Could your flulike symptoms be more than a run-of-the-mill virus? Vague complaints of malaise, fever, muscle aches and loss of appetite can signal hepatitis, an inflammation of the liver. What’s more, some types of hepatitis can become chronic and cause extensive liver damage, cirrhosis (potentially fatal scarring), liver cancer and liver failure. Hepatitis leads to as many as 15,000 deaths each year, a statistic expected to rise dramatically over the next two decades.
A number of factors cause hepatitis, but in the United States, the usual culprit is a viral infection by one of three different strains, hepatitis A, B or C. Hepatitis D and E viruses exist but are far less common. The illnesses produced by the viruses vary, but they share common symptoms:
- fatigue or general malaise
- loss of appetite
- nausea and vomiting
- joint pain
- jaundice, or yellowing of the skin and eyes
- abdominal pain or discomfort
- dark or tea-colored urine
- light or clay-colored bowel movements
- bad breath with a bitter taste in the mouth
Not everyone with hepatitis has symptoms. Millions of people become infected, suffer liver damage and transmit the viruses to others unknowingly.
The illness caused by hepatitis A virus (HAV) is usually mild, especially among children. Experts estimate that one-third of the U.S. population becomes infected during their lifetime.
The virus is concentrated in the stool and most commonly transmitted when an infected person neglects to wash his or her hands after using the toilet and then handles the food you will eat. You may also contract HAV through direct contact with an infected person or by eating raw shellfish from sewage-polluted waters. Young children attending day care may contract the virus through diaper changing.
Symptoms usually appear abruptly within five to 15 days after exposure; however, children often don’t show symptoms other than tiring easily. Treatment involves resting, eating more protein and drinking plenty of fluids. The liver heals completely within one to two months in most people.
The HAV vaccine is advised for all children, people with liver disease, day-care workers, household members of infected people, travelers to areas with poor sanitation and residents of states with a high rate of hepatitis.
Experts estimate one in 20 people will be infected with the hepatitis B virus (HBV) in his or her lifetime. The disease will become chronic for some of them.
The virus is spread by coming in contact with the blood, saliva, semen or vaginal secretions of infected people. This can occur by sharing razors, toothbrushes or needles; getting tattoos or body piercings with unsterilized equipment; or having unprotected intercourse. Healthcare workers may be at risk because of accidental needle sticks. Pregnant women should be tested for HBV because their babies can become infected during childbirth. If you test positive for HBV during pregnancy, your newborn will be given immune globulin and the HBV vaccine to prevent infection.
Symptoms of HBV appear between 45 days and 160 days after exposure. The infection resolves within six months for most adults, and patients develop immunity. While not a cure, treatment for chronic HBV infection may include the drugs alpha interferon, lamivudine or adefovir dipivoxil as well as ongoing monitoring of liver health. A liver transplant may be necessary in cases of severe organ damage.
People with chronic HBV infection are “carriers” and can infect others even if they appear healthy. But, because more than two-thirds of cases don’t show symptoms and chronic infection can go undetected for decades, thousands become carriers and don’t know it. Anyone infected with HBV is susceptible to hepatitis D, and having both increases the risk for liver damage and disease.
Hepatitis B is called a preventable tragedy because a vaccine can protect you. The HBV vaccine is advised for all infants and children; international travelers; hemodialysis patients; people with liver disease; and healthcare, emergency or correctional facility workers.
The hepatitis C virus (HCV), considered an emerging epidemic, may cause the greatest harm since up to 85 percent of infected people develop chronic disease, but most are unaware they ever contracted the virus. Typically, a person learns he or she has HCV when a routine blood test shows elevated liver enzymes (indicating impaired liver function) or a test taken during a blood donation comes back positive for the HCV antibody.
The virus is spread primarily through direct exposure to infected blood, and so healthcare and emergency workers are most at risk, as are people who share needles. You should be tested for HCV if you received a blood transfusion or organ transplant before 1992 or clotting factors (such as those used by hemophiliacs) before 1987, when reliable testing was instituted.
Treatment for HCV may include six months to a year of the antiviral agents interferon and riboflavin. No vaccine for HCV exists.
Take these steps to protect yourself and your family against hepatitis:
- If you think you might have been recently exposed to a hepatitis virus, see your doctor right away. Receiving immune globulin and vaccinations may thwart infection.
- Get vaccinated against hepatitis A and B.
- Always wash your hands after using the bathroom and changing diapers and before preparing and eating food.
- Don’t eat raw shellfish.
- Avoid sharing personal items such as toothbrushes and razors.
- Don’t share or reuse hypodermic needles you may need for medication.
- If you’re pregnant, get tested for hepatitis viruses.
- Reconsider a tattoo or body piercing—the equipment may not be sterile.