Communicable Disease & Epidemiology

Hepatitis

Hepatitis C Resource Book

General Information

  • Viral hepatitis is one of the most common infectious diseases, causing an estimated 1.5 million deaths worldwide each year.
  • Each year 200,000 people in the United States will become infected with hepatitis.
  • There are more than 1.2 million chronic carriers of hepatitis B in the US, and one-third of these carriers do not know they are infected.
  • There are an estimated 3.9 million Americans infected with hepatitis C of whom 2.7 million have chronic hepatitis C. That’s 1 out of every 50 Americans, 75% of which have no idea they are infected and capable of transmitting the disease to others.
  • The liver is a non-complaining organ. Symptoms may not manifest themselves for years until the liver is badly damaged.

Hepatitis refers to an “inflammation of the liver”, which can be caused by many things such as viruses, bacteria, drugs (including alcohol), and toxic chemicals. Hepatitis that is caused by a virus is called “viral hepatitis”. The three most common types of viral hepatitis in the United States are hepatitis A, hepatitis B and hepatitis C. In January, 2005, the Department of Health and Human Services added hepatitis B and hepatitis C to its list of known carcinogens (cancer-causing agents).

Hepatitis A
Hepatitis A, formerly called “infectious hepatitis”, is caused by the hepatitis A virus (HAV) and is an acute (short-term) infection. There is no chronic (long-lasting) infection associated with HAV. Most patients recover completely within two months. Hepatitis A is spread from person to person by putting something in the mouth that has been contaminated with the feces (bowel movement) of a person with HAV. Most infections result from contact with a household member or sex partner who is infected with HAV. There is a safe vaccine available to prevent HAV.

Hepatitis B
Hepatitis B, formerly called “serum hepatitis”, is caused by the hepatitis B virus (HBV). About 5-10% of infected adults progress to chronic (long-lasting) hepatitis B; 90% of newborns born to HBV-infected women develop chronic infections; and young children who become infected have a 30-50% chance of developing a chronic infection. Hepatitis B is spread when blood or body fluids from an infected person enter the body of a person who is not infected. For example, HBV is spread by having sex with an infected person without using a condom, by sharing drugs, needles or “works” when “shooting” drugs, through needle stick or sharps exposures on the job and from an infected mother to her newborn during the delivery process. There is a safe vaccine available to prevent HBV.

Hepatitis C
Hepatitis C, formerly known as “non-A, non-B hepatitis”, is caused by the hepatitis C virus (HCV). About 85% of infected adults will develop chronic (long-lasting) hepatitis C infections. HCV is spread when blood or body fluids from an infected person enter the body of a person who is not infected. HCV occurs primarily in those who have a history of using illicit street drugs and those who received blood transfusions prior to 1992 (the first year that a blood test for HCV became available for screening the nation’s blood supply). It can also be spread through needle stick or sharp exposures on the job or from an infected mother to her baby during the delivery process. There is currently no vaccine available to prevent HCV.

Why is my liver important?

Your liver is one of the largest and most important organs in your body. It is about the size of a football and is located behind the lower right part of your ribs. The liver is such an important organ that we can survive only one or two days if it shuts down. If your liver fails, your body will fail, too.

What does my liver do?

The liver’s job is to run over 500 bodily functions. For example, it transforms food into usable body chemicals. It filters waste, bacteria and poisons from your blood. The liver stores vitamins, sugars, fats and other nutrients your body uses for energy. It also controls the production and removal of cholesterol and makes clotting factors to stop excessive bleeding after cuts and injuries.

How can I tell if my liver is damaged?

Some signs of liver problems are:

  • Feeling tired or weak
  • Loss of appetite
  • Nausea and/or vomiting
  • Weight loss
  • Bruising or bleeding easily
  • Jaundice (yellowing of the eyes and skin)

Most people with chronic liver disease will have no ongoing symptoms, and the damage will be detected only by blood tests.

How can I take care of my liver?

Your liver depends on you to take care of it. When it is injured you may not know until the damage is advanced. You can make some changes in your behavior that will help you live a longer, healthier life.

  • Don’t drink alcohol. Alcohol on its own can hurt your liver. Alcohol and chronic hepatitis B or hepatitis C is a deadly combination, leading to serious liver damage.
  • Talk to your healthcare provider about your medications. Many prescription and over-the-counter medications may affect your liver. The same is true for some vitamins, minerals, and dietary supplements. Talk to your doctor to find out if the medications you take will be harmful to your liver.
  • Get vaccinated for hepatitis A and B. Hepatitis A and B are two other viruses that can affect your liver and cause damage, especially in people with hepatitis C. But unlike hepatitis C, they can be prevented by vaccine.
  • Don’t use illegal drugs. Using illegal drugs is not only harmful to your overall health, but can also affect the decisions you make after being diagnosed with hepatitis C. Sharing needles or “works” can put you at risk for getting HIV or another type of hepatitis, and may put others at risk for getting hepatitis C from you.
  • Eat a healthy diet. The liver helps to digest food, absorb nutrients from the food we eat and changes food into the energy our body needs to live. Eating a nutritious diet and maintaining a healthy weight can help keep your liver healthy.
  • Avoid raw shellfish (such as raw oysters). Raw shellfish may carry the bacteria Vibrio vulnificus which can cause a serious infection in persons with liver disease. About 40% of these cases are fatal. Well-cooked shellfish is not dangerous.

Are You at Risk?

Take this survey to find out if you are at risk of becoming infected with one of the hepatitis viruses.

Check your risk of hepatitis A

  1. Do you believe you have been exposed to hepatitis A in the past 2 weeks?
  2. Do you live with someone currently ill with hepatitis A?
  3. Have you had sex with someone currently ill with hepatitis A in the past 2 weeks?
  4. Do you currently live in an area that has a high rate of hepatitis A? (view map)
  5. Do you travel to areas outside of the United States where hepatitis A is common? (view map)
  6. Are you a man who has sex with other men?
  7. Have you ever injected drugs not prescribed by a doctor or used non-injecting (e.g. snort cocaine) street drugs?

If you answered yes to any of the questions, you are at risk and should see your doctor if you desire testing.

Check your risk of hepatitis B

  1. Do you live with someone who has hepatitis B?
  2. Have you had sex with someone infected with hepatitis B?
  3. Have you been diagnosed with a sexually transmitted disease?
  4. Have you had sex with more than one partner in a six month period?
  5. Were you born in a country outside the United States where there are high rates of hepatitis B? (view map)
  6. Have you had direct contact with human blood?
  7. Have you worked in a health care or other occupation where you had a needle stick injury or other sharps exposure on the job?
  8. Do you have hemophilia?
  9. Have you ever received hemodialysis?
  10. Are you a man who has sex with other men?
  11. Did your mother have hepatitis B when she gave birth to you?
  12. Have you shared a toothbrush, razor, or any other item that might have blood on it (visible or not) with a person who has hepatitis B?
  13. Have you or any of your sex partners ever injected drugs not prescribed by a doctor?

If you answered yes to any of the questions, you are at risk and should see your doctor if you desire testing.

Check your risk of hepatitis C

  1. Have you ever injected drugs not prescribed by a doctor or used non-injecting (e.g. snort cocaine) street drugs?
  2. Did you receive clotting factors made before 1987?
  3. Have you ever received hemodialysis?
  4. Have you had blood tests that showed a liver problem?
  5. Did you have a blood transfusion (including blood products received during a cesarean section) or organ transplant before 1992?
  6. Did your mother have hepatitis C when she gave birth to you?
  7. Have any of your sex partner(s) injected illegal drugs, even if it was only one time many years ago?
  8. Have you shared a toothbrush, razor, or any other item that might have blood on it (visible or not) with a person who has hepatitis C?
  9. Have you had a needle stick injury working in a health care setting?

If you answered yes to any of the questions, you are at risk and should see your doctor if you desire testing.

References

  1. Centers for Disease Control and Prevention, National Center for Infectious Diseases. (accessed on 4/14/05)
  2. New York State Health Department Hepatitis Risk Assessment (accessed 2/14/05).

Hepatitis A, B, C Prevention

Hepatitis A Prevention

  • Hepatitis A vaccine is the best protection.
  • Short-term protection against hepatitis A is available from immune globulin. It can be given before and within 2 weeks after coming in contact with HAV.
  • Always wash your hands with soap and water after using the bathroom, changing a diaper, before smoking and before preparing and eating food.
  • Avoid anal/oral sex with someone known to have acute hepatitis A

Hepatitis B Prevention

  • Hepatitis B vaccine is the best protection.
  • If you are having sex, but not with one steady partner, use latex condoms correctly and every time you have sex. The efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission.
  • If you are pregnant, you should get a blood test for hepatitis B; Infants born to HBV-infected mothers should be given HBIG (hepatitis B immune globulin) and vaccine within 12 hours after birth. Infants should also complete the hepatitis series at 6 months of age.
  • Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share drugs, needles, syringes, water, or "works", and get vaccinated against hepatitis A.
  • Do not share personal care items that might have blood on them (razors, toothbrushes).
  • Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.
  • If you have or had hepatitis B, do not donate blood, organs, or tissue.
  • If you are a health care or public safety worker, get vaccinated against hepatitis B, and always follow routine barrier precautions and safely handle needles and other sharps.

Hepatitis C Prevention

  • There is no vaccine to prevent hepatitis C.
  • Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water, or "works", and get vaccinated against hepatitis A & B.
  • Do not share personal care items that might have blood on them (razors, toothbrushes).
  • If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps; get vaccinated against hepatitis B.
  • Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.
  • HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms* correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.
  • If you are HCV positive, do not donate blood, organs, or tissue.

Hepatitis-Related Services Provided at the Kent County Health Department.

Personal Health Services

Confidential testing for hepatitis B and C, sexually transmitted diseases and anonymous testing for HIV (AIDS). Available only at the Fuller Clinic, 700 Fuller N.E. Testing is by appointment only. Personal Health Clinic hours: Monday, Tuesday, Wednesday, Friday, 8:00 a.m. to 5:00 p.m.; Thursday, 1:00 p.m. to 7:00 p.m. Services available to Kent County residents, age 13 and older. Clients may be required to meet certain eligibility criteria for free hepatitis testing.

Immunizations

Locations & Hours
Kent County Health Department has 4 clinic locations throughout the county so you may receive routine immunization services at a location convenient to you. The clinics are open Monday through Friday, however hours vary by location.

Fees
Receiving routine vaccinations does not have to be expensive. At Kent County Health Department, individuals who qualify and receive certain vaccines through special programs like the Vaccines for Children (VFC) program or the Michigan Vaccine Replacement Program (MI-VRP) are eligible to receive the vaccine free of charge. However, a sliding scale ($0 - $10) vaccine administration fee may be charged for each injection given. Costs for individual vaccines vary. Many health insurance plans also cover routine vaccinations when they are provided by your primary care physician.

Perinatal Hepatitis B Prevention Program

The Perinatal Hepatitis B Prevention Program serves to identify hepatitis B-infected pregnant women, early in their pregnancy or at the time of delivery, to prevent the perinatal transmission of the hepatitis B virus (HBV) to infants exposed at birth. This program provides free Hepatitis B Immune Globulin (HBIG) and hepatitis B vaccine to the infant. Free hepatitis B testing is offered after the vaccine series is complete to ensure that the baby has developed protective antibodies against HBV. The program also provides free hepatitis B testing and hepatitis B vaccinations for the pregnant woman’s sexual partners and household contacts. For more information, please contact the Communicable Disease Unit at Kent County Health Department at (616) 632-7228.

Treatment for Hepatitis

Not all patients with viral hepatitis require treatment. In hepatitis A and about 90% of the cases of hepatitis B, the body will fight off the infection on its own. However, up to 85% of cases of hepatitis C become chronic. If left untreated, chronic hepatitis B and C can lead to cirrhosis, liver cancer, and even liver failure. In the United States, hepatitis C is now the leading cause of liver transplants. Patients who receive treatment early in the course of chronic hepatitis infections, and those who make lifestyle changes to protect their liver, have a better chance of avoiding serious liver disease. While there is no guaranteed cure for chronic hepatitis B or hepatitis C, a significant percentage of people do improve with treatment.

The information provided on this website is not intended to be a substitute for professional medical advice. Please consult your health care provider directly with any questions you may have regarding your health, condition or treatment. Kent County Health Department does not provide treatment for hepatitis.

Resource Guide

Download the following pdf file for more information on agencies that provide services to uninsured/underinsured individuals.

Hepatitis C Resource Book

The Hepatitis C Resource Book is designed for Health Care Providers to use when they or their patients have questions related to Hepatitis C. The contents of the book are listed below and all documents are available for download. For more information contact the Kent County Health Department (KCHD) Communicable Disease Unit at (616) 632-7228.

Table of Contents

Hepatitis C Fact Sheet
Hepatitis B Vaccine Availability
Hepatitis A Vaccine Availability
Health Care Resources For Uninsured/Underinsured Individuals At Risk For Hepatitis

“Easy C” Facts Sheets (English)

Additional Links & Information