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HIV / Hepatitis Management


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Hepatitis is inflammation and swelling of the liver. It can be caused by alcohol, medications, chemicals or other medical conditions.

Viral Hepatitis is caused by a virus.  There are several hepatitis viruses and they are identified as A. B, C, D
and E.

Hepatitis A virus causes a relatively mild infection and does not cause chronic hepatitis.  When you are first infected with the virus it is called an acute infection. With Hepatitis A symptoms will appear.

Common symptoms of acute viral hepatitis are:
- Decreased appetite
- Nausea
- Tiredness (fatigue)
- Lack of energy (lethargy)
- Abdominal pain
- Dark urine
- Jaundice (yellowish eyes and skin)

You get Hepatitis A from contaminated food due to poor hygienic practices. Hepatitis A is passed through the stool of an infected person often in food preparation. It is very important that people who prepare food wash their hands often and thoroughly. Hepatitis A does not lead to chronic disease but is a serious infection in the elderly and those with a poor immune system. Once you have been exposed to Hepatitis A and have recovered you develop a lifelong immunity to the Hepatitis A virus.

There is no treatment for Hepatitis A. Recovery time varies by person but once you have recovered from Hepatitis A you have a lifelong immunity to the virus.

Hepatitis B is common in Asia and Africa where it is thought that 1 in 5 people are infected with the virus. Many people (95%) recover completely from Hepatitis B. Some people (5%) may not clear the virus and become infected for life. Slowly over time the Hepatitis B virus causes liver damage. Symptoms of this liver damage will not appear until the liver is severely scarred.  Chronic Hepatitis B has no cure but there are effective treatments for the disease.  Once you have cleared the Hepatitis B virus from your body you have immunity for life.

Hepatitis B is spread through contact with the blood, semen or vaginal fluids of an infected person. Sexual contact with an infected person is the most common route of transmission of Hepatitis B.

The good news is that there is an effective vaccine that can prevent Hepatitis B infection.  If you are travelling to countries where Hepatitis B virus is common it is advised that you get the Hepatitis B vaccine before your travel.

Hepatitis C like Hepatitis B is common world-wide. It is a silent disease as no symptoms of the infection occur until there is major scarring in the liver. The acute infection phase of Hepatitis C may have no symptoms and may last up to 8 weeks. You may not know you have been infected as symptoms are usually mild and include fatigue, lethargy, abdominal pain, nausea and jaundice. Approximately 25% of people infected with Hepatitis C clear the virus on their own. In 75% of those infected the virus stays active in the body for over 6 months. This is then called a chronic infection.

In 3 out of 4 people with chronic Hepatitis C the damage to the liver is moderate over time. But in 1 in 4 cases of chronic Hepatitis C more serious problems occur such as cirrhosis, liver failure and liver cancer. These very serious problems with chronic Hepatitis C are more likely to occur if you are male, obese, became infected over the age of 40 and drink alcohol. Chronic Infections like HIV add to the possibility of cirrhosis occurring with Hepatitis C infection.

You get infected with Hepatitis C through blood to blood contact during sex or through a contaminated needle injection or blood transfusion.

There is treatment for Hepatitis C but unlike Hepatitis A or B you do not become immune to the virus and can be re-infected if you share blood to blood exposure again. This is because the Hepatitis C virus changes so quickly that your body cannot create efficient antibodies to the virus. Unfortunately, there is no Hepatitis C vaccine currently available.

Over 250,000 people are infected with Hepatitis C in Canada and 1in3 of them do not know they are infected.  Blood tests and perhaps a liver biopsy are the best way to identify a Hepatitis C infection. Treatment then can be started by your doctor.

Who should get tested for Hepatitis C
- Anyone who has done something to put them at risk (risky sex, IV drug use, sharing a crack pipe)
- Anyone who has symptoms of hepatitis (fatigue, loss of appetite, nausea, lethargy, abdominal pain,
jaundice or dark urine)
- Anyone who has lived in India, Pakistan, Vietnam, Egypt or south Italy and has been exposed to blood products, medical procedures or vaccinations.

For much more information on Hepatitis and how to live well with hepatitis please go to www.catie.ca or ask a question of the NKS Health pharmacist or nurse or nutritionist at HIV-Hepatitis@nkshealth.ca