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Hepatitis A
Hepatitis A is a liver disease that is caused by the hepatitis A virus (HAV). It is generally preventable. There is no current evidence HAV can cause chronic infection (an infection that lasts over six months), unlike hepatitis B, C and D. Persons who are infected with hepatitis A display acute symptoms—symptoms are short-term, fast-onset and non-permanent, and last less than six months.
Symptoms
Symptoms of hepatitis A can include:
- Fatigue
- Nausea (feeling sick)
- Vomiting
- Stomach (abdominal) pain
- Yellowing of the whites of the eyes and skin (jaundice)
- Dark urine
- Low grade fever (37.5°C-38.3°C lasting more than 24 hours)
- Loss of appetite
Many people with hepatitis A experience mild symptoms or no symptoms at all! Younger people are less likely to have symptoms of HAV. People who already have liver disease, such as chronic hepatitis B or C, may have more symptoms or experience increased severity of the hep A virus.
How hep A is passed
Hepatitis A is transmitted through the fecal-oral route and is found in the bowels of a person infected with the virus. HAV can be transmitted through two different routes: person to person contact, or through ingesting contaminated food or water products. Some examples of each of these types of transmission are:
Person-to Person Contact
- Consuming food or drink contaminated with hepatitis A, such as if a person who has hep A hasn’t washed their hands properly after using the bathroom and/or prior to preparing food for others.
- Sexual contact where faeces may enter the mouth
- Contaminated unregulated drug supplies (ie. contaminated cocaine)
Contaminated Food or Beverages
- Eating undercooked or raw shellfish that has been exposed to contaminated sewage.
- Eating contaminated foods like fruits and vegetables.
- Drinking water or ice that has been contaminated by HAV
There are many more examples of ways that Hepatitis A can be transmitted than are listed.
How can I be tested for hepatitis A?
The only way to get reliable confirmation that a person has contracted HAV is through a blood test.
Treatment
There is no treatment currently available for hepatitis A. The current standard practice for dealing with hepatitis A is letting the virus run its course—in time, the infected person will recover completely. How long takes for a person to recover is dependent on many factors, including age and medical history among others. Once a person has contracted HAV they are immune and cannot contract the hepatitis A virus again.
Prevention
There are multiple safe and effective vaccines created to prevent hepatitis A, and there is also a combination vaccine to prevent both hepatitis A and B. Vaccines for hepatitis A are generally given in two separate doses, six months apart. A person who receives the vaccine for hepatitis A can expect protection from the virus for around 20 years. Persons who are travelling outside of Canada are the largest cohort (group) of persons who get infected by the hepatitis A virus. It is recommended to get the vaccine at least 6 weeks before travelling.
Sources
- http://www.bccdc.ca/health-info/diseases-conditions/hepatitis-a
- https://www.liver.ca/patients-caregivers/liver-diseases/hepatitis-a/
Hepatitis D
Hepatitis D is one of the more unique among the viruses in the hepatitis family as it only affects someone if they have the hepatitis B virus—it may be contracted at the same time as hep B, or appear later in a person who is already living with hep B.
How hepatitis D is passed
Hepatitis D is passed in similar ways to Hepatitis B and C:
- Contact with infectious blood or blood products
- Exposure to contaminated needles (such as improperly sterilized medical, tattooing or piercing equipment, as well as through sharing of needles or other drug use supplies)
- Household transmission
- Sexual transmission
Treatment
There is no effective anti-viral, direct-acting anti-viral, or vaccine to treat hepatitis D. In some cases, the medication interferon-alpha may be used to treat hepatitis, including hepatitis D. However, the BC Centre for Disease Control estimates that 60-97 percent of persons who initially responded to interferon treatment will experience relapse.
Prevention
Those who do not have hepatitis B currently will be protected from hepatitis D if they receive a hepatitis B vaccination. This is because HDV must co-occur or occur after an already present chronic HBV infection. There are no vaccines available for Hepatitis D. There is also no standard antiretroviral treatment for HDV.
We can decrease our risk of contracting hep B by:
- Practicing universal precautions including wearing gloves and other protective equipment when we might come into contact with someone else’s blood and cleaning up blood and body fluids safely.
- Practicing safer substance use: always use new equipment, do not share using equipment, dispose of used syringes, cookers, and other equipment safely in proper receptacles (such as a sharps container) to whenever possible.
- Ensuring we use new/sterilized tattooing, or piercing equipment.
- Practicing safe or safer sex, using devices that prevent exchange of sexual fluids
- If you currently have hepatitis B, talk with a trusted medical professional or a peer navigator about how you can reduce possible exposure to blood/blood products.
Sources:
- http://www.bccdc.ca/health-info/diseases-conditions/hepatitis-d
- https://www.who.int/news-room/fact-sheets/detail/hepatitis-d
Hepatitis E
Hepatitis E virus (HEV) is a liver disease in the same family as Hepatitis A,B,C & D. It is not commonly seen in developed nations but is still present around the globe. It is most common in East and South Asian countries.
Transmission
HEV Is transmitted via the oral-fecal route. That means that the virus can be transmitted in the following ways:
- Contaminated drinking water
- Contaminated and undercooked meat products
- Perinatal transmission (passed from mom to baby during birth)
- Contaminated blood products
Symptoms
Hepatitis E symptoms are like the symptoms experienced when other types of hepatitis are contracted. Symptoms such as:
- Feeling extremely tired (fatigue)
- Abdominal (stomach) pain
- Nausea (feeling sick) and vomiting
- Loss of appetite
- Diarrhea
- Dark-colored urine
- Pale-coloured faeces
- Yellowing of the white part of the eyes and the of the skin, also known as jaundice.
Persons who have Hepatitis E can still be infectious for up to 2 weeks after symptoms appear.
Treatment
Hepatitis E is called a ‘self-limiting disease,’ which means that the virus is expected to run its course with no long-term effects on the body. Individuals who contract HEV are expected to recover completely.
In Canada there is currently no treatment for hepatitis E due to its designation as a self-limiting disease. In some rare cases the hepatitis E virus can lead to acute liver failure. This is a very serious and potentially lethal complication and is a contributing factor in HEV-related deaths.
Prevention
There is currently no vaccine to prevent contracting the hepatitis E virus in Canada, but in China there is a vaccine available as a form of prevention due to higher rates of HEV in that region.
We can prevent contracting HEV when travelling abroad to countries with high infection rates by:
- Avoiding drinking tap water and drinks with ice cubes in them
- Avoiding eating uncooked shellfish
- Avoiding drinking unpasteurized milk
- Avoiding eating peeled fruits and uncooked vegetables.
In general, the best advice for preventing the transmission of hepatitis E is practicing good hygiene: wash your hands after each time you use the washroom and before handling any food or beverages.