May was designated as National Hepatitis Awareness Month by the CDC in 2001 to raise awareness about viral hepatitis in the US. The viruses that cause hepatitis are complex, coming in 3 prevalent forms (A,B, and C) and 2 less common forms (D and E) in the US. Viral hepatitis refers to infections that directly attack the liver. Viral hepatitis can lead to life-threatening scarring of the liver (cirrhosis), liver failure and liver cancer.

Hepatitis A is primarily transmitted through contaminated food and water. Hepatitis A can affect anyone. Hepatitis A is one of the most common vaccine preventable diseases reported in the US. It occurs as individual cases and as widespread epidemics. People at high risk include those who travel to countries with high rates of hepatitis A, homosexual males, IV drug users, and people with chronic liver disease. The incubation period is usually 30 days but carriers can be contagious 2 weeks before symptoms occur. Children with hepatitis A will often have no symptoms, but adults usually become quite ill. Symptoms include sudden jaundice, fatigue, vomiting, abdominal pain, fever, and dark urine and stools. There is no treatment and symptoms will usually resolve in 6 to 12 months without serious after effects.

Hepatitis B is transmitted through blood, sex, needles, and from an infected mother to her baby. One out of 20 people in the US will be infected by hepatitis B virus at some point in their lives. Those at higher risk include those that have sex with more than one partner, homosexual males, living with someone infected with the virus, contact with human blood, IV drug use, hemophilia, and travel to high-risk countries. The incubation period is 45 to 180 days. Symptoms are usually mild and flu-like. The only diagnosis is a blood test. The blood test may not show the presence of the virus during the incubation period. There are medications to treat hepatitis B, but only half of those with the disease will be candidates for treatment; of those only 35% will benefit from the therapy. 95% of patients will recover in about 6 months. They will not be infectious to others. The remaining 5% will become carriers of the disease and infectious to others throughout their lifetime. Hepatitis B can cause cirrhosis and liver cancer in some people.

Hepatitis C is transmitted by infected blood and needles. It is a slow progressing disease that may take 10 to 40 years to cause serious liver damage. Those at greatest risk include IV drug users or snorting drugs, having sex with multiple partners, tattoos or body piercing with unsterile instruments, blood transfusions prior to 1992, hemodialysis patients, and babies born to infected mothers (about 5% transmission rate). Most people infected have no symptoms. The incubation period is 2 to 26 weeks. A blood test is used to diagnose the infection. About 20-30% of patients respond to medication treatment to become virus free. The other 70-80% are classified as chronic. Of these, about 20% develop cirrhosis. About 25% of these develop liver failure. Hepatitis C accounts for about 1/2 of all liver transplants done in the US. Often the virus will infect the transplanted liver requiring another transplant.

Hepatitis A and B can be prevented by vaccines. There is no vaccine for hepatitis C. People concerned about their risk of hepatitis should ask their doctor to do a blood test for all 3 types.

References: http://www.hepb.org/hepb/abc.htm, http://www.hepfi.org/living/liv_abc.html.

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