HEPATITIS A Hepatitis A is a communicable, contagious disease that spreads from person to person. It is estimated there are between 84,000 and 134,000 total infections per year in the United States. Hepatitis A virus can be transmitted through oral-anal sex. Blood tests, widely available, can accurately detect the body response to the presence of hepatitis A. About 2 persons in 1000 with symptoms of acute hepatitis A will die of acute liver failure. Hepatitis A may cause no symptoms at all when it is contracted, especially in young people. When symptoms are present they appear as sudden onset of an influenza-like illness. The direct and indirect costs of Hepatitis A  exceed $300 million when considered that this disease is totally preventable through active or passive immunization and that Outbreaks need not occur if responsible preventive measures are taken. If you have been vaccinated for Hepatitis A some of the blood tests may result positive indicating immunity and not an infection.   Hepatitis A is a liver disease caused by the Hepatitis A virus. According to Centers for Disease Control and Prevention, It is estimated that there are between 125,000 and 200,000 total infections per year in the United States,84,000 to 134,000 of the total infections will be with symptoms of hepatitis A. Hepatitis A (HAV) is transmitted primarily through oral contact with feces (oral-fecal contact). This includes contaminated food or water sources and sexual contact, especially oral-anal sex. HAV has on rare occasions been transmitted by blood. The presence of virus in the blood occurs with the onset of infection and is thought to be short-lived. Most adults infected with HAV usually do develop some symptoms. Symptoms may develop about 15-50 days after exposure; the average is 28 days. These may include: Low-grade fever Malaise (feeling of ill-health) Loss of appetite Nausea Abdominal discomfort Dark-colored urine Jaundice (yellowing of the skin and eyes) Sexual prevention: Abstinence (not having sex). Latex condoms for oral sex (recommended). Moisture barriers, like household plastic wraps or dental dams, may be suggested to reducing risk from oral-anal sex. There is no accepted treatment for HAV. Supportive care is recommended, usually guided by symptoms. Once recovered, an individual is immune and will not get hepatitis A again. As part of good partner communication, deciding to use latex condoms and moisture barriers during sex helps reduce the risk of transmitting a sexually transmitted disease. HAV can be transmitted through oral-anal sex so it is recommended to always use safer sex methods to reduce the risk of transmission. Vaccination: HAV is preventable by vaccination. A new combination vaccine called Twinrix has been approved for protection from both HAV and HBV in persons 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three. This two-dose series given at least six months apart, provides pre-exposure protection from HAV infection in children aged 2 years or older and in adults. Vaccination against HAV is recommended for those who are at risk of infection. People who have been exposed to hepatitis A should  talk with their health care provider about a post-exposure immune globulin (IG) injection.

HEPATITIS B Hepatitis B (HBV) is a serious viral infection of the liver.  It is estimated that 1 to 1.25 million people in the United States have chronic Hepatitis B. There are an estimated 140,000 to 320,000 new Hepatitis B infections each year in the United States. Hepatitis B can cause chronic infection, cirrhosis (scarring) of the liver, liver cancer, liver failure and death. Hepatitis B is preventable through vaccination.     HBV is found in transmittable levels in body fluids including: Semen Vaginal secretions Saliva Blood HBV may be transmitted: Sexually (having unprotected sex with an infected person) Intravenously (sharing injecting drug needles or paraphernalia with an infected person) Neonatally (mother-to-child if the mother is infected with HBV) HBV may also be transmitted in rare cases: Horizontally (oral exposure to infected secretions such as saliva). Saliva can be a means of transmission through bites; however, other types of exposure to saliva, including kissing, are unlikely ways of transmission. Risk of transmission from blood transfusion is currently low in the United States since blood banks screen donated blood that appears to be infected. What are the signs or symptoms of Hepatitis B? Many adults have few or no symptoms. When symptoms are present they may include: Anorexia (loss of appetite) Malaise Nausea and vomiting Abdominal pain Dark urine Jaundice (yellowing of the skin and eyes) Rash or arthritis may occur during the prodromal or early acute stage.   Your health care provider can confirm HBV by using a special blood test to detect HBV particles or antibodies in the blood.   Babies born to infected mothers should get blood tests at aged 9 to 15 months to be certain that the vaccine worked well and that the mother did not pass HBV to her baby during birth.   Reducing the risk:   Hepatitis B is preventable through vaccination. Since hepatitis D can only co-exist with hepatitis B, getting vaccinated against hepatitis B also protects you against hepatitis D.   The HBV vaccine is given in a series of three doses. A new combination vaccine called Twinrix has been approved for protection from both HAV and HBV in persons 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three. The first and second doses must be given at least one month apart. The first and third doses must be given at least 4 months apart. If a dose is missed, it should be given as soon as possible. The series should not be restarted if a dose is missed. Routine booster doses of the HBV vaccine are NOT currently recommended. Consult your health care provider for more information about the HBV vaccine and if it is right for you. HIV can impair the response to the hepatitis vaccine. Sexual prevention: Latex condoms are effective prevention during vaginal, oral and anal sex by reducing contact with infected bodily fluids (semen, vaginal secretions and blood). Abstinence and mutual monogamy also offer a high level of protection. Hepatitis B can cause: Chronic infection Cirrhosis (scarring) of the liver Liver cancer Death The best news is that hepatitis B is preventable through vaccination. A person can choose to be vaccinated and not have to worry. If you have an acute or chronic hepatitis B infection then you need to talk to your partner about it so they can decide what option is best for them to prevent getting infected. If you find out you have been exposed to hepatitis B, consult your health care provider as soon as possible to discuss your best options to help prevent infection.

HEPATITIS C Up to 90 percent of those infected with the hepatitis C virus (HCV) have no symptoms at all It ranks second only to alcoholism as a cause of liver disease and is the leading reason for liver transplants in the United States. There is currently no vaccine for hepatitis C. In many cases, symptoms may not appear for up to 30 years.     An estimated 3 percent of the world's population — more than 170 million people — carry a mysterious virus that silently attacks their livers, often without their knowledge. That's because up to 90 percent of those infected with the hepatitis C virus (HCV) have no symptoms at all. In fact, most people don't know they have the disease until decades later when liver damage shows up during routine medical tests. Sometimes people may learn they have hepatitis C when they try to donate blood, because blood banks now routinely screen for the virus. The liver — which weighs between 3 and 4 pounds — is the largest and most complex internal organ in your body. It sits behind your lower ribs on the right side of your abdomen and performs a variety of crucial functions — including detoxifying harmful substances, purifying your blood and manufacturing vital nutrients. Hepatitis C is one of six currently identified hepatitis viruses — the others are A, B, D, E and G. All cause the liver to become inflamed, which interferes with its ability to function. Hepatitis C is generally considered to be among the most serious of these viruses. In many cases, HCV leads to chronic liver diseases such as cirrhosis — irreversible and potentially fatal scarring of the liver — liver cancer or liver failure. It ranks second only to alcoholism as a cause of liver disease and is the leading reason for liver transplants in the United States. Although vaccines are used for hepatitis A and B, there is currently no vaccine for hepatitis C. In addition, standard treatments for HCV are not universally effective, so the search for new treatments is ongoing. Normally, HCV produces no symptoms in its earliest stages. If you do have symptoms, they'll generally be mild and flulike. They include: Slight fatigue Nausea or poor appetite Muscle and joint pains Tenderness in the area of the liver Even if you develop chronic hepatitis from the hepatitis C virus, you may have few, if any, symptoms. In many cases, symptoms may not appear for up to 30 years. Sometimes, though, you may experience one or more of the following: Fatigue Lack of appetite Nausea and vomiting Persistent or recurring yellowing of your skin and eyes (jaundice) Low-grade fever Hepatitis C can cause damage to your liver even if you don't have symptoms. You're also able to pass the virus to others without having any symptoms yourself. That's why it's important to be tested if you think you've been exposed to hepatitis C or you engage in behavior that puts you at risk. Causes: Blood transfusions Contaminated needles Tattooing and Body piercing Sexual activity

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