Hepatitis A

SIGNS & SYMPTOMS * jaundice * fatigue* abdominal pain
 loss of appetite* nausea* diarrhea * fever

CAUSE * Hepatitis A virus (HAV)

LONG-TERM EFFECTS
* There is no chronic (long-term) infection. * Once you have had hepatitis A you cannot get it again. * About 15% of people infected with HAV will have prolonged or relapsing symptoms over a 6-9 month period.

TRANSMISSION
* HAV is found in the stool (feces) of persons with hepatitis A.
* HAV is usually spread from person to person by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A.

PERSONS AT RISK OF INFECTION
* Household contacts of infected persons* Sex contacts of infected persons
* Men who have sex with men* Injecting and non-injecting drug users

PREVENTION * Hepatitis A vaccine is the best protection.
* Short-term protection against hepatitis A is available from immune globulin. It can be given before and within 2 weeks after coming in contact with HAV. * Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing and eating food.

VACCINE RECOMMENDATIONS Vaccine is recommended for the following persons 2 years of age and older:
* Men who have sex with men* Injecting and non-injecting drug users
* Persons with clotting-factor disorders (e.g. hemophilia)* Persons with chronic liver disease
Hepatitis B

SIGNS & SYMPTOMS About 30% of persons have no signs or symptoms.
* jaundice * fatigue * abdominal pain * loss of appetite * nausea, vomiting * joint pain

CAUSE * Hepatitis B virus (HBV)

LONG-TERM EFFECTS WITHOUT VACCINATION Chronic infection occurs in:
* 90% of infants infected at birth* 30% of children infected at age 1 - 5 years
* 6% of persons infected after age 5 years
Death from chronic liver disease occurs in: * 15-25% of chronically infected persons

TRANSMISSION
* HBV is spread through having sex with an infected person with HBV by sharing drugs, needles, or "works" when "shooting" drugs, through sharps exposures on the job, or from an infected mother to her baby during birth.

RISK GROUPS
* Persons with multiple sex partners or diagnosis of a sexually transmitted disease
* Men who have sex with men* Sex contacts of infected persons
* Injection drug users * Household contacts of chronically infected persons
* Infants born to infected mothers * Infants/children of immigrants from areas with high rates of HBV infection (view map) * Health care and public safety workers * Hemodialysis patients

VACCINE RECOMMENDATIONS * Hepatitis B vaccine

TREATMENT & MEDICAL MANAGEMENT * HBV infected persons should be evaluated by their doctor for liver disease.
* Adefovir dipivoxil, alpha interferon, and lamivudine are three drugs licensed for the treatment of persons with chronic hepatitis B.
* These drugs should not be used by pregnant women.
* Drinking alcohol can make your liver disease worse.


Hepatitis C


SIGNS & SYMPTOMS 80% of persons have no signs or symptoms.
* jaundice* fatigue* dark urine
* abdominal pain * loss of appetite* nausea

CAUSE * Hepatitis C virus (HCV)

LONG-TERM EFFECTS
* Chronic infection: 55%-85% of infected persons* Chronic liver disease: 70% of chronically infected persons* Deaths from chronic liver disease: 1%-5% of infected persons may die* Leading indication for liver transplant

TRANSMISSION
Occurs when blood or body fluids from an infected person enters the body of a person who is not infected.
*HCV is spread through sharing needles or "works" when "shooting" drugs, through needle sticks or sharps exposures on the job, or from an infected mother to her baby during birth.

PERSONS RISK OF INFECTION TESTING RECOMMENDED?
Injecting drug users High Yes
Hemodialysis patients Intermediate Yes
Recipients of blood before 1992 Intermediate Yes
People with undiagnosed liver problems Intermediate Yes
Infants born to infected mothers Intermediate After 12-18 mos. old
Healthcare/public safety workers Low Only after known exposure
People having sex with multiple partners Low No*
People having sex with an infected steady partner Low No*
*Anyone who wants to get tested should ask their doctor.

PREVENTION
* There is no vaccine to prevent hepatitis C.
* Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water, or "works", and get vaccinated against hepatitis A & B.
* Do not share personal care items that might have blood on them (razors, toothbrushes).
* If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps; get vaccinated against hepatitis B.
* Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.
* HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms* correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.
* If you are HCV positive, do not donate blood, organs, or tissue.

TREATMENT & MEDICAL MANAGEMENT
* HCV positive persons should be evaluated by their doctor for liver disease.
* Interferon and ribavirin are two drugs licensed for the treatment of persons with chronic hepatitis C.
 Combination therapy can get rid of the virus in up to 5 out of 10 persons
 * Drinking alcohol can make your liver disease worse.