Hepatitis A, B & C

Hepatitis A, B & C are all viruses that cause inflammation of the liver. There are three different kinds of Hepatitis. Each has different symptoms and different treatments.

Hepatitis A

Hepatitis A is a virus which can cause inflammation of the liver. Symptoms can include a mild flu-like illness, vomiting, abdominal pain and jaundice.

It is transmitted through small quantities of infected faeces entering a person’s mouth through activities such as anal play, rimming and by not washing hands properly after sex with an infected person. It can also be passed on by using eating and drinking utensils previously used by an infected person. People are infectious for around three weeks, starting two weeks before they develop symptoms to about a week afterwards.

Hepatitis A can be detected by a blood test.

People with hepatitis A infection should avoid drugs, alcohol, excessively fatty diets or anything that may affect the liver. If you suspect that you have Hepatitis A you should see your doctor.

While hepatitis A will not seriously impact upon HIV, it may lead to difficulties of compliance with anti-retroviral medication if there is severe nausea and vomiting.

People who get hepatitis A will recover and develop permanent immunity to the virus.

An effective vaccination against hepatitis A is available. A combination hepatitis A & B vaccination is also available. Gamma globulin can also be used to provide immediate protection against hepatitis A for unimmunised people at high risk of infection. See a GP for more information. NZAF recommends the twinrix vaccination for hepatitis A & B.

Hepatitis B

Hepatitis B is a virus that causes inflammation of the liver.

Symptoms, if they are present, will show up one to six months after exposure and may include loss of appetite, tiredness, nausea, jaundice and dark urine.

It is transmitted by infected blood or cum entering a person’s bloodstream through activities such as unprotected sex, sharing injecting equipment, toothbrushes or razors, oral sex, tattooing or body piercing with unsterile equipment.

Hepatitis B can be detected by a blood test.

Most people recover from hepatitis B. Some retain the virus in their body and there are treatments for these people. Speak to your doctor.

Co-infection with both HIV and hepatitis B may lead to more rapid progression of hepatitis B to liver cancer. Treatment for hepatitis B may also be less successful and limited by resistance to some antiviral medications that may already have been used for HIV treatment.

There is an effective hepatitis B vaccination. A combination hepatitis A & B vaccination (twinrix) is also available. See your doctor.

Hepatitis C

Hepatitis C (HCV) is a virus that causes serious damage to the liver. For some people this can lead to cirrhosis, or scarring of the liver, and eventually to liver failure and death after many years.

In the early stages of hepatitis C, symptoms may be absent and they can take years after the initial infection to show up. If they are present, symptoms may include fatigue, nausea, pain under the ribs, sweating and intolerance of fatty diets.

The virus is spread by blood to blood contact. Most hepatitis C is transmitted by sharing injecting equipment or other blood contact. Strictly speaking hep C isn’t considered an STI. However, there is now definitive evidence that it can be passed on during sex – and especially during group sex. It can be transmitted when tiny amounts of blood are present on fingers, fists, toys or penises which are moved from one anus to the next without being cleaned.

75% of people infected with hep C may carry the virus in their blood for life and 15% of these people may develop cirrhosis of the liver. A small number of people with cirrhosis may develop liver cancer or liver failure.

Hepatitis C can be detected by a blood test.

Maintaining a healthy diet, reducing alcohol intake and cutting down on smoking can improve the body’s ability to cope with hepatitis C. There have been major developments in hep C treatment during 2010, and these new medications are currently going through the funding approval process in New Zealand. 

Co-infection with hepatitis C and HIV is not uncommon, though many who are co-infected are unaware of it. Co-infection is dangerous because it can speed up the progress of both infections and make both more difficult to treat.

People who inject drugs and share equipment are at a high risk of contracting hepatitis C. If injecting, do not share any equipment including spoons and tourniquets.

Wash hands, penis and toys and change condoms and gloves when moving from anus to anus during group sex.

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