Hepatitis B and C

Hepatitis B
What Is Hepatitis B?

 Hepatitis B is an infection of your liver. It can cause scarring of the organ, liver

failure, and cancer. It can be fatal if it isn’t treated.
 It’s spread when people come in contact with the blood, open sores, or body fluids
of someone who has the hepatitis B virus.
 It's serious, but if you get the disease as an adult, it shouldn’t last a long time.
Your body fights it off within a few months, and you’re immune for the rest of
your life. That means you can't get it again. But if you get it at birth, it’ unlikely to
go away.
 What Are the Symptoms of Hepatitis B?

 Jaundice- Your skin or the whites of the eyes turn yellow, and your pee turns
brown or orange.)
 Light-colored poop
 Fever
 Fatigue that persists for weeks or months
 Stomach trouble like loss of appetite, nausea, and vomiting
 Belly pain

Symptoms may not show up until 1 to 6 months after you catch the virus. You might
not feel anything. About a third of the people who have this disease don’t. They only
find out through a blood test.
What Causes Hepatitis B?

 Caused by Hepatitis B virus (HBV), a partially double-stranded DNA virus, a

species of the genus Orthohepadnavirus and a member of the Hepadnaviridae
family of viruses
How Do You Get Hepatitis B?

The most common ways to get hepatitis B include:

 Sex. You can get it if you have unprotected sex with someone who has it and your
partner’s blood, saliva, semen, or vaginal secretions enter your body.
 Sharing needles. The virus spreads easily via needles and syringes contaminated
with infected blood.
 Accidental needle sticks. Health care workers and anyone else who comes in
contact with human blood can get it this way.
 Mother to child. Pregnant women with hepatitis B can pass it to their babies during
childbirth. But there’s a vaccine to prevent newborns from becoming infected.
How Common Is Hepatitis B?

 The number of people who get this disease is down, the CDC says. Rates have
dropped from an average of 200,000 per year in the 1980s to around 20,000 in
2016. People between the ages of 20 and 49 are most likely to get it.
 Only 5% to 10% of adults and children older than 5 who have hepatitis B end up
with a chronic infection. The numbers aren’t so good for those younger than 5
(25% to 50%) and even higher for infants infected at birth (90%).
 As many as 1.4 million people in the U.S. are carriers of the virus.
 How Is Hepatitis B Diagnosed?
If your doctor thinks you have it, he’ll give you a complete physical exam. He’ll test your blood to
see if your liver is inflamed. If you have hepatitis B symptoms and high levels of liver enzymes,
you’ll be tested for:
 Hepatitis B surface antigen and antibody (HBsAg). Antigens are proteins on the hepatitis B
virus. Antibodies are proteins made by your immune cells. They show up in your blood between
1 and 10 weeks after exposure. If you recover, they go away after 4 to 6 months. If they’re still
there after 6 months, your condition is chronic.
 Hepatitis B surface antibody (anti-HBs). These show up after HBsAg disappears. They’re what
make you immune to hepatitis B for the rest of your life.

If your disease becomes chronic, your doctor might take a tissue sample from your
liver, called a biopsy. This will tell him how severe your case is.
How Is Hepatitis B Treated?
 If you think you’ve been exposed to the virus, get to a doctor as soon as possible.
The earlier you get treatment, the better. He’ll give you a vaccine and a shot of
hepatitis B immune globulin. This protein boosts your immune system and helps
it fight off the infection.
 If you do get sick, your doctor may put you on bed rest to help you get better
faster.
 You’ll have to give up things that can hurt your liver, like alcohol and
acetaminophen. Check with your doctor before taking any other drugs, herbal
treatments, or supplements. Some of them can harm this organ, too. Also, eat a
healthy diet.
 If the infection goes away, the doctor will tell you you’re an inactive carrier. That
means there’s no more virus in your body, but antibody tests will show that you
had hepatitis B in the past.
If the infection is active for longer than 6 months, he’ll tell you that
you have chronic active hepatitis B. He may prescribe some of these
medications to treat it:
 Entecavir ( Baraclude ). This is the newest drug for hepatitis B. You can take it as a liquid or tablet.
 Tenofovir (Viread). This drug comes as a powder or tablet. If you take it, your doctor will check often to
make sure it doesn’t hurt your kidneys.
 Lamivudine (3tc, , Epivir A/F, Epivir HBV, Heptovir). It comes as a liquid or tablet you take once a day.
Most people don’t have a problem with it. But if you take it for a long time, the virus might stop responding
to the drug.
 Adefovir dipivoxil ( Hepsera ). This drug, which you take as a tablet, works well for people who don’t
respond to lamivudine. High doses can cause kidney problems.
 Interferon alfa ( Intron A, Roferon A, Sylatron). This medicine boosts your immune system. You take it as a
shot for at least 6 months. It doesn’t cure the disease. It treats liver inflammation. Long-acting interferon,
peginterferon alfa2a (Pegasys, Pegasys Proclick) can also help. This drug can make you feel bad all over or
depressed, and it can and zap your appetite. It also lowers your white blood cell count, which makes it
harder to fight off infection.
What Are the Complications of
Hepatitis B?
Chronic hepatitis B can lead to:
 Cirrhosis or scarring of the liver
 Liver cancer
 Liver failure
 Kidney disease
 Blood vessel problems
How Do You Prevent Hepatitis B From Spreading?

 To help keep a hepatitis B infection from spreading:

 Get vaccinated (if you haven’t already been infected).
 Use condoms every time you have sex.
 Wear gloves when you clean up after others, especially if you have to touch bandages,
tampons, and linens.
 Cover all open cuts or wounds.
 Don’t share razors, toothbrushes, nail care tools, or pierced earrings with anyone.
 Don’t share chewing gum, and don’t pre-chew food for a baby.
 Make certain that any needles for drugs, ear piercing, or tattoos -- or tools for manicures
and pedicures -- are properly sterilized.
 Clean up blood with one part household bleach and 10 parts water.
Hepatitis C
Hepatitis C
 The hepatitis C virus (HCV) is a small (55–65 nm in size), enveloped, positive-sense single-
stranded RNA virus of the family Flaviviridae. The hepatitis C virus is the cause of hepatitis C
and some cancers such as liver cancer (hepatocellular carcinoma, abbreviated HCC) and
lymphomas in humans
What Is Hepatitis C?

 Hepatitis C is a liver infection that can lead to serious liver damage. It’s caused by
the hepatitis C virus. About 3.9 million people in the U.S. have the disease. But it
causes few symptoms, so most of them don't know. The virus spreads through an
infected person’s blood or body fluids.

 There are many forms of the hepatitis C virus, or HCV. The most common in the
U.S. is type 1. None is more serious than any other, but they respond differently to
treatment.
Stages of Hepatitis C

The hepatitis C virus affects people in different ways and has several stages:
 Incubation period. This is the time between first exposure to the start of the disease. It can last
anywhere from 14 to 80 days, but the average is 45
 Acute hepatitis C. This is a short-term illness that lasts for the first 6 months after the virus
enters your body. After that, some people who have it will get rid of, or clear, the virus on
their own.
 Chronic hepatitis C. If your body doesn’t clear the virus on its own after 6 months, it becomes
a long-term infection. This can lead to serious health problems like liver cancer or cirrhosis.
 Cirrhosis. This disease leads to inflammation that, over time, replaces your healthy liver cells
with scar tissue. It usually takes about 20 to 30 years for this to happen, though it can be
faster if you drink alcohol or have HIV.
 Liver cancer. Cirrhosis makes liver cancer more likely. Your doctor will make sure you get
regular screenings because there are usually no symptoms in the early stages.
What Are the Symptoms of Hepatitis C?

Many people with hepatitis C have no symptoms. But between 2 weeks and 6 months after the virus enters
your bloodstream, you could notice:
 Clay-colored poop
 Dark urine
 Fever
 Fatigue
 Jaundice (a condition that causes yellow eyes and skin, as well as dark urine)
 Joint pain
 Loss of appetite
 Nausea
 Stomach pain
 Vomiting

Symptoms usually last for 2 to 12 weeks.

How Do You Get Hepatitis C?
Hepatitis C spreads when blood contaminated with the hepatitis C virus gets into
your bloodstream through contact with the blood or body fluids of an infected
person.
You can be exposed to the virus from:
 Sharing injection drugs and needles
 Having sex, especially if you have an STD, an HIV infection, several partners, or
have rough sex
 Being stuck by infected needles
 Birth -- a mother can pass it to a child
 Sharing personal care items like toothbrushes, razor blades, and nail clippers
 Getting a tattoo or piercing with unclean equipment
You can’t catch hepatitis C through:
 Breastfeeding (unless nipples are cracked and bleeding)
 Casual contact
 Coughing
 Hugging
 Holding hands
 Kissing
 Mosquito bites
 Sharing eating utensils
 Sharing food or drink
 Sneezing
Symptoms of Advanced Hepatitis C
You could notice acute symptoms along with:
 Fluid buildup in the abdominal cavity (ascites) or the legs (edema)
 Gallstones
 Your brain doesn’t work as well (encephalopathy)
 Kidney failure
 Easy bleeding and bruising
 Intense itching
 Muscle loss
 Problems with memory and concentration
 Spider-like veins on the skin
 Vomiting blood due to bleeding in the lower esophagus (esophageal varices)
Hepatitis C Risk Factors
The CDC recommends you get tested for the disease if you:
 Received blood from a donor who had the disease
 Have ever injected or inhaled drugs
 Had a blood transfusion or an organ transplant before July 1992
 Received a blood product used to treat clotting problems before 1987
 Were born between 1945 and 1965, the age group with the highest rate of infection
 Have been on long-term kidney dialysis
 Have HIV
 Were born to a mother with hepatitis C
 Have symptoms of liver disease
 Got a tattoo or piercing with unclean equipment
 Are or have ever been in prison
Hepatitis C Testing and Diagnosis
Doctors will start by checking your blood for:
 Anti-HCV antibodies: These are proteins your body makes when it finds the hep C virus in your
blood. They usually show up about 12 weeks after infection.
 It usually takes a few days to a week to get results, though a rapid test is available in some places.
 The results can be:
 Nonreactive, or negative:
 That may mean you don’t have hep C.
 If you’ve been exposed in the last 6 months, you’ll need to be retested.
 Reactive, or positive:
 That means you have hep C antibodies and you’ve been infected at some point.
 You’ll need another test to make sure.
If your antibody test is positive, you’ll get this test:
 HCV RNA: It measures the number of viral RNA (genetic material from the hepatitis virus)
particles in your blood. They usually show up 1-2 weeks after you’re infected.
The results can be:
 Negative: You don’t have hep C.
 Positive: You currently have hep C.
As part of the diagnosis process, you might also get:
 Liver function tests: They measure proteins and enzyme levels, which usually rise 7 to 8 weeks
after you’re infected. As your liver gets damaged, enzymes leak into your bloodstream. But you
can have normal enzyme levels and still have hepatitis C. Learn the reasons why you should get
tested for hepatitis C.
Treatment and Medication for Hepatitis C

If you have acute hepatitis C, there is no recommended

treatment. If your hepatitis C turns into a chronic hepatitis C
infection, there are several medications available:

Interferon, peginterferon, and ribavirin used to be the main

treatments for hepatitis C. They can have side effects like
fatigue, flu-like symptoms, anemia, skin rash, mild anxiety,
depression, nausea, and diarrhea.
Hepatitis C treatments have changed a lot in recent years.
Now you’re more likely to get one of these medications:
 Daclatasvir (Daklinza). You’ll take this pill once a day along with sofosbuvir for 12 weeks.
 Sofosbuvir-velpatasvir (Epclusa). This daily pill, which you take for 12 weeks, should cure your disease.
 Ledipasvir-sofosbuvir (Harvoni). This once-daily pill cures the disease in most people in 8-12 weeks.
 Glecaprevir and pibrentasvir (Mavyret). This daily pill offers a shorter treatment cycle of 8 weeks for adult
patients with all types of HCV who don’t have cirrhosis and who haven’t already been treated. The treatment is
longer for those who are in a different disease stage. The prescribed dosage for this medicine is 3 tablets daily.
 Ribavirin (Copegus, Moderiba, Rebetol, Ribasphere, Virazole). This comes as a tablet, capsule, or liquid. You
take it with food twice a day, in the morning and evening, for 24 to 48 weeks or longer.
 Sofosbuvir (Sovaldi) with interferon and ribavirin. Take this tablet at the same time every day with food. You
have to take it along with ribavirin and/or interferon, and you’ll probably be on it for 12 to 24 weeks.
 Ombitasvir-paritaprevir- ritonavir (Technivie). You’ll take this tablet by mouth, possibly along with ribavirin.
 Ombitasvir-paritaprevir-dasabuvir-ritonavir (Viekira Pack). This treatment is a combo of pills: two that you'll
take once a day, and one you'll take twice with meals. You’ll take it for 12 to 24 weeks.
 Sofosbuvir-velpatasvir-voxilaprevir (Vosevi). This combination is approved to treat adults with chronic HCV,
either with no cirrhosis or with compensated cirrhosis (the stage of the disease that doesn't have symptoms),
who’ve already had certain treatments.
What Are the Complications of
Hepatitis C?
About 75% to 85% of people who have it get a long-term infection called chronic hepatitis C. If the
condition goes untreated, it can lead to:
 Cirrhosis, or scarring of the liver
 Liver cancer
 Liver failure
Can You Prevent Hepatitis C Infection?

There’s no vaccine to prevent hepatitis C. To help avoid getting the virus:

 Use a latex condom every time you have sex.

 Don't share personal items like razors.
 Don't share needles, syringes, or other equipment when injecting drugs.
 Be careful if you get a tattoo, body piercing, or manicure. The equipment may
have someone else's blood on it.
Can Hepatitis C Be Cured?

 The goal of antiviral medications is a condition called sustained virologic

response. If your blood tests negative for the virus 3 months after you complete
treatment, you’re considered cured.