Hepatitis A? B? C? D?

Symptoms Most people do not experience symptoms when newly infected. Chronic symptoms, which may not appear for decades, include fatigue, nausea, muscle aches and pains, abdominal discomfort, and depression.

Prevention There is no vaccine for hepatitis C. However, hepatitis C transmission is easily prevented if you are blood-safe. Avoid non-sterile injecting, tattooing or body-piercing equipment. Do not share household items which may carry particles of blood (combs, razors, toothbrushes, etc). Follow standard infection control guidelines for First Aid. Testing Hepatitis C testing involves: • an antibody test to see if you have been exposed to the virus and, if your antibody test is positive, this is followed by • a PCR test to confirm if you still have the virus.

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Sources • who.int/news-room/fact-sheets/detail/hepatitis-d • who.int/news-room/fact-sheets/detail/hepatitis-b • hepatitissa.asn.au/about-hepatitis/hepatitis-c • who.int/news-room/fact-sheets/detail/hepatitis-a • hepatitissa.asn.au/about-hepatitis/hepatitis-b • hepb.org/research-and-programs/hepdeltaconnect/ treatment/ • hepb.org/research-and-programs/hepdeltaconnect/ what-is-hepatitis-delta

Hepatitis A? B? C? D?

The Hepatitis D virus (HDV), also known as hepatitis delta, can only live alongside hepatitis B, making use of that virus to multiply itself. This means it can only infect someone at the same time as they are exposed to hepatitis B, or if they already have hepatitis B. Coinfection leads to more serious liver disease than hepatitis B infection alone, with faster progression to liver fibrosis, increased risk of liver cancer and liver failure.

Hepatitis D symptoms are inseparable from the symptoms of hepatitis B.

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Although hepatitis D is uncommon in Australia, it is important that people with hepatitis B are tested for hepatitis D. Transmission Hepatitis D virus is transmitted via the same routes as the hepatitis B virus (see above).

Prevention Because hepatitis D depends on hepatitis B to exist, the hepatitis B vaccine will also prevent hepatitis D. Treatment Hepatitis D is difficult to treat. On-going monitoring by a liver specialist is recommended. The first hepatitis D drug introduced in Europe in July 2020 is still being evaluated for its long-term effects.

ABCD

Hepatitis SA Ph 1800 437 222 or (08) 8362 8443 3 Hackney Rd Hackney SA 5069 PO Box 782 Kent Town SA 5071 www.hepsa.asn.au Last update: February 2021 SA Health has contributed funds towards this Program.

Cover image derved from photo by Joanna Poe [flickr.com/photos/jopoe]

Treatment Hepatitis C can be cured. For most people, hepatitis C treatment consists of a tablet taken once a day for 8 to 12 weeks. Being cured of hepatitis C does not protect you from being infected again.

HEPATITIS D

What is Hepatitis?

‘Hepatitis’ means inflammation of the liver. Viral hepatitis refers to hepatitis resulting from infection of the liver by viruses, most commonly hepatitis A, B, C or D. Each of these is a different disease caused by a different virus with different modes of transmission, treatment and health outcomes.

Short-term hepatitis is described as “acute” and long-term hepatitis that lasts more than six months is termed “chronic”.

There are vaccines to prevent hepatitis A, B and D, but there is no vaccine for hepatitis C. However, hepatitis C can be cured.

Hepatitis A

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Hepatitis A is an inflammation of the liver caused by the hepatitis A virus (HAV).

Transmission HAV is transmitted through ingestion of food or water contaminated by faecal matter, direct contact with an infectious person or unprotected oral-anal sex.

Symptoms & Outcomes Symptoms may include fever, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-coloured urine and jaundice (a yellowing of the skin and whites of the eyes). Not everyone will have all the symptoms.

Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small proportion of people infected with hepatitis A could develop sudden liver failure (fulminant hepatitis), which can be fatal.

Prevention There is a safe and effective vaccine against hepatitis A. Other preventions are safe water supply, food safety, improved sanitation and hand washing.

People travelling overseas should check health advice and consider vaccination if they are not already immune.

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Hepatitis B

Hepatitis B is inflammation of the liver caused by the hepatitis B virus (HBV).

About 90% of adults and 10% of children who get hepatitis B will recover within six months and are immune for life. The remaining 10% of adults, and 90% of children, will develop chronic hepatitis B. One in four people with chronic hepatitis B may develop serious liver disease including liver cancer.

A small number of people, when first infected, may develop acute liver failure which can lead to death.

Transmission Hepatitis B is spread when infected blood enters the bloodstream of a person with no hepatitis B immunity. It is also transmitted via semen and vaginal fluid. This can happen during • birth (from mother to infant) • unprotected sexual activity • sharing injecting equipment • body art and piercing with unsterilised equipment • non-sterile medical, dental or cosmetic procedures • household contact through open cuts and scratches Hepatitis B is not transmitted via hugs, sneezes, coughs, saliva, water, food or faeces.

Symptoms Most people, especially children, do not experience symptoms when newly infected, but some may have acute illness with symptoms including jaundice, dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

Similarly, people with chronic hepatitis B often experience no symptoms. Symptoms, if any, may include abdominal discomfort and fatigue.

Prevention The best prevention is vaccination. Universal hepatitis B vaccination for infants and people at high risk has been implemented in Australia since 2000.

It is also important to practise safe sex, and to avoid non-sterile injecting, tattooing or body-piercing equipment. If you’re newly exposed to HBV, an immunoglobulin injection can help stop the disease.

Do not share household items which may carry particles of blood (combs, razors, toothbrushes, etc).

Follow standard infection control guidelines for First Aid. Testing A simple blood test will show whether you: • are immune to hepatitis B • have had hepatitis B before and cleared it • have chronic hepatitis B Treatment There is currently no cure for hepatitis B but there is effective treatment to control the virus and slow down liver damage. Everyone with hepatitis B needs regular check-ups (usually every six months) so that treatment can be started if and when it is needed, and serious liver disease including cancer can be detected early.

Hepatitis C

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Hepatitis C is inflammation of the liver caused by the hepatitis C virus (HCV). About 25% of people who get the virus will get rid of it naturally. The remaining 75% will develop chronic hepatitis C. Left untreated, 1 in 5 people with chronic hepatitis C may develop serious liver disease, including liver cancer.

Transmission Hepatitis C is spread by blood to bloodstream. This may be during • sharing injecting equipment, • body art and piercing with unsterilised equipment • non-sterile medical, dental or cosmetic procedures • unprotected sexual activity where blood is present