The term "Hepatitis" refers to an inflammation of the liver. There are several types of Hepatitis, labeled A, B, C, D and E. Each type is similar but different. Our discussion here is limited to coverage of the first three types, as they are most common. Though these three forms of Hepatitis can be spread in a variety of ways, all of them can be sexually transmitted.
All forms of hepatitis are serious illnesses. The liver is the body's primary means of filtering toxins out of the blood. When the liver becomes compromised, as is the case in hepatitis, the entire body is necessarily compromised.
Hepatitis A
Hepatitis A is caused by a virus (Hepatitis A Virus or HAV). It is spread by ingesting stool (feces) from a person who has the virus. This can happen when a very small amount of stool comes into contact with food while that food is being prepared (such as might occur if a cook does not adequately wash his or her hands after using the bathroom). In such cases, the amount of stool involved is typically very small and all but invisible. Hepatitis A transmission can also occur during sexual contact, usually when oral-to-anal sex occurs (e.g., a "rimming", or "rim-job", or when oral sex occurs after anal sex).
Symptoms of Hepatitis A generally occur between fifteen and fifty days after infection, with the average waiting time approximately 30 days. Symptoms of Hepatitis A are similar to the flu, and include: loss of appetite, fever, headaches, muscle aches, nausea, vomiting, diarrhea, and yellow skin (called jaundice). Hepatitis A symptoms can last from one to two weeks in duration.
People who contract Hepatitis A remain contagious and able to give the virus to someone else for three to six months after their own infection. For the duration of their infection, people with Hepatitis A should avoid eating or otherwise ingesting substances that will put strain on the liver. Fatty foods, alcohol, drugs and many medications should be avoided. Sexual activity should be avoided too during the infectious period so that the disease is not passed to anyone else.
Though doctors are able to test for the presence of the Hepatitis virus with a blood test, there is little they can do once the illness is established. There is no treatment for Hepatitis A. However, there is a vaccine that can be administered to people prior to their becoming infected with Hepatitis A that will help prevent them from getting the disease in the first place. The vaccine is only used in certain locations in the world and is not commonly given in the United States unless someone is traveling to an endemic area internationally. Luckily, Hepatitis A does not result in chronic disease or disability. A person gets the virus, has symptoms, and is infected for several months after which symptoms disappear.
Besides the vaccine, Hepatitis A can be prevented in the usual ways: by limiting your sexual partners to one disease free person (monogamy), or by abstaining from sexual contact (abstinence), and by using latex condoms and dental dams when engaged in any sexual contact, and especially when engaged in rimming (oral-to-anal sex).
Hepatitis B
Like Hepatitis A, Hepatitis B is also caused by a virus (Hepatitis B Virus or HBV). HBV infection is known to be very common, with some estimates suggesting that fully a third of the people in the world have been infected, with rates of infection higher in the developing world than in the west. Approximately twelve million Americans, or about one out of every twenty people, carry the virus.
There are two stages of Hepatitis B infection- acute (the early phase) and chronic (the phase that lasts indefinitely). The acute or early symptoms of Hepatitis B usually occur within one to nine months of infection. About 70% of the time no acute phase symptoms occur, and infected people have no warning of their infection. Another 29% or so of infected people experience flu-like symptoms which include loss of appetite, tiredness, nausea, yellow skin (jaundice), vomiting, white colored stools, and joint pain. These symptoms generally pass with time. In about 1% of cases HBV results in "fulminant hepatitis" during which the liver shuts down and patients' lives are in danger if medical care is not promptly administered. There are no medications to treat the acute (early) phase of Hepatitis B infection, but doctors can administer other therapies to help patients through their liver crisis. Some 5000 Americans die of HBV infection complications each year.
In the majority of adult cases, patients recover after the acute phase, eradicate the HBV virus from their bodies, and develop immunities to help combat future HBV infections. A minority of adults, but unfortunately a majority of children go on to develop a chronic (long-term) HBV infection.
A person who has chronic Hepatitis B can expect to have a long and reasonably healthy life, but they can also expect their liver functioning to be somewhat compromised. They will remain infectious throughout their lives. Because of their liver problems, they may have problems digesting some medications. They may also get cirrhosis of the liver (which is when the liver cells start dying) and possibly liver cancer. Antiviral medications are of some help to chronic HBV patients in about 50% of cases.
HBV can be transmitted when a person comes into contact with another person's infected bodily fluids (blood, vaginal fluids, and semen). This can occur through sex, tattooing (when equipment is shared), sharing razors, needles, nails files, earrings and even toothbrushes. Because the majority of HBV infected persons never know they have the virus, it is vital to take precautions against HBV transmission whenever you live in close contact with other people.
Fortunately, HBV is transmitted through contact with body fluids only; it is not casually transmitted via sneezing, coughing or simple skin contact. HBV infection can be avoided by avoiding contact with an infected person's body fluids, or anything they may have gotten body fluids on. When properly used, barrier method contraception devices such as condoms and dental dams can help reduce (but not eliminate) the risk of HBV transmission.
A vaccination for HBV is available that helps people build antibodies to the virus and thus become resistant to HBV infection. This vaccination is given in three doses distributed over several months. It is a good idea for you to be vaccinated for HBV if you haven't done so already.
HBV and Pregnancy
HBV infection can be transmitted from a mother to a newborn infant during birth. Because of high risk of HBV infection and the likelihood that an infected infant will become a chronic, and thus life-long HBV patient, it is important that pregnant women discuss their HBV status with their doctor, and that doctors take care to minimize the risk of HBV transmission to the newborn.
Hepatitis C
Like other forms of Hepatitis, Hepatitis C is caused by a virus (Hepatitis C, or HCV). HVC is found in blood and is spread through sexual contact or sharing needles and other objects that have become contaminated with infected body fluids. As with other forms of Hepatitis, the risk of HCV infection can be reduced by abstaining from sexual contact, by limiting contacts to known safe partners, or by using appropriate barrier contraception such as condoms and dental dams if other alternatives are not acceptable. Needles and other objects that may have been contaminated with infected body fluids must be avoided.
As is the case with HBV, HCV infection occurs in two stages: an acute or early stage, and a chronic or long-term stage. Approximately 50% of people who become infected experience symptoms, while the remainder show a silent presentation with no obvious symptoms. When symptoms do occur, they begin between two and fifteen weeks of infection, and include general weakness, loss of appetite, belly pain, and yellow skin (called jaundice).
Hepatitis C is a chronic disease which does not leave the body, although its chronic effects may be mild or severe for different patients. Chronic HCV infection is diagnosed after about six months of infection, via blood test and sometimes also a liver biopsy (tissue sample). In mild cases patients may not know they remain infected. In more severe cases, however, the chronic infection can lead to cirrhosis (liver disease) and reduced liver function, which in turn can lead to ascites (fluid inside the belly), yellow skin (jaundice), kidney and heart problems, difficulty digesting drugs and food and many other fairly serious health consequences.
There is no cure for Hepatitis C, but there are some treatments that are helpful to patients. First, patients are counseled to greatly reduce or eliminate alcohol use and use caution starting new medications or herbal supplements. Patients may also be counseled to remove foods from their diet that are difficult for their compromised livers to eliminate from their bodies. Doctors may also prescribe antiviral drugs and "Interferon Alpha" to reduce patient's viral load and liver inflammation.
HCV and Pregnancy
HCV infection can be transmitted from a mother to a newborn infant during birth. Because of high risk of infants becoming infected with HCV at birth and the life-long and serious nature of HCV infection, it is important that pregnant women discuss their HCV status with their doctor, and that doctors take care to minimize the risk of HCV transmission to newborns.
