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The STI Files: Hepatitis

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Stat: Each year an estimated 25,000 people in the U.S. are infected with Hepatitis A; 43,000 with Hepatitis B, and 17,000 with Hepatitis C, many of whom do not know they are infected. Worldwide, more than 350 million people have Hepatitis B.

What is it exactly? Hepatitis is an inflammation of the liver almost always caused by one of a few different hepatitis viruses. The most common types of those viruses are Hepatitis A (HAV), B (HBV), and C (HCV), and together these three types cause over 90% of hepatitis cases.

Hepatitis B is the type most often sexually transmitted. Hepatitis A also can be transmitted sexually, and Hepatitis C can, too, but sexual transmission of hepatitis C is understood to be rare.

How is it spread? Through bodily fluids, most commonly blood, semen (including pre-ejaculate) and vaginal fluids. Hepatitis A can also be spread through fecal matter or trace amounts of fecal matter. Hepatitis B is 100 times more contagious than the virus that causes AIDS.

Transmission can occur through any kind of sex where there is exposure to body fluids, but can also happen through use of used/shared needles (such as with tattooing or IV drug use) or other items used for recreational drugs, or from mother to child during birth.

What are its symptoms? Many people do not know they have hepatitis or experience obvious symptoms. But when symptoms are present, though they differ somewhat for the types of hepatitis, with A, B and/or C, some common symptoms are flu-like illness, nausea, vomiting or loss of appetite, abdominal pain, weight loss, diarrhea, jaundice (yellowing skin and whites of eyes) and/or itchy skin. The incubation period of the illness (the time it takes for symptoms to appear after a person is exposed to the virus) is usually between fifteen days and four months.

With hepatitis, there are acute (only lasting a little while) and chronic (long-lasting or recurrent) states of the illness. Most people -- 90% or more -- will not wind up having Hepatitis A or B chronically, but only acutely. A majority of people with Hepatitis C, however, will develop chronic illness.

How is it diagnosed? Through different blood tests given by a healthcare provider. People who donate blood have usually been screened for hepatitis.

Is it treatable? Yes, but how and if hepatitis is treated depends on which type of the virus someone has, how much it has impacted the liver and the rest of the body, what state of health they are in and if the infection is chronic or not.

The majority of people who acquire HAV and HBV recover without treatment, but only around 20% people infected with HCV will clear the virus from their bodies. For those who do only get it acutely, in a few months the immune system should fight off the virus, and provide the person who had it immunity from it from there on out. Until that happens, and that's established through testing, someone with it should be considered to be contagious.

Those who do not clear any kind of hepatitis like that may have it for life and be at risk of transmitting the virus to others lifelong.

For those who require and receive treatment, antiviral medications are the typical treatments, in order to help prevent further liver damage. Whether acute or chronic, because of the impact Hepatitis can have on the liver, people with hepatitis are also always strongly advised to avoid alcohol, to get get plenty of rest and to eat in a healthy way, including eating low-sodium and low-fat foods. Regular blood tests and physical check-ups to monitor the virus are also recommended, whether or not someone is receiving treatment.

Is it curable? Treatments can't get rid of the virus. Instead, they tend to protect the body, especially the liver, from it as best they can to prevent damage or further damage.

If someone has been infected with hepatitis and their body has fought off the virus, they are permanently immune and cannot acquire it again and also cannot transmit it to others.

For those with chronic infections, treatments can continue to help best protect their health over time from the impact of the viruses. For those who develop cirrhosis of the liver or liver cancer because of hepatitis, which are risks with the virus, those conditions will require their own treatments.

Can it affect fertility? Not usually, but some treatments for it can, and a hepatitis infection can complicate delivery (birth) for pregnant women, especially those without quality pre-natal care and healthcare during delivery.

Can it cause death? Yes, particularly with Hepatitis C and chronic hepatitis infections that result in liver disease.

How can we protect against it? Vaccines are available for both HAV and HBV. There is not yet a vaccine available for Hepatitis C.

Safer sex practices, especially latex barriers, offer excellent protection against hepatitis, as does avoiding anyone else's genital fluids, blood or behaviors which might introduce someone else's blood or fluids to your body, particularly to the genitals, mouth or other mucous membranes.

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