Know your risk for hepatitis

Hepatitis means inflammation of the liver, a vital organ that processes nutrients, filters the blood and fights infections.

When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications and certain medical conditions can cause hepatitis. However, hepatitis is most often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B and hepatitis C, according to the Centers for Disease Control and Prevention (CDC).

A, B and C

May is National Hepatitis Awareness Month. It’s a good time to know about the different types of viral hepatitis and if you may be at risk and should be tested. Symptoms of hepatitis can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, grey-colored stools, joint pain and jaundice.

Here’s a look at the different types:

• Hepatitis A is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water. Hepatitis A is a self-limited disease that does not result in chronic infection. The best way to prevent hepatitis A is to get vaccinated.
• Hepatitis B is transmitted when blood, semen, or another body fluid from someone with the hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact, sharing needles, syringes, or other drug-injection equipment, or from mother to baby at birth. For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection. Chronic hepatitis B can lead to serious health issues, like cirrhosis or liver cancer. The best way to prevent hepatitis B is to get vaccinated.
• Hepatitis C (HCV) is a blood-borne virus. Most people become infected by sharing needles or other equipment to inject drugs. For some people, hepatitis C is a short-term illness but for 70 to 85 percent of people infected with hepatitis C, it becomes a long-term, chronic infection. Chronic hepatitis C is a serious disease than can result in long-term health problems, even death. The majority of those infected might not be aware of their infection because they are not clinically ill. There is no vaccine for hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs.

A generation at risk

While anyone can get hepatitis C, people born between 1945 and 1965 are five times more likely to have HCV than other adults, according to the CDC.

Marcie Lindstrom, a family nurse practitioner with OSF HealthCare Medical Group – Gastroenterology in Bloomington, said approximately 3.4 million people are infected with HCV. Risk factors for HCV include blood transfusions prior to 1992, tattoos, body piercings, intravenous drug use, intranasal drug use, hemodialysis, mother with hepatitis C and unprotected sexual activity.

“If you have risk factors or were born between 1945 and 1965 – the baby boomer generation – you should get screened for HCV,” Marcie said.

Dr. Omar Khokhar, also with OSF HealthCare Medical Group – Gastroenterology in Bloomington, said it’s not completely understood why people born between 1945 and 1965 have high rates of hepatitis C.

“Most baby boomers are believed to have become infected in the 1960s through the 1980s when transmission of hepatitis C was at a peak,” he said. “Most people with hepatitis C do not know they are infected. Since many people can live with hepatitis C for decades without symptoms or feeling sick, testing is critical so those who are infected can get treated and cured.”

Some people who get infected are able to be free of the hepatitis C virus, but most people who get infected develop a chronic, or long-term infection. Over time, chronic hepatitis C can cause serious health problems. In fact, hepatitis C is a leading cause of liver cancer and the leading cause of liver transplants. Treatments are now available that can cure hepatitis C, Dr. Khokhar said.

“The only way to know if you have hepatitis C is to get tested. A blood test, called a hepatitis C antibody test, can tell if a person has ever been infected with the hepatitis C virus. This test looks for antibodies to the hepatitis C virus. Antibodies are chemicals released into the bloodstream when someone gets infected,” he said.

Getting tested

When getting tested for hepatitis C, Dr. Khokhar suggests asking when and how test results will be shared. There are two possible antibody test results:

• Non-reactive, or a negative, means that a person does not have hepatitis C. However, if a person has been recently exposed to the hepatitis C virus, he or she will need to be tested again.
• Reactive, or a positive, means that hepatitis C antibodies were found in the blood and a person has been infected with the hepatitis C virus at some point in time. A reactive antibody test does not necessarily mean a person has hepatitis C. Once someone has been infected, they will always have antibodies in their blood. This is true even if they have cleared the hepatitis C virus.

A reactive antibody test requires an additional, follow-up test to determine if a person is currently infected with hepatitis C, he said.

Treating hepatitis C

Recently, several oral options have become available to treat HCV, Dr. Khokhar said.

“Previously, treatment consisted of injections for up to a year. Now, we can treat a hepatitis C infection with oral therapy that may be as short as eight weeks,” he said.

Marcie said today’s treatment is easy with very little side effects.

“And best of all,” she said, “most treatment is 98 percent effective.”