Viral Hepatitis

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What is hepatitis?
What are the signs of viral hepatitis?
What are the types of viral hepatitis?
What’s the difference between acute viral hepatitis and chronic viral hepatitis?
How is viral hepatitis diagnosed?
Is it safe to visit someone with hepatitis?
How does a pregnant woman pass hepatitis B virus to her baby?
Can I breastfeed my baby if I have hepatitis B?
If I have hepatitis B, what does my baby need so that she doesn't get the virus?
How long do the hepatitis A and B vaccines protect you?

What is hepatitis?

Hepatitis means liver inflammation. Viral hepatitis means that a person has liver inflammation due to a virus. Viral infection of the liver makes the liver swell up and stop working well. The liver is an important organ. It helps your body with these functions:

Digests food
Stores energy
Removes poisons

There are five types of viral hepatitis. The most common types in the United States are viral hepatitis A, B, and C.

What are the signs of viral hepatitis?

Some people with viral hepatitis have no signs of the infection. For other people, these signs might occur:

Low grade fever
Headache
Muscle aches
Tiredness
Loss of appetite
Nausea
Vomiting
Diarrhea
Dark-colored urine and pale bowel movements
Pain in the stomach
Skin and whites of the eyes turning yellow, also called jaundice

What are the types of viral hepatitis?

Hepatitis A

How you get it: Eating food or drinking water contaminated with feces, or the bowel movement (BM), from a person infected with the hepatitis A virus (HAV). It can also be caused by anal-oral contact. Some examples include:
Eating food contaminated by a person with hepatitis A who prepares food. It can happen if the person did not wash his hands after using the bathroom and then touched the food.
From infected household members or sexual partners
Diaper changing tables, if not cleaned properly
Eating raw selfish that came from sewage-contaminated water
What it does to your body: While it can cause swelling of the liver, it doesn't normally cause permanent liver damage.
Treatment: It usually gets better on its own. Almost everyone who gets hepatitis A gets better.
Prevention:
Get the hepatitis A vaccine. The vaccine is given in two doses, 6 to 18 months apart. The vaccine is recommended for the following groups:
Travelers to areas with high rates of hepatitis A
Men who have sex with men
Injecting and non-injecting drug users
Persons with clotting factor disorders, like hemophilia
People with chronic liver disease
Children who live in areas that had historically high rates of hepatitis A from 1987-1997
Get an immune globulin (IG) shot for short-term protection. If you’re traveling to a place where hepatitis A is common and leaving in less than 4 weeks, an IG shot can temporarily keep you from getting the virus. An IG shot can also be given within 2 weeks after exposure to hepatitis A.
Be careful about drinking the tap water when traveling internationally.
Wash your hands with soap and water after using the toilet, changing a diaper, and before preparing and eating food.
People who get hepatitis A once will not get it again.

Hepatitis B

How you get it: Contact with a person infected with the hepatitis B virus (HBV). This can occur through having sex with an infected person, from an infected mother to her baby during childbirth, or through sharing needles with an infected person.
What it does to your body: The liver swells, and liver damage can occur. Most people will get rid of the virus after a few months. Some people are not able to get rid of the virus, which makes the infection chronic, or life-long. This may lead to a scarring of the liver, called cirrhosis, liver failure, and can also lead to liver cancer.
Treatment: Acute hepatitis B usually gets better on its own. Most people develop immunity to the virus and after recovery, can’t give it to others. Someone with chronic (long-term) hepatitis B still carries the virus and can pass it to others. Chronic hepatitis B can be treated with the drugs interferon, lamivudine, or adefovir. These drugs do not work for everyone.
Prevention:
Get the hepatitis B vaccine. The vaccine is usually given through 3 injections over 6 months. The vaccine is recommended for the following groups:
All girls and boys from 0 to 18 years old
A person whose sex partner has chronic hepatitis B
Men who have sex with men
Someone who has been recently diagnosed with a sexually transmitted disease
People with multiple sex partners
Someone who shoots drugs
Someone who lives with a person with chronic hepatitis B
People whose jobs expose them to human blood
If you are having sex, but not with one steady partner, use latex condoms correctly and every time you have sex. Using condoms may lower your risk of getting hepatitis B.
Don't share anything that could have an infected person's blood on it, like toothbrushes, razors, nail clippers, or washcloths.
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.
If you are a health care or public safety worker, get vaccinated against hepatitis B, and always follow routine barrier precautions and safely handle needles and other sharp objects.
People with hepatitis B should not donate blood, organs, or tissue.
Do not shoot drugs. If you shoot drugs, stop and get into a treatment program. If you can't stop, never share drugs, needles, syringes, water, or "works," and get vaccinated against hepatitis A and B.
If exposed to hepatitis B, get a hepatitis B immune globulin injection within 14 days following exposure, and begin the hepatitis B vaccine series.
If you are pregnant, get a blood test for hepatitis B. Infants born to infected mothers should be given hepatitis B immune globulin and vaccine within 12 hours after birth.
If you have chronic hepatitis B, make sure your babies get all of their hepatitis B shots with the last shot at 6 months of age.

Hepatitis C

How you get it: Most often through sharing injection drugs with a person infected with the hepatitis C virus (HCV). Many people don’t have symptoms and don’t know they have it.
What it does to your body: Causes swelling of the liver and liver damage. Most people who are infected with HCV develop a chronic infection. This might lead to scarring of the liver, called cirrhosis, liver failure, and can also lead to liver cancer.
Treatment: In some cases, it gets better on its own. The current treatment of choice is combination therapy using pegylated interferon and ribavirin.
Prevention:
Do not shoot drugs. If you shoot drugs, stop and get into a treatment program. If you can't stop, never share drugs, needles, syringes, water, or "works," and get vaccinated against hepatitis A and B.
Don't share personal items like toothbrushes, razors, or nail clippers.
Get vaccinated against hepatitis A if your liver is damaged and hepatitis B if you are in a group at increased risk of getting hepatitis B.
Limit sexual partners and use latex condoms every time you have sex.
Cover your cuts and open sores.

Hepatitis D

How you get it: Contact with a person infected with the hepatitis D virus (HDV). You also must have current HBV infection to get HDV infection. HDV infection can occur by sharing needles to inject drugs, by having sex with an infected person, and from infected mother to child during childbirth.
What it does to your body: Causes swelling of the liver and can lead to liver disease and cirrhosis.
Treatment: It might get better on its own. Antiviral drugs might be helpful in treating chronic HDV infection.
Prevention:
Get hepatitis B vaccine.
Do not shoot drugs. If you shoot drugs, stop and get into a treatment program. If you can't stop, never share drugs, needles, syringes, water, or "works," and get vaccinated against hepatitis A and B.
Don't share personal items like toothbrushes, razors, and nail clippers with someone who has the virus.
Use latex condoms every time you have sex.

Hepatitis E

How you get it: A person can get infected with hepatitis E virus (HEV) by eating food or drinking water contaminated with feces from an infected person. Hepatitis E is usually a disease that occurs in persons who travel to areas that have high rates of HEV infection. This type of hepatitis is not common in the United States.
What it does to your body: It causes swelling of the liver, but no long-term damage. Pregnant women and their babies are at increased risk of dying if infected with HEV.
Treatment: It usually goes away on its own.
Prevention: Be careful about drinking the tap water and eating uncooked foods when traveling internationally.

What’s the difference between acute viral hepatitis and chronic viral hepatitis?

Acute viral hepatitis is a short-term, viral infection. Chronic viral hepatitis is a longer-lasting, and generally life-long, viral infection lasting at least six months. To find out if you have acute or chronic viral hepatitis, your doctor will do a medical evaluation that includes blood tests.

How is viral hepatitis diagnosed?

Through blood tests and a medical evaluation. There are different blood tests, depending on the type of viral hepatitis that the doctor thinks you have.

Is it safe to visit someone with hepatitis?

It is safe to visit someone with viral hepatitis. You cannot get hepatitis through casual contact. It is ok to shake hands with, hug, or kiss someone who is infected with any of the viral hepatitis types.

How does a pregnant woman pass hepatitis B virus to her baby?

During the birth, blood from the mother gets inside the baby’s body. A very small number of babies get infected while the infected mother is pregnant. There is no treatment to prevent this from happening.

Can I breastfeed my baby if I have hepatitis B?

Yes, you can. Make sure your baby gets a shot called H-BIG and a shot of hepatitis B vaccine within 12 hours of birth. Take good care of your nipple areas to prevent cracking and bleeding. If your nipples are cracking or bleeding, avoid nursing your baby on that breast until the sores heal. Until they heal, you can pump your milk to keep up your milk supply. But you should discard this pumped milk.

If I have hepatitis B, what does my baby need so that she doesn't get the virus?

Make sure your baby gets all three hepatitis B shots plus H-BIG. If you are a mother with hepatitis B, follow this schedule for your baby:

At birth: hepatitis B vaccine and H-BIG
1 to 2 months old: hepatitis B vaccine
6 months old: hepatitis B vaccine (not before 24 weeks, but no later than six months)

These shots will fight off the virus, and they are safe for your baby. If your baby gets those shots, there is a much lower chance your baby will get hepatitis B. A few months after your baby gets all of these shots, the doctor should do blood tests to see if your baby has the virus or if your baby is protected from HBV infection. If your baby does not get these shots, the baby has a very high chance of getting hepatitis B and developing serious liver disease.

How long do the hepatitis A and B vaccines protect you?

Only 1 series of the hepatitis A vaccine (2 shots) and hepatitis B vaccine (3 shots) is needed during a person's lifetime. Currently, there are no recommendations to give booster doses of either hepatitis A or hepatitis B vaccine.

For More Information . . .

You can find out more about viral hepatitis by contacting the National Women's Health Information Center at (800) 994-9662 or the following organizations:

CDC Info, HHS
Phone: (800) CDC-INFO or (800) 232-4636
Internet Address: http://ask.hrsa.gov/pc

Division of Viral Hepatitis, NCID, CDC, HHS
Phone: (888) 443-7232 (Hepatitis Information Line)
Internet Address: http://www.cdc.gov/hepatitis

National Institute of Allergy and Infectious Diseases (NIAID), NIH, HHS
Phone: (301) 496-5717
Internet Address: http://www.niaid.nih.gov

National Digestive Diseases Information Clearinghouse (NIDDK), NIH, HHS
Phone: (800) 891-5389
Internet Address: http://digestive.niddk.nih.gov/ddiseases/topics/hepatitis.asp

American Liver Foundation
Phone: (800) 465-4837
Internet Address: http://www.liverfoundation.org

American Social Health Association
Phone: (800) 783-9877
Internet Address: http://www.ashastd.org

Hepatitis Foundation International
Phone: (800) 891-0707
Internet Address: http://www.hepfi.org/

Immunization Action Coalition
Phone: (612) 647-9009
Internet Address: www.immunize.org

Hepatitis A, B, and C Prevention Programs
Phone: (651) 647-9009
Internet Address: http://hepprograms.org/

This FAQ was reviewed by the Division of Viral Hepatitis, National Center for Infectious Diseases at the Centers for Disease Control and Prevention (CDC).

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January 2005