% of these developing cirrhosis or liver cancer, 40% of all liver disease in US, 51% of liver transplants, might be most common cause of primary liver cancer in US.

Prevention:  No vaccine, avoid sharing razors and toothbrushes, cover wounds with dressings, self clean-up of blood spills

Symptoms: All forms of hepatitis can have similar symptoms with varying degrees of severity: fatigue, right upper quadrant pain/tenderness, nausea, poor appetite, muscle and joint pains.

Treatment: Bed rest in acute phase (3-16 wks) as needed with gradual return to normal activities, with the majority having complete recovery. Avoid physical exertion, alcohol, and medications that may be toxic to the liver (check with your MD). Antiviral medications are being developed for treatment of chronic hepatitis B & C. The best treatment however is prevention by use of the vaccine and avoiding the risky behaviors listed previously in this article.