Hepatitis

Hepatitis is an inflammation of the liver and is caused by many different factors. There are three main types of hepatitis.

Hepatitis can be categorised as either acute or chronic.

 

Acute hepatitis

Acute hepatitis occurs suddenly or gradually, but in either case it is short-lived, usually lasting less than two months. For someone with acute hepatitis, liver damage is usually mild.

On rare occasions, acute hepatitis can be fatal. In some circumstances, acute hepatitis can progress to chronic hepatitis.

 

Chronic hepatitis

Chronic hepatitis persists for long periods of time and is classified as either chronic persistent or chronic acute. Chronic persistent hepatitis is usually mild and progresses slowly. However, it can become more severe, progressing to chronic acute hepatitis. As liver damage becomes more extensive and severe, chronic acute hepatitis can cause cirrhosis, most often resulting in liver failure and even death.

 

Viral causes of hepatitis

There are seven viruses that are known to cause hepatitis. These are designated by the letters A to G. However, the cause of some hepatitis is still unknown, leading scientists to believe there are other viruses that have yet to be discovered.

The three most common viral forms of hepatitis are:

  •   Hepatitis A
  •   Hepatitis B
  •   Hepatitis C

The other forms of hepatitis – D, E, F and G – are very rare.

‘Co-infection’ with hepatitis B virus and hepatitis C virus is increasingly becoming a major cause of illness in people with HIV. Both these viruses affect the liver, can make you very ill and in some cases can be fatal.

But there are treatments, and these can work well in people with HIV.

 

Hepatitis A

Hepatitis A is caused by a virus that attacks the liver. It is easy to pass on during sex or get from contaminated food and water. Nearly everyone makes a full recovery.

 

Symptoms

Hepatitis A symptoms can be so mild you may not realise you have it, but up to six weeks after infection it can cause mild flu-like symptoms.

You may get diarrhoea, feel sick or very tired or have itchy skin and stomach pain. You may get jaundice, meaning your skin and the whites of your eyes turn yellow, your urine is dark and your faeces (poo) are pale.

Symptoms can last several weeks, taking months to get back to normal.

 

Transmission

Someone with hepatitis A is most infectious two weeks before the symptoms appear. The virus lives in faeces and minute traces of it carry the infection on the hands or on food prepared by an infected person. Water can also be contaminated, especially abroad.

The virus needs to get into the mouth to infect someone. This can happen during sex when tiny amounts of faeces get on fingers and into mouths through:

  •   Rimming
  •   Fingering
  •   Anal sex without condoms
  •   Handling used condoms and sex toys that have been in someone else’s anus.

 

Protect yourself and others

You can protect yourself by getting vaccinated. People at higher risk of Hepatitis A are recommended to have a vaccination, eg, close contacts of someone with the infection, gay men, and those travelling to parts of the world where the infection is common. You might be able to get vaccinated for free by your GP or sexual health clinic. The vaccine protects you for 10 years or longer. A vaccine exists that protects against Hepatitis A and B.

If you have Hepatitis A tell people you live with or have recently had sex with to ask their doctor about having an urgent vaccination. Avoid sex and preparing food for others until told you are no longer infectious.

Although they are not as good as being vaccinated these also cut the risk:

  •   Avoiding sex that involves contact with faeces
  •   Using condoms for anal sex
  •   Washing hands after touching someone’s anus or handling used condoms and sex toys
  •   Using a latex barrier (like a condom cut into a square) for rimming and latex gloves for fisting.

 

Treatment

What can I do if I think I have Hepatitis A?

Most cases are diagnosed by GPs (family doctors) rather than sexual health clinics and no special treatment is needed. If you recently had sex with someone or share your house with others, they should see a doctor straight away about getting vaccinated to stop them getting infected. Avoid sex and preparing food for others until told you are no longer infectious.

 

Testing

A blood test will confirm whether you have picked up the virus.

 

Treatment

Rest is the usual treatment for Hepatitis A. You may need several weeks off work and will be advised to avoid alcohol until your liver recovers. Smokers often avoid smoke as it can make them feel sick. Recreational drugs should be avoided to allow your liver to get better. Once you have had the infection you’re immune and can’t get it again, but you can get other types of hepatitis.

 

Hepatitis B

Hepatitis B is caused by a virus that attacks the liver. It is easy to pass on during sex or by sharing injecting equipment. Most people who get it make a full recovery, but for a minority it can be more serious.

 

Symptoms

Many people who get Hepatitis B notice no symptoms or they are so mild that they may not realise they have it. But weeks or months after infection it can cause mild flu-like symptoms.

You may get diarrhoea, feel sick or very tired, have itchy skin and stomach pain. You may get jaundice, meaning your skin and the whites of your eyes turn yellow, your urine is dark and your faeces (poo) are pale.

Symptoms can last several weeks, taking months to get back to normal. Most people make a full recovery but up to 1 in 10 become ‘carriers’ with chronic (long term) infection. They feel fine but stay infectious to others, with a small risk of going on to develop liver disease.

Around 1 in a 100 people get a more serious illness which can be fatal if not treated immediately.

 

Transmission

You are most infectious to others in the two weeks before symptoms show. The virus can be passed on in these body fluids: blood, semen, pre-cum, and vaginal secretions.

It is passed on through:

  •   Oral, vaginal or anal sex without a condom
  •   Rimming.

The virus can also spread through sharing injecting drug equipment such as needles and syringes which can carry infected blood. It can be found in saliva but there are no proven cases of kissing passing it on -infections from bites are rare.

A pregnant woman with the virus can give it to her baby during childbirth.

 

Protect yourself and others

You can protect yourself by getting a vaccination. People at higher risk of Hepatitis B are recommended to have a vaccination, eg, close contacts of someone with the infection, gay men, and those travelling to parts of the world where the infection is common. You might be able to get vaccinated for free by your GP or some sexual health clinics. The vaccine protects you for ten years or longer – there is a vaccine which can protect you against both Hepatitis A and B.

If you have Hepatitis B tell people you live with or recently had sex with to urgently ask their doctor about vaccination. Avoid sex until told you are no longer infectious.

Although not as good as being vaccinated these also cut the risk:

  •   Using condoms for penetrative sex
  •   Using a latex barrier (like a condom cut into a square) for rimming.

If you are a ‘carrier’ you may want to tell a partner and explain you are infectious. They can then decide if they want to take precautions (eg, get vaccinated) or are happy to take any risk. That way they cannot accuse you of infecting them without them knowing the risk was there.

 

Treatment

What can I do if I think I have Hepatitis B?

Most cases are diagnosed by GPs (family doctors), not sexual health clinics and treatment isn’t needed for most people. If you had sex with someone recently or share your house with others they can be vaccinated to stop them getting the infection – they should see a doctor straight away. Avoid sex until told you are no longer infectious.

 

Testing

A blood test will confirm whether you have the virus.

 

Treatment

In most cases no treatment for Hepatitis B is needed, other than rest. You may need several weeks off work and will be advised to avoid alcohol until your liver recovers. Smokers often avoid smoke as it can make them feel sick. Recreational drugs should be avoided to allow your liver to get better. Once you have had the infection you’re immune and can’t get it again, but you can get other types of hepatitis.

Drugs are available for ‘carriers’. A small number of ‘carriers’ go on to get liver disease (and a small number of those get liver cancer),and may need a liver transplant.

 

Why get treated?

If someone becomes a ‘carrier’, drugs can limit liver damage and make it less likely they pass the virus on.

 

Hepatitis C

Hepatitis C is caused by a virus that attacks the liver and is easily spread by sharing drug injecting equipment. It is also spreading through sex between men.

Hepatitis C is the most serious type of hepatitis. Most people with Hepatitis C can’t clear it without treatment, and stay infectious to others. There is no vaccine against Hepatitis C, treatment doesn’t work for everyone and the virus can cause liver disease that can be fatal.

 

Symptoms

Most people who get this infection don’t notice any symptoms when they are first infected. It can take years before you feel ill, with symptoms often not easily identified as being due to Hepatitis C.

They can include mild flu-like symptoms, diarrhoea, feeling sick or very tired, itchy skin and stomach pain.

You may get jaundice, meaning your skin and the whites of your eyes turn yellow, your urine is dark and your faeces (poo) are pale.

Symptoms specific to Hepatitis C include mental confusion and depression.

 

Transmission

The Hepatitis C virus is found in blood and is passed on when infected blood gets into another person’s blood stream. It is seen as unlikely (but not impossible) that it can be passed on in semen.

Most people get the virus from sharing drug injecting equipment such as needles, syringes, spoons, filters and swabs. Sharing things like straws and bank notes which are used for snorting drugs might pass the virus on.

In the UK piercing and tattooing should be safe but abroad unsterilised equipment can spread the virus.

Blood transfusions in the UK are safe as blood is screened.

Hepatitis C isn’t often passed on during sex between a man and a woman but is more likely during sex between men.

An infected person risks infecting others if they share anything that might have blood on it like toothbrushes or razors.

A pregnant woman with the virus can give it to her baby during childbirth.

 

Protect yourself and others

There is no vaccination against Hepatitis C. The risk of infection is reduced by not sharing injecting drug equipment (eg, needles, syringes, swabs, spoons, filters) or things that may have blood on them such as toothbrushes and razors.

The risk of contact with blood during sex can be reduced by using condoms for anal and vaginal sex. If you have Hepatitis C you shouldn’t give blood or be an organ donor.

If you are a ‘carrier’ you may want to tell a partner and explain you are infectious. They can then decide if they are happy to take any risk and want to take precautions. That way they cannot accuse you of infecting them without them knowing the risk was there.

 

Treatment

What can I do if I think I have Hepatitis C?

A doctor or sexual health clinic can test you to see if you have Hepatitis C. If you do, treatment is available and you can discuss how to avoid infecting your sexual partners or people you live with.

 

Testing

It can take three to nine months before the blood test for Hepatitis C will be able to detect signs of infection in your blood.

 

Treatment

If tests show you have had the virus for longer than two months you are a ‘carrier’ with chronic (long term) infection. Drug treatment is available and getting better but still only works for about half of people. Treatment can last for six months and involves tablets and injections into the stomach. Avoiding alcohol and recreational drugs is advised.

If you are cured of Hepatitis C you are not immune, you can get it again. You can also still get other types of hepatitis, and having Hepatitis C and another type is more serious.

 

Why get treated?

Hepatitis C can be fatal. A small number of ‘carriers’ go on to get liver disease, and a small number of those get liver cancer and will need a transplant. Although treatment has side effects, the sooner you start it, the less damage your liver will suffer. You will also have a better chance of getting rid of the virus, with less risk of infecting others.

 

Page content supplied by www.tht.org.uk. Copyright 2012 © Terrence Higgins Trust.

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