Dear Dr. Know,
What is hepatitis and how is it spread?
Does a condom protect me?
Curious in Tampa
Dear Curious in Tampa, here’s what you need to know about hepatitis. You can find this information at the CDC. www.cdc.gov/hepatitis
What is hepatitis?
“Hepatitis” means inflammation of the liver. Heavy alcohol use, toxins, certain medications, bacterial infections, and some diseases can cause hepatitis. Hepatitis also refers to a group of viral infections that affects the liver. These are three different, contagious liver diseases caused by three unrelated viruses. Although all three types of hepatitis can cause similar symptoms, they have different modes of transmission.
The best way to protect yourself from hepatitis A and B is to get vaccinated.
How is hepatitis spread?
HEPATITIS A is usually spread when a person ingests fecal matter— even in microscopic amounts—from an infected person. Among men who have sexual contact with other men, hepatitis A can be spread through direct anal-oral contact or contact with fingers or objects that have been in or near the anus of an infected person. Hepatitis A can also be spread through contaminated food or water, which is why travelers to certain countries are at risk.
HEPATITIS B is spread when body fluid—such as semen or blood— from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus is 50–100 times more infectious than HIV and is easily transmitted during sexual activity. Hepatitis B can also be spread through sharing needles, syringes, or other drug-injection equipment.
HEPATITIS C is spread through contact with the blood of an infected person, primarily through sharing needles, syringes, or other drug-injection equipment. Hepatitis C can also be spread through sexual contact, although scientists do not know how frequently this occurs. Rough sex, sex with multiple partners, or having a sexually transmitted disease or HIV appears to increase a person’s risk for hepatitis C.
How common is viral hepatitis in the United states?
While rates of acute viral hepatitis have been declining, around 1.2 million people are living with chronic hepatitis B virus infection and 3.2 million with chronic hepatitis C virus infection. Many do not know they are infected.
Should I be vaccinated?
Experts recommend that all gay and bisexual men be vaccinated for hepatitis A and B. The hepatitis A and B vaccines can be given separately or as a combination vaccine. The vaccines are safe, effective, and require 2–3 shots within a 6-month period depending on the type of vaccine. If you are HIV positive, you should receive double the adult dose of Hepatitis B vaccine. For maximum protection, a person should complete all shots in the series. There is no vaccine for hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially sharing needles or other equipment to inject drugs.
Should I also be tested?
Experts recommend that, if at all possible, gay and bisexual men should be tested for hepatitis B at the same time they get their first dose of vaccine. If tests reveal that a man has never been infected, then vaccination will protect him. If he has a resolved infection, he is now immune and the vaccine offers no benefit. If he is living with a chronic infection, the vaccine offers no protection and he is capable of spreading the virus to others. His sexual partners should be tested and he should be referred for medical care. Testing is not recommended for hepatitis A, and testing for hepatitis C is recommended only for gay and bisexual men who engage in risky behaviors or have HIV.
Acute and chronic viral hepatitis
Hepatitis A appears only as an acute or newly occurring infection and usually lasts no more than 6 months. Although hepatitis B and hepatitis C can also begin as acute infections, each can develop into a chronic, or lifelong, infection.Over time, about 15%–25% of people with chronic hepatitis infection develop serious liver conditions, including liver damage, cirrhosis, liver failure, and even liver cancer.
What are the symptoms of viral hepatitis?
Not everyone shows symptoms when they have viral hepatitis. Symptoms, if they appear, are similar for all types of hepatitis and can include: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice. Symptoms of acute infection typically last a few weeks to several months. Although most people remain symptom free for many years, some experience ongoing symptoms similar to those of acute hepatitis.
How is viral hepatitis diagnosed and treated?
Doctors diagnose the infection using one or more blood tests, depending on the type of hepatitis. For people with acute viral hepatitis, doctors usually recommend rest, adequate nutrition, fluids, and in certain situations, antiviral medication. In a few cases, people with acute hepatitis are hospitalized. People who have acute hepatitis typically feel sick for a few months before they recover. People with chronic viral hepatitis infection should seek the advice of a doctor experienced in treating hepatitis B or hepatitis C and should be monitored on a regular basis. Some may also benefit from antiviral medication. Several treatments are available that can significantly improve health and may delay or reverse the effects of liver disease.
For more information
Talk to your health professional, call your health department, or visit www.cdc.gov/hepatitis
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