What is hepatitis A?

Hepatitis* A is a virus, or infection, that causes liver disease and inflammation of the liver. Viruses can cause sickness. For example, the flu is caused by a virus. People can pass viruses to each other. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can cause organs to not work properly.

What is the liver?

The liver is an organ that does many important things. You cannot live without a liver.

Hepatitis A is a virus, or infection, that causes inflammation of the liver.

The liver

removes harmful chemicals from your blood fights infection helps digest food stores nutrients and vitamins stores energy

[Top]

Who gets hepatitis A?

Anyone can get hepatitis A, but those more likely to are people who

travel to developing countries live with someone who currently has an active hepatitis A infection use illegal drugs, including non injection drugs have unprotected sex with an infected person provide child care

Also, men who have sex with men are more likely to get hepatitis A. [Top]

How could I get hepatitis A?

You could get hepatitis A through contact with an infected persons stool. This contact could occur by

eating food made by an infected person who didnt wash his or her hands after using the bathroom drinking untreated water or eating food washed in untreated water placing a finger or object in your mouth that came into contact with an infected persons stool having close personal contact with an infected person, such as through sex or caring for someone who is ill

You cannot get hepatitis A from

being coughed or sneezed on by an infected person sitting next to an infected person hugging an infected person

A baby cannot get hepatitis A from breast milk. [Top]

What are the symptoms of hepatitis A?

Most people do not have any symptoms of hepatitis A. If symptoms of hepatitis A occur, they include

feeling tired muscle soreness upset stomach fever loss of appetite stomach pain diarrhea dark-yellow urine light-colored stools yellowish eyes and skin, called jaundice

Symptoms of hepatitis A can occur 2 to 7 weeks after coming into contact with the virus. Children younger than age 6 may have no symptoms. Older children and adults often get mild, flulike symptoms. See a doctor right away if you or a child in your care has symptoms of hepatitis A. [Top]

How is hepatitis A diagnosed?

A blood test will show if you have hepatitis A. Blood tests are done at a doctors office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis A.

A blood test will show if you have hepatitis A.

[Top]

How is hepatitis A treated?

Hepatitis A usually gets better in a few weeks without treatment. However, some people can have symptoms for up to 6 months. Your doctor may suggest medicines to help relieve your symptoms. Talk with your doctor before taking prescription and over-the-counter medicines. See your doctor regularly to make sure your body has fully recovered. If symptoms persist after 6 months, then you should see your doctor again. When you recover, your body will have learned to fight off a future hepatitis A infection. However, you can still get other kinds of hepatitis.

Hepatitis A usually gets better in a few weeks without treatment.

[Top]

How can I avoid getting hepatitis A?

You can avoid getting hepatitis A by receiving the hepatitis A vaccine. Vaccines are medicines that keep you from getting sick. Vaccines teach the body to attack specific viruses and infections. The hepatitis A vaccine teaches your body to attack the hepatitis A virus. The hepatitis A vaccine is given in two shots. The second shot is given 6 to 12 months after the first shot. You should get both hepatitis A vaccine shots to be fully protected. All children should be vaccinated between 12 and 23 months of age. Discuss the hepatitis A vaccine with your childs doctor.

Adults at higher risk of getting hepatitis A and people with chronic liver disease should also be vaccinated. If you are traveling to countries where hepatitis A is common, including Mexico, try to get both shots before you go. If you dont have time to get both shots before you travel, get the first shot as soon as possible. Most people gain some protection within 2 weeks after the first shot. You can also protect yourself and others from hepatitis A if you

always wash your hands with warm, soapy water after using the toilet or changing diapers and before fixing food or eating

use bottled water for drinking, making ice cubes, and washing fruits and vegetables when you are in a developing country

tell your doctor and your dentist if you have hepatitis A

Always wash your hands with warm, soapy water after using the toilet or changing diapers and before fixing food or eating.

[Top]

What should I do if I think I have been in contact with the hepatitis A virus?
See your doctor right away if you think you have been in contact with the hepatitis A virus. A dose of the hepatitis A vaccine or a medicine called hepatitis A immune globulin may protect you from getting sick if taken shortly after coming into contact with the hepatitis A virus. [Top]

Eating, Diet, and Nutrition

If you have hepatitis A, you should do things to take care of yourself, including eating a healthy diet. Avoid drinking alcohol, which can harm the liver. Talk with your doctor before taking vitamins and other supplements. [Top]

Points to Remember

Hepatitis A is a virus, or infection, that causes inflammation of the liver. Anyone can get hepatitis A, but some people are more likely to than others. You could get hepatitis A through contact with an infected persons stool. Most people do not have any symptoms of hepatitis A. Children younger than age 6 may have no symptoms of hepatitis A. Hepatitis A may cause mild, flulike symptoms in older children and adults. See a doctor right away if you or a child in your care has symptoms of hepatitis A. A blood test will show if you have hepatitis A. Hepatitis A usually gets better in a few weeks without treatment. You can avoid getting hepatitis A by receiving the hepatitis A vaccine. Tell your doctor and your dentist if you have hepatitis A. See your doctor right away if you think you have been in contact with the hepatitis A virus.

[Top]

Hope through Research

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) supports basic and clinical research into many digestive disorders, including hepatitis A. Researchers are studying new ways to prevent hepatitis A. Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov. [Top]

Pronunciation Guide
hepatitis (HEP-uh-TY-tiss) inflammation (IN-fluh-MAY-shuhn) jaundice (JAWN-diss) vaccine (vak-SEEN) virus (VY-ruhss) [Top]

What is hepatitis B?
Hepatitis* B is a virus, or infection, that causes liver disease and inflammation of the liver. Viruses can cause sickness. For example, the flu is caused by a virus. People can pass viruses to each other. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can cause organs to not work properly. *See the Pronunciation Guide for tips on how to say the underlined words. [Top]

What is the liver?

The liver is an organ that does many important things. You cannot live without a liver.

Hepatitis B is a virus, or infection, that causes liver disease and inflammation of the liver.

The liver

removes harmful chemicals from your blood fights infection helps digest food stores nutrients and vitamins stores energy

[Top]

Who gets hepatitis B?

Anyone can get hepatitis B, but those more likely to are people who

were born to a mother with hepatitis B are in contact with blood, needles, or body fluids at work live with someone who currently has an active hepatitis B infection have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease

are on kidney dialysisthe process of filtering wastes and extra water from the body by means other than the kidneys

are taking medicines that suppress the immune system, such as steroids or chemotherapy medicines have lived in or travel often to parts of the world where hepatitis B is common are from Asian and Pacific Island nations are infected with HIV or hepatitis C have injected illegal drugs work or live in a prison had a blood transfusion or organ transplant before the mid-1980s

Also, men who have sex with men are more likely to get hepatitis B. [Top]

How could I get hepatitis B?

You could get hepatitis B through contact with an infected persons blood, semen, or other body fluid. This contact could occur by

being born to a mother with hepatitis B getting an accidental stick with a needle that was used on an infected person having unprotected sex with an infected person having contact with blood or open sores of an infected person sharing drug needles or other drug materials with an infected person being tattooed or pierced with unsterilized tools that were used on an infected person using an infected persons razor, toothbrush, or nail clippers

You could get hepatitis B from having unprotected sex with an infected person.

You cannot get hepatitis B from

shaking hands or holding hands with an infected person being coughed or sneezed on by an infected person hugging an infected person sitting next to an infected person sharing spoons, forks, and other eating utensils drinking water or eating food

A baby cannot get hepatitis B from breast milk. [Top]

What are the symptoms of hepatitis B?

Most people do not have any symptoms of hepatitis B. Adults and children ages 5 and older may have one or more of the following symptoms:

feeling tired muscle soreness upset stomach stomach pain fever loss of appetite diarrhea

dark-yellow urine light-colored stools yellowish eyes and skin, called jaundice

When symptoms occur, they can begin 2 to 5 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis B. [Top]

What is acute hepatitis B?

Acute hepatitis B is a short-term infection with the hepatitis B virus. Symptoms usually last several weeks but they can last up to 6 months. The infection sometimes clears up because your body is able to fight off the infection and get rid of the virus. Most healthy adults and children older than 5 who have hepatitis B get better without treatment. [Top]

What is chronic hepatitis B?

Chronic hepatitis B is a long-lasting infection with the hepatitis B virus. Chronic hepatitis B occurs when the body cant get rid of the hepatitis B virus. Children, especially infants, are more likely to get chronic hepatitis B, which usually has no symptoms until signs of liver damage appear. Without treatment, chronic hepatitis B can cause liver cancer or severe liver damage that leads to liver failure. Liver failure occurs when the liver stops working properly. [Top]

How is hepatitis B diagnosed?

A blood test will show if you have hepatitis B. Blood tests are done at a doctors office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis B. If you are at higher risk of getting hepatitis B, get tested. If you are pregnant, you should also get tested. Many people with hepatitis B do not know they are infected. Early diagnosis and treatment can help prevent liver damage.

A blood test will show if you have hepatitis B.

Your doctor may suggest getting a liver biopsy if chronic hepatitis B is suspected. A liver biopsy is a test to take a small piece of your liver to look for liver damage. The doctor may ask you to stop taking certain medicines before the test. You may be asked to fast for 8 hours before the test. During the test, you lie on a table with your right hand resting above your head. Medicine is applied to numb the area where the biopsy needle will be inserted. If needed, sedatives and pain medicine are also given. The doctor uses a needle to take a small piece of liver tissue. After the test, you must lie on your right side for up to 2 hours. You will stay 2 to 4 hours after the test before being sent home. A liver biopsy is performed at a hospital or outpatient center by a doctor. The liver tissue is sent to a special lab where a doctor looks at the tissue with a microscope and sends a report to your doctor. [Top]

How is hepatitis B treated?

Hepatitis B is not usually treated unless it becomes chronic. Chronic hepatitis B is treated with medicines that slow or stop the virus from damaging the liver. Medicines for Chronic Hepatitis B Your doctor will choose medicines or a combination of medicines that are likely to work for you. The doctor will closely watch your symptoms and schedule regular blood tests to make sure treatment is working. Medicines given by shots include

interferon peginterferon

Medicines taken by mouth include

adefovir entecavir lamivudine telbivudine tenofovir

The length of treatment varies. Talk with your doctor before taking other prescription medicines and over-the-counter medicines. Liver Transplant A liver transplant may be necessary if chronic hepatitis B causes severe liver damage that leads to liver failure. Symptoms of severe liver damage include the symptoms of hepatitis B and

generalized itching a longer than usual amount of time for bleeding to stop easy bruising swollen stomach or ankles spiderlike blood vessels, called spider angiomas, that develop on the skin

Liver transplant is surgery to remove a diseased or injured liver and replace it with a healthy one from another person, called a donor. If your doctors tell you that you need a transplant, you should talk with them about the long-term demands of living with a liver transplant. A team of surgeonsdoctors who specialize in surgeryperforms a liver transplant in a hospital. You will learn how to take care of yourself after you go home and about the medicines youll need to take to protect your new liver. Medicines taken after liver transplant surgery can prevent hepatitis B from coming back. Testing for Liver Cancer

Having hepatitis B increases your risk for getting liver cancer, so your doctor may suggest an ultrasound test of the liver every 6 to 12 months. Finding cancer early makes it more treatable. Ultrasound is a machine that uses sound waves to create a picture of your liver. Ultrasound is performed at a hospital or radiology center by a specially trained technician. The image, called a sonogram, can show the livers size and the presence of cancerous tumors. [Top]

How can I avoid getting hepatitis B?

You can avoid getting hepatitis B by receiving the hepatitis B vaccine. Vaccines are medicines that keep you from getting sick. Vaccines teach the body to attack specific viruses and infections. The hepatitis B vaccine teaches your body to attack the hepatitis B virus. Since the 1980s, a hepatitis B vaccine has been available and should be given to newborns and children in the United States. Adults at higher risk of getting hepatitis B should also get the vaccine. The hepatitis B vaccine is given in three shots over 6 months. You must get all three hepatitis B vaccine shots to be fully protected.

You can avoid getting hepatitis B by receiving the hepatitis B vaccine.

If you are traveling to countries where hepatitis B is common, try to get all the shots before you go. If you dont have time to get all the shots before you travel, get as many as you can. Even one shot may provide some protection against the virus. You can protect yourself and others from getting hepatitis B if you

use a condom during sex

do not share drug needles and other drug materials do not donate blood or blood products wear gloves if you have to touch another persons blood or open sores do not share or borrow a toothbrush, razor, or nail clippers make sure any tattoos or body piercings you get are done with sterile tools tell your doctor and your dentist if you have hepatitis B

If you are pregnant and have hepatitis B, tell the doctor and staff who deliver your baby. The hepatitis B vaccine and hepatitis B immune globulin should be given to your baby right after birth. The vaccine will greatly reduce the chance of your baby getting the infection.

Wear gloves if you have to touch another persons blood or open sores.

[Top]

What should I do if I think I have been in contact with the hepatitis B virus?
See your doctor right away if you think you have been in contact with the hepatitis B virus. A dose of the hepatitis B vaccine taken with a medicine called hepatitis B immune globulin may protect you from getting sick if taken shortly after coming into contact with the hepatitis B virus. [Top]

Eating, Diet, and Nutrition

If you have chronic hepatitis B, you should do things to take care of yourself, including eating a healthy diet. Avoid drinking alcohol, which can harm the liver. Talk with your doctor before taking vitamins and other supplements. [Top]

Points to Remember

Hepatitis B is a virus, or infection, that causes liver disease and inflammation of the liver. Anyone can get hepatitis B, but some people are more likely to than others. You could get hepatitis B through contact with an infected persons blood, semen, or other body fluid. Most people do not have any symptoms of hepatitis B. Adults and children ages 5 and older may have symptoms.

See a doctor right away if you or a child in your care has symptoms of hepatitis B. Acute hepatitis B is a short-term infection with the hepatitis B virus. Chronic hepatitis B is a long-lasting infection with the hepatitis B virus. Chronic hepatitis B occurs when the body cant get rid of the hepatitis B virus.

Children, especially infants, are more likely to get chronic hepatitis B. A blood test will show if you have hepatitis B. If you are at higher risk of getting hepatitis B, get tested. If you are pregnant, you should also get tested. Many people with hepatitis B do not know they are infected. Early diagnosis and treatment can help prevent liver damage.

Hepatitis B is usually not treated unless it becomes chronic. Chronic hepatitis B is treated with medicines that slow or stop the virus from damaging the liver.

You can avoid getting hepatitis B by receiving the hepatitis B vaccine. Tell your doctor and your dentist if you have hepatitis B. If you are pregnant and have hepatitis B, tell the doctor and staff who deliver your baby. See your doctor right away if you think you have been in contact with the hepatitis B virus.

[Top]

Hope through Research

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts and supports basic and clinical research into many digestive disorders, including hepatitis B. A team of NIDDK researchers is studying individuals who have been diagnosed with hepatitis B to identify factors that affect how the disease progresses. To improve current knowledge about the disease and long-term outcomes, the Hepatitis B Research Network is collecting health and disease information from these individuals. The study is funded under NIH clinical trial number NCT01306071. Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.

YESTERDAY

By 1970, the hepatitis B virus had been identified and shown to be a major cause of acute and chronic liver disease. Reliable but somewhat insensitive tests for the virus were newly available. Hepatitis B was the most common cause of acute liver disease in the United States with an estimated 200,000 to 300,000 persons infected annually with the hepatitis B virus, including approximately 20,000 children. The United States was in the midst of an epidemic of hepatitis B that lasted into the 1980s. Hepatitis B was a major cause of liver disease associated with blood transfusions. With the introduction of tests to detect hepatitis B in the screening

of blood products, the rate of transfusion-associated hepatitis B began to decrease.

In addition to blood transfusion, studies showed that hepatitis B could be spread by injection drug use and through sexual intercourse. The first hepatitis B virus vaccine was derived from human serum. It was found to be effective in preventing hepatitis in experimental animals, but it had yet to be tested in humans and there were major concerns about its safety, long-term efficacy, and cost. A growing body of evidence demonstrated that hepatitis B was a significant cause of chronic infections leading to liver disease, cirrhosis of the liver and liver cancer in about one fourth of carriers. Despite being able to diagnose chronic hepatitis B, there were no ways to prevent it from progressing to cirrhosis or developing into liver cancer. End-stage liver disease from hepatitis B was an untreatable and invariably fatal illness. There were no effective treatments for chronic hepatitis B. Corticosteroids were often prescribed, but subsequent studies would show that they were ineffective and potentially harmful. The World Health Organization listed hepatitis B among the top 10 causes of death in the world.

TODAY

Over the past 40 years, major accomplishments have been achieved in the prevention, diagnosis, and treatment of chronic hepatitis B in the United States. Safe and effective recombinant hepatitis B vaccines are available and should be given to all newborns and children in the United States and many other countries throughout the world. Through public health programs to vaccinate Americans against hepatitis B, the rate of acute hepatitis B has fallen by more than 80 percent, with numbers of new cases at an all-time low. The disease is now virtually unknown in children born in the United States. Demonstration that the hepatitis B vaccine decreased chronic hepatitis B and cirrhosis in areas of the world where these diseases used to be common can be considered one of the great achievements of 20th century medicine. The widespread use of the hepatitis B vaccine has also appeared to decrease the rate of liver cancer, this being most noticeable in parts of the world where hepatitis B is common.

Blood banks now screen all blood donations using sensitive tests for hepatitis B, as well as many other diseases. As a result, transfusion-associated hepatitis B has virtually disappeared in the United States. There is now a better understanding of the hepatitis B virus in terms of how it grows and how it affects patients. Sensitive tests for the virus help in evaluating patients for the seriousness of the infection and need for treatment. Several safe and effective antiviral treatments are now available for chronic hepatitis B. These treatments can control the disease in the majority of patients. The 2008 NIH Consensus Development Conference on Management of Hepatitis B (http://consensus.nih.gov/2008/hepb.htm) set forth medical evidence-based recommendations for therapy and gave recommendations for future research. If persons develop cirrhosis and end-stage liver disease from hepatitis B, they can be effectively treated with liver transplantation. Because re-infection of the transplanted liver by the hepatitis B virus can now be prevented, the long-term survival after transplantation for hepatitis B is now excellent. In the United States, the combined use of the hepatitis B vaccine along with the currently available treatments for chronic hepatitis B has reduced the need for liver transplantation. However, chronic hepatitis B continues to affect an estimated 800,000 to 1.4 million people in the United States. Many of these persons are unaware of their infection. Challenges remain in identifying persons with chronic hepatitis B and providing them with sound recommendations for management and treatment.

TOMORROW

Continued use of universal vaccination during childhood should promote further decreases in rates of hepatitis B in the United States. As a result, acute hepatitis B will become a disease that is rarely seen by physicians. Cases of chronic hepatitis B are also likely to become less frequent and most cases will be among immigrants from areas of the world where hepatitis B is common because vaccination has not been widely used. A policy of screening of immigrants for hepatitis B is likely to be implemented to help reduce the burden of this disease. Combined use of the hepatitis B vaccine and anti-viral treatments will greatly reduce the need for liver transplantation for hepatitis B. Furthermore, the rate of liver cancer due to hepatitis B should fall considerably. The NIH continues to support meritorious research focused on enhancing our understanding of disease mechanisms and developing better approaches to

treatment and prevention that are expected to result in further improvements in hepatitis B management and control.

Research supported by NIH continues to address areas to further our understanding of the hepatitis B virus. NIH-funded scientists are testing novel antiviral drugs, therapeutic vaccines, molecules that modulate the immune response, and are utilizing recently developed animal models. The NIH has launched the Hepatitis B Research Network (http://www.hepbnet.org/), a multi-center Network charged with advancing our understanding of disease processes and natural history, as well as to test the safety and efficacy of approaches using currently available drugs to treat and control hepatitis B. The Network plans to develop several clinical studies in both adults and children, and to apply state-of-the-art virologic and immunologic research techniques to understanding the factors that determine the course and outcome of hepatitis B. Clinical trials of new approaches to treat hepatitis B, including use of antiviral drugs in combination, are also conducted by scientists at the NIH Clinical Center in Bethesda, MD. In 2010, the Institute of Medicine published a report on Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C that provides a blueprint for the public health response to viral hepatitis in the United States, aimed at reducing the burden of hepatitis B and C. The U.S. Department of Health and Human Services has responded to this challenge and is putting in place a plan to carry out these recommendations, some of which are for future research components that are the focus of scientists at the NIH who have joined the Departments Interagency Viral Hepatitis Working Group. In the future, hepatitis B will no longer be a major cause of death worldwide. Indeed, the World Health Organization is likely to develop a long-range program aimed at worldwide eradication of hepatitis B.
For more information, contact: NIDDKinquiries@nih.gov National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):http://www2.niddk.nih.gov/ National Institute of Allergy and Infectious Diseases (NIAID) Viral Hepatitis Research: http://www.niaid.nih.gov/topics/hepatitis/research/pages/introduction.aspx

Did you know that Asian and Pacific Islander Americans and other foreign-born Americans are at higher risk for chronic hepatitis B, which can lead to liver failure and liver cancer?

What is hepatitis B?

Hepatitis B is a liver disease spread through contact with blood, semen, or other body fluids from a person infected with the hepatitis B virus. The disease is most commonly spread from an infected mother to her infant at birth. Hepatitis B is also spread through sex, wound-to-wound contact, and contact with items that may have blood on them, such as shaving razors, toothbrushes, syringes, and tattoo and body piercing needles. Hepatitis B is not spread through casual contact such as shaking hands or hugging; nor is it spread by sharing food or beverages, by sneezing and coughing, or through breastfeeding. [Top]

What is chronic hepatitis B?

Hepatitis B may start as a brief, fl ulike illness. Most healthy adults and children older than 5 completely recover after the bodys immune system gets rid of the virus. Hepatitis B becomes chronic when the bodys immune system cant get rid of the virus. Over time, having the virus can lead to inflammation of the liver; scar tissue in the liver, called cirrhosis; or liver cancer. Inflammation is the painful red swelling that results when tissues of the body become infected. Young children and people with weakened immune systems are especially at risk. People who were infected as infants have a 90 percent chance of developing chronic hepatitis B.1
1

Weinbaum CM, Williams I, Mast EE et al. Recommendations for identification and public health

management of persons with chronic hepatitis B virus infection. Morbidity and Mortality Weekly Report Recommendations and Reports. 2008 September 19;57(RR8):120. [Top]

Why are Asian and Pacific Islander Americans at higher risk?

Since 1986, a hepatitis B vaccine has been available and should be given to newborns and children in the United States. The vaccine, however, is unavailableor has only recently become available in many parts of the world. You are at higher risk for hepatitis B if you or your mother was born in a region of the world where hepatitis B is common, meaning 2 percent or more of the population is chronically infected with the hepatitis B virus.1 In most Asian and Pacific Island nations, 8 to 16 percent of the population is chronically infected.2

Custer B, Sullivan SD, Hazlet TK, Iloeje U, Veenstra DL, Kowdley KV. Global epidemiology of

hepatitis B virus. Journal of Clinical Gastroenterology. 2004 November;38(10 Suppl 3):S158S168. [Top]

What are the symptoms of chronic hepatitis B?

Hepatitis B is called a silent killer because many people have no symptoms, so the disease often progresses unnoticed for years. Unfortunately, many people first learn they have chronic hepatitis B when they develop symptoms of severe liver damage, which include

yellowish eyes and skin, called jaundice a swollen stomach or ankles tiredness nausea weakness loss of appetite weight loss spiderlike blood vessels, called spider angiomas, that develop on the skin

[Top]

Who is at risk for hepatitis B?

Anyone can get hepatitis B, but some people are at higher risk, including

people who were born to a mother with hepatitis B people who have close household contact with someone infected with the hepatitis B virus people who have lived in parts of the world where hepatitis B is common, including most Asian and Pacific Island nations

people who are exposed to blood or body fluids at work people on hemodialysis people whose sex partner(s) has hepatitis B

people who have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease

injection drug users men who have sex with men

[Top]

How can I protect myself and others from hepatitis B?

Get tested if you are from an Asian or Pacific Island nation or other region where the hepatitis B virus is common. The sooner you get tested, the sooner you can take steps to protect yourself and others. A health care provider can test your blood to see if you are currently infected or were infected in the past. If you test positive, your doctor may measure virus and liver enzyme levels in your blood to determine if the virus is active or causing liver injury. The doctor may use ultrasounda procedure that uses sound waves to create images of the body's internal tissues and organsto screen for liver cancer, also called hepatocellular carcinoma. You may not need treatment right away, but you will need periodic tests to monitor the health of your liver. Encourage your family members and other close personal contacts to get tested. Hepatitis B is preventable. Get vaccinated if you have not been infected. The hepatitis B vaccine is given in three shots over 6 months. You must get all three shots to be fully protected. The vaccine is safe for people of all ages, including pregnant women and infants. If you think you have been recently exposed to the hepatitis B virus, see your doctor right away. The first dose of hepatitis B vaccine combined with hepatitis B immune globulinan injection of antibodies that temporarily protects against hepatitis B infectionmay prevent infection. No cure exists for hepatitis B, but several medicines are approved for treating chronic hepatitis B. The goal of treatment is to reduce the risk of liver damage, liver cirrhosis, and liver cancer by decreasing liver inflammation and the amount of virus in the body. Current medicines do not completely get rid of the virus, so treatment is often lifelong. People with chronic hepatitis B should avoid alcohol, drugs, supplements, and herbal medicines that may harm the liver. [Top]

How can I protect my baby from hepatitis B?

Getting tested for hepatitis B is especially important for pregnant women. If you are not infected, get the vaccine. If you have hepatitis B, make sure the doctor and staff that deliver your baby know so they can minimize your babys risk of infection. The hepatitis B vaccine and hepatitis B immune globulin should be given to your baby immediately after birth, greatly reducing the chance of infection. [Top]

Acknowledgments

What is hepatitis C?
Hepatitis* C is a virus, or infection, that causes liver disease and inflammation of the liver. Viruses can cause sickness. For example, the flu is caused by a virus. People can pass viruses to each other. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can cause organs to not work properly. *See the Pronunciation Guide for tips on how to say the underlined words. [Top]

What is the liver?

The liver is an organ that does many important things. You cannot live without a liver.

Hepatitis C is a virus, or infection, that causes liver disease and inflammation of the liver.

The liver

removes harmful chemicals from your blood fights infection helps digest food stores nutrients and vitamins stores energy

[Top]

Who gets hepatitis C?

Anyone can get hepatitis C, but those more likely to are people who

were born to a mother with hepatitis C are in contact with blood or infected needles at work have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease are on kidney dialysisthe process of filtering wastes and extra water from the body by means other than the kidneys

are infected with HIV

have injected illegal drugs have had tattoos or body piercings work or live in a prison had a blood transfusion or organ transplant before July 1992 have hemophilia and received clotting factor before 1987

Also, men who have sex with men are more likely to get hepatitis C. [Top]

How could I get hepatitis C?

You could get hepatitis C through contact with an infected persons blood. This contact could occur by

being born to a mother with hepatitis C getting an accidental stick with a needle that was used on an infected person having unprotected sex with an infected person having contact with blood or open sores of an infected person sharing drug needles or other drug materials with an infected person being tattooed or pierced with unsterilized tools that were used on an infected person using an infected persons razor, toothbrush, or nail clippers

You could get hepatitis C from sharing drug needles or other drug materials with an infected person.

You cannot get hepatitis C from

shaking hands or holding hands with an infected person being coughed or sneezed on by an infected person hugging an infected person sitting next to an infected person sharing spoons, forks, and other eating utensils drinking water or eating food

A baby cannot get hepatitis C from breast milk. [Top]

What are the symptoms of hepatitis C?

Most people do not have any symptoms until the hepatitis C virus causes liver damage, which can take 10 or more years to happen. Others may have one or more of the following symptoms:

feeling tired muscle soreness upset stomach stomach pain fever loss of appetite diarrhea dark-yellow urine light-colored stools yellowish eyes and skin, called jaundice

When symptoms of hepatitis C occur, they can begin 1 to 3 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis C. [Top]

What is acute hepatitis C?

Acute hepatitis C is a short-term infection with the hepatitis C virus. Symptoms can last up to 6 months. The infection sometimes clears up because your body is able to fight off the infection and get rid of the virus. [Top]

What is chronic hepatitis C?

Chronic hepatitis C is a long-lasting infection with the hepatitis C virus. Chronic hepatitis C occurs when the body cant get rid of the hepatitis C virus. Most hepatitis C infections become chronic. Without treatment, chronic hepatitis C can cause liver cancer or severe liver damage that leads to liver failure. Liver failure occurs when the liver stops working properly. [Top]

How is hepatitis C diagnosed?

A blood test will show if you have hepatitis C. Blood tests are done at a doctors office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis C. If you are at higher risk of getting hepatitis C, get tested. Many people with hepatitis C do not know they are infected.

A blood test will show if you have hepatitis C.

Your doctor may suggest getting a liver biopsy if chronic hepatitis C is suspected. A liver biopsy is a test to take a small piece of your liver to look for liver damage. The doctor may ask you to stop taking certain medicines before the test. You may be asked to fast for 8 hours before the test. During the test, you lie on a table with your right hand resting above your head. Medicine is applied to numb the area where the biopsy needle will be inserted. If needed, sedatives and pain medicine are also given. The doctor uses a needle to take a small piece of liver tissue. After the test, you must lie on your right side for up to 2 hours. You will stay 2 to 4 hours after the test before being sent home. A liver biopsy is performed at a hospital or outpatient center by a doctor. The liver sample is sent to a special lab where a doctor looks at the tissue with a microscope and sends a report to your doctor. [Top]

How is hepatitis C treated?

Hepatitis C is usually not treated unless it becomes chronic. Chronic hepatitis C is treated with medicines that slow or stop the virus from damaging the liver. Your doctor will closely watch your symptoms and schedule regular blood tests to make sure the treatment is working. Medicines for Chronic Hepatitis C Chronic hepatitis C is most often treated with a medicine combination that attacks the hepatitis C virus. Treatment may last from 24 to 48 weeks. Today, newer treatments with medicine for chronic hepatitis C are appearing quickly. Talk with your doctor if you have questions about treatment. Talk with your doctor before taking other prescription medicines and over-the-counter medicines.

Liver Transplant A liver transplant may be necessary if chronic hepatitis C causes severe liver damage that leads to liver failure. Symptoms of severe liver damage include the symptoms of hepatitis C and

generalized itching a longer than usual amount of time for bleeding to stop easy bruising swollen stomach or ankles spiderlike blood vessels, called spider angiomas, that develop on the skin

Liver transplant is surgery to remove a diseased or injured liver and replace it with a healthy one from another person, called a donor. If your doctors tell you that you need a transplant, you should talk with them about the long-term demands of living with a liver transplant. A team of surgeonsdoctors who specialize in surgeryperforms a liver transplant in a hospital. You will learn how to take care of yourself after you go home and about the medicines youll need to take to protect your new liver. You will continue to take medicines because hepatitis C may come back after surgery. Testing for Liver Cancer Having hepatitis C increases your risk for liver cancer, so your doctor may suggest an ultrasound test of the liver every 6 to 12 months. Finding cancer early makes it more treatable. Ultrasound is a machine that uses sound waves to create a picture of your liver. Ultrasound is performed at a hospital or radiology center by a specially trained technician. The image, called a sonogram, can show the livers size and the presence of cancerous tumors.

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How can I avoid getting hepatitis C?

You can protect yourself and others from getting hepatitis C if you

do not share drug needles and other drug materials do not donate blood or blood products wear gloves if you have to touch another persons blood or open sores do not share or borrow a toothbrush, razor, or nail clippers make sure any tattoos or body piercings you get are done with sterile tools tell your doctor and your dentist if you have hepatitis C use a condom during sex

A vaccine for hepatitis C does not yet exist.

Do not share drug needles and other drug materials.

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What should I do if I think I have been in contact with the hepatitis C virus?
See your doctor right away if you think you have been in contact with the hepatitis C virus. Early diagnosis and treatment of chronic hepatitis C can help prevent liver damage.

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Eating, Diet, and Nutrition

If you have chronic hepatitis C, you should do things to take care of yourself, including eating a healthy diet. Avoid drinking alcohol, which can harm the liver. Talk with your doctor before taking vitamins and other supplements. [Top]

Points to Remember

Hepatitis C is a virus, or infection, that causes inflammation of the liver. Anyone can get hepatitis C, but some people are more likely to than others. You could get hepatitis C through contact with an infected persons blood. Most people do not have any symptoms until the hepatitis C virus causes liver damage, which can take 10 or more years to happen.

See a doctor right away if you or a child in your care has symptoms of hepatitis C. Acute hepatitis C is a short-term infection with the hepatitis C virus. Chronic hepatitis C is a long-lasting infection with the hepatitis C virus. Chronic hepatitis C occurs when the body cant get rid of the hepatitis C virus.

A blood test will show if you have hepatitis C. If you are at higher risk of getting hepatitis C, get tested. Many people with hepatitis C do not know they are infected.

Hepatitis C usually is not treated unless it becomes chronic. Chronic hepatitis C is treated with medicines that slow or stop the virus from damaging the liver.

Tell your doctor and your dentist if you have hepatitis C.

See your doctor right away if you think you have been in contact with the hepatitis C virus. Early diagnosis and treatment of chronic hepatitis C can help prevent liver damage.

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Hope through Research

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts and supports basic and clinical research into many digestive disorders, including hepatitis C. A team of NIDDK researchers has shown that a dietary supplement, S-adenosyl methionine (SAMe), safely and effectively boosts response to standard medicine therapy in people infected with a type of hepatitis C virus that typically does not respond well to such therapy. More information about the study can be found under clinical trial number NCT00475176. Researchers in the NIDDK-funded Peds-C Clinical Research Network conducted a clinical trial at 11 U.S. medical centers in which they treated children ages 5 to 18 years who have chronic hepatitis C. The study found that the combination of peginterferon and ribavirin is more effective than treatment with peginterferon and placebo in treating chronic hepatitis C in children. More information about the study can be found under clinical trial number NCT00100659. Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.