THE A, B, C S OF HEPATITIS. Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas (972)

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1 THE A, B, C S OF HEPATITIS Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas (972)

2 WHAT IS HEPATITIS? Hepatitis means inflammation of the liver Hepatitis is also the name of a family of viral infections that affect the liver

3 VIRAL HEPATITIS TYPES 5 types: A: fecal-oral transmission B: sexual fluids & blood to blood C: blood to blood D: travels with B E: fecal oral transmission Vaccine Preventable

4 WHY IS YOUR LIVER IMPORTANT? Liver The liver is a part of the digestive system The liver has four main functions: Purification Synthesis Storage Transformation

5 HEALTHY LIVER VS. SICK LIVER This is a healthy liver This is a sick, scarred liver (cirrhosis)

6 STAGGERING STATISTIC The total medical expenditures for people with Hepatitis is $15 Billion/year.

7 HEPATITIS A STATISTICS Between 11% and 22% of persons who have the disease are hospitalized. Adult case of hepatitis A will result in 27 lost days of work. Average costs (direct and indirect) of hepatitis A range from $1,817 to $2,459 per case for adults. Health departments incur substantial costs responding to outbreaks up to $500M/year. Colorado food-borne outbreak affected 43 persons and cost the community $800,000.

8 HOW IS HEP A TRANSMITTED? A person can get hepatitis A through: Person to person contact Contaminated food or water

9 PREVALENCE OF HEP A

10 SYMPTOMS OF HEP A Does hepatitis A cause symptoms? Not always. Some people get hepatitis A and have no symptoms of the disease. Adults are more likely to have symptoms than children. What are the symptoms of hepatitis A? Some people with hepatitis A do not have any symptoms. If you do have symptoms, they may include the following: Fever Fatigue Loss of appetite Nausea Vomiting Abdominal pain Dark urine Clay-colored bowel movements Joint pain Jaundice (a yellowing of the skin or eyes)

11 WAYS TO PREVENT HEPATITIS A Hygiene (e.g., hand washing) Sanitation (e.g., clean water sources) Hepatitis A vaccine (pre and post exposure) Immune globulin (pre and post exposure)

12 HEPATITIS A VACCINE IMPACT Vaccine was introduced in 1995 The rate of acute Hepatitis A in the US has steadily decreased since 1996 Source: CDC

13 WHO SHOULD GET VACCINATED? Hepatitis A vaccination is recommended for: All children > 1yr Travelers Homosexual Men Drug Users People with chronic liver diseases

14 HEPATITIS A Source of virus Virus transmission Incubation period Chronic infection Pre/Post Prophylaxis Prevention Feces Fecal-oral days No Pre and Post (vaccine and IG) Hep A Vaccine Ensure safe drinking water Risk behavior modification (promote hand washing)

15 HEPATITIS B STATISTICS 1.4 million Americans are chronically infected with hepatitis B Responsible for 5,000 deaths annually Medical costs and lost wages as the result of HBV annually is $658 million

16 HOW IS HEP B TRANSMITTED? Through contact with blood, semen, or other body fluid infected with the hepatitis B virus. Examples include: Birth (spread from an infected mother to her baby during birth) Sex with an infected partner Sharing needles, syringes, or other drug-injection equipment Sharing items such as razors or toothbrushes with an infected person Direct contact with the blood or open sores of an infected person Exposure to blood from needlesticks or other sharp instruments

17 PREVALENCE OF HEP B

18 SYMPTOMS OF HEP B Symptoms of acute hepatitis B, if they appear, can include: Fever Fatigue Loss of appetite Nausea Vomiting Abdominal pain Dark urine Clay-colored bowel movements Joint pain Jaundice (yellow color in the skin or the eyes)

19 HEPATITIS B TRENDS The rate of acute Hepatitis B in the US has steadily decreased since 1996 Source: CDC

20 WAYS TO PREVENT HEPATITIS B Get vaccinated against hepatitis B. Wear gloves and dispose of syringes properly if you are a person who works with blood at your job (medical personnel, laboratory researchers, police officers and those in related fields). Practice safe sex Avoid sharing toothbrushes and razors with other people. Try to limit sharing foods with other people, especially foods that involve a high potential for saliva exchange (such as chewing gum and drinks). Check that all equipment used for body piercing and tattooing is sterile.

21 WHO SHOULD GET VACCINATED? Hepatitis B vaccination is recommended for: All infants Required vaccination for school Sexually active persons who are not in a long-term, mutually monogamous relationship Injection drug users Healthcare and public safety workers Residents and staff of facilities for developmentally disabled persons Travelers Dialysis patients

22 HEPATITIS B Source of virus Virus transmission Incubation period Chronic infection Pre/Post Prophylaxis Prevention Blood/body fluids Percutaneous, permucosal days Yes Pre and Post (vaccine and IG) Donor screening; risk behavior modification Source: CDC

23 HEPATITIS C STAGGERING STATISTICS Between 4 and 5 million Americans (approximately 2% of the population) are infected with HCV. Chronic HCV is responsible for 40-60% of liver disease in the U.S and accounts for the majority of liver transplants 8,000-10,000 Americans die each year from HCV-related liver disease, by 2010 special studies indicate that 30,000 people will die annually from HCV in the U.S. Direct medical costs and lost wages is $750 million/year Cost of premature disability and death projected from 2010 to 2019 if inaction continues related to HCV is $75.5 billion.

24 HOW IS HEP C TRANSMITTED? Through contact with blood, semen, or other body fluid infected with the hepatitis C virus. Examples include: Sharing needles, syringes, or other equipment to inject drugs Needlestick injuries in healthcare settings Being born to a mother who has hepatitis C Sharing personal care items that may have come in contact with another person s blood, such as razors or toothbrushes Having sexual contact with a person infected with the hepatitis C virus

25 HEPATITIS C TRENDS The rate of acute Hepatitis C in the US has seen an increase since 2003 Source: CDC

26 THE BAD NEWS IS There is no Hepatitis C vaccine.

27 SYMPTOMS OF HEP C Approximately 70% 80% of people with acute hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms soon after being infected, including Fever Fatigue Loss of appetite Nausea Vomiting Abdominal pain Dark urine Clay-colored bowel movements Joint pain Jaundice (yellow color in the skin or eyes)

28 LONG TERM EFFECTS OF HEP C Of every 100 people infected with the hepatitis C virus, about people will develop chronic hepatitis C virus infection; of those, people will go on to develop chronic liver disease 5 20 people will go on to develop cirrhosis over a period of years 1 5 people will die from cirrhosis or liver cancer

29 TREATMENT Home Self Care include: Rest, adequate nutrition, and fluids Avoid alcohol Avoid medications that harm the liver Avoid prolonged, vigorous exercise Medical Treatments include: Starting Medications after consultation with Gastroenterologist or Liver Specialist Liver transplant

30 PREVENTION Never share tooth brushes/razors or any personal hygiene articles that have blood on them (even tiny amounts). Practice safe sex Always make sure new & sterilized equipment is being used for tattooing & piercing Make sure ink for tattooing is not being shared Do not touch dirty needles without proper equipment or following proper procedures Never share drug equipment

31 HEPATITIS C Source of virus Virus transmission Incubation period Chronic infection Pre/Post Prophylaxis Blood/body fluids Percutaneous, permucosal days Yes None Prevention Donor screening; risk behavior modification Source: CDC

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