Dr. MJ Bazos MD, Patient Handout
Hepatitis B and C
What are chronic hepatitis B and chronic hepatitis C?
Hepatitis B and C are similar kinds of liver infection that are caused by viruses. Chronic hepatitis B and C are long-term infections of the liver that develop after a bout of acute hepatitis.
How does a person get hepatitis B or C?
Hepatitis B or C can be caught in different ways. Hepatitis B and hepatitis C are spread by contact with infected blood or other body fluids of people who have hepatitis B or C infection. For example, you can get hepatitis B and C by having sex with an infected person.
People who use intravenous drugs can get hepatitis B or C when they share needles with someone who has the virus. Health care workers, such as nurses, lab technicians and doctors, can get these infections if they are accidentally stuck with a needle that was used on an infected patient.
What are the symptoms of acute hepatitis B or C?
Symptoms of hepatitis B or C include headache, nausea, vomiting, abdominal pain, jaundice (the skin turns yellow), weakness and fatigue. Bowel movements may be gray in color. The urine may be dark and look like tea.
Sometimes, though, hepatitis is a mild illness. If you have a mild case of hepatitis, you may not even realize that you have it. It may not cause symptoms or may only cause symptoms similar to the stomach flu. You might think you have the flu, and not know you have hepatitis.
What is the difference between acute and chronic hepatitis?
When you are having symptoms, hepatitis is in the acute stage. The acute stage can last from several weeks to several months. In some people, hepatitis B or C becomes an illness that lasts a long time, a condition called chronic hepatitis. Other people recover from the infection and have no long-lasting problems.
After a person has recovered from acute hepatitis, chronic hepatitis can set in. Chronic hepatitis occurs when the liver has been damaged from the acute illness and doesn't recover. Chronic hepatitis develops in 10% to 20% of people who have hepatitis B and in 30% to 50% of people who have hepatitis C.
Are there any symptoms with chronic hepatitis B or C?
People with chronic hepatitis B or C may not have any symptoms at all. But in some people, chronic hepatitis can lead to cirrhosis of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The liver stops working and can't cleanse the body of wastes. People in the early stages of cirrhosis may not have symptoms. When cirrhosis gets worse, symptoms begin. They may include weight loss, fatigue, jaundice, nausea, vomiting and loss of appetite. Cirrhosis can lead to liver failure (the liver stops working) and liver cancer.
How long does it take chronic hepatitis to develop after acute hepatitis?
The time between the acute illness and signs of chronic hepatitis varies. It may take a short time, or it may take years after the acute infection before chronic hepatitis develops.
How is chronic hepatitis diagnosed?
Blood tests are used to diagnose chronic hepatitis B and C. Blood tests can also tell your doctor whether your liver is working properly. They can also be used to follow your condition during treatment.
Your doctor may also want to look at your liver with an ultrasound exam and x-rays. A liver biopsy may also be needed. With a liver biopsy, a small piece of the liver is removed through a needle and looked at under a microscope. A liver biopsy may help your doctor find out what is wrong with your liver.
How are chronic hepatitis B and C treated?
Interferon alfa-2b (brand name: Intron A) is used to treat chronic hepatitis B or C. This drug helps the immune system fight the hepatitis virus. Treatment with interferon alfa-2b is successful in many patients with chronic hepatitis B or C.
Interferon alfa-2b is given as a shot. The shots may be given every day, every other day, or 3 times a week. Lamivudine (brand name: Epivir) is another medicine used to treat hepatitis B or C. It is given as a pill. Treatment may last for a number of months. The length of treatment depends on how severe the chronic infection is. To increase your chance of recovering from chronic hepatitis, it is important to complete the entire course of treatment.
Are there side effects from interferon alfa-2b?
Yes, there may be side effects from this drug. The most common side effects are flu-like symptoms, such as fever, headache, fatigue, nausea, vomiting and loss of appetite. You can reduce the side effects by taking the drug right before bedtime. The longer interferon alfa-2b is taken, the more likely that the side effects will go away. Your doctor can give you advice about what you can do to relieve some of the side effects.
Can hepatitis B or C be prevented?
The best way to prevent hepatitis B or hepatitis C is to avoid sharing needles and having unprotected sex (without a condom).
A vaccine is available to prevent hepatitis B. This vaccine should be given to people who are at high risk for this illness, such as health care workers, all children, drug users, people who get tattoos or body piercing, prostitutes and homosexuals with multiple sex partners. No vaccine is available for hepatitis C.
American Liver Foundation: http://www.liverfoundation.org