Hepatitis A is caused by a virus

A virus is a germ that causes sickness. (For example, the flu is caused by a virus.) People can pass viruses to each other. The virus that causes hepatitis A is called the hepatitis A virus.

How could I get hepatitis A?

Hepatitis A is spread by close personal contact with someone else who has the infection.

You could also get hepatitis A by:

· eating food that has been prepared by someone with hepatitis A

· drinking water that has been contaminated by hepatitis A (in parts of the world with poor hygiene and sanitary conditions)

Who can get hepatitis A?

Anyone can get hepatitis A. But some people are more likely to than others:

· people who live with someone who has hepatitis A

· children who go to day care

· people who work in a day care center

· men who have sex with men

· people who travel to other countries where hepatitis A is common

What are the symptoms?

Hepatitis A can make you feel like you have the flu.

You might:

 feel tired

 feel sick to your stomach

 have a fever

 not want to eat

 have stomach pain

 have diarrhea

Some people have:

· dark yellow urine

· light-colored stools

· yellowish eyes and skin

Some people don't have any symptoms.

If you have symptoms, or think you might have hepatitis A, go to a doctor. The doctor will test your blood.

How is hepatitis a treated?

Most people who have hepatitis A get well on their own after a few weeks.

You may need to rest in bed for several days or weeks, and you won't be able to drink alcohol until you are well. The doctor may give you medicine for your symptoms.

How can I protect myself?

You can get the hepatitis A vaccine. A vaccine is a drug that you take when you are healthy that keeps you from getting sick. Vaccines teach your body to attack certain viruses, like the hepatitis A virus.

The hepatitis A vaccine is given through a shot. Children can get the vaccine after they turn 2 years old. Children aged 2 to 18 will need three shots. The shots are spread out over a year. Adults get two or three shots over 6 to 12 months.

You need all of the shots to be protected. If you miss a shot, call your doctor or clinic right away to set up a new appointment.

You can protect yourself and others from hepatitis A in these ways, too:

· Always wash your hands after using the toilet and before fixing food or eating.

· Wear gloves if you have to touch other people's stool. Wash your hands afterwards.

· Drink bottled water when you are in another country. (And don't use ice cubes or wash fruits and vegetables in tap water.)

What You Should Know About Hepatitis C

Scientists isolated and sequenced the hepatitis C virus (HCV) genome 10 years ago. This led to the development of diagnostic tests to identify people infected with HCV. Almost 4 million people in the United States or 1.8 percent are persistently infected, and the Institute of Medicine now includes hepatitis C virus in its list of emerging infectious diseases. Those with the greatest risk of infection are individuals who ever experimented with injection drugs, even once or twice in the distant past, had multiple sexual partners, or received blood or blood products, for example, a transfusion prior to 1992.

The Disease

HCV damages the liver, one of the body's most important organs. Symptoms of both acute and chronic infections are easily confused with less serious and shorter-term illnesses. In fact, most infected people are relatively free of physical symptoms -- signs of liver damage may not occur for a couple of decades. Unfortunately, by the time the disease becomes apparent, liver damage can be considerable and even irreversible.

HCV is not related to the other hepatitis viruses (A-E) and diagnostic tests readily distinguish them. The virus is usually detected by an antibody test. Unlike many other infections, the presence of antibodies in the blood does not mean recovery. Although rare, recovery does occur; it can be confirmed using highly sensitive diagnostic tests that detect the viral genome (RNA). Unfortunately, such tests are not yet licensed and there is laboratory variability.

Roughly 50 percent of chronic carriers do not even know they have hepatitis C, a disease that moves through specific stages of liver damage. Currently, diagnosis of the stage requires a liver biopsy, i.e., removal of a very small piece of the liver, and evaluation of an even smaller piece using a microscope. The rate of progression is highly individual and can be characterized as slow, medium or fast. For most people it is slow, i.e., after 20 years of chronic infection, only 20 percent of individuals progress to cirrhosis. Alcohol and other hepatitis viruses hasten progression of the disease. Thus, if they know they are infected, individuals can help themselves by not using alcohol, and by getting vaccinated to prevent hepatitis A and B.

Treatments

The Food and Drug Administration (FDA) has approved treatments that can get rid of the virus and make the liver more normal. Three are interferons and the fourth combines interferon and ribavirin. Unfortunately, none of these drugs is very effective (approximately 5 percent of infections are eradicated with interferons and 35 percent with the combination) and all have significant side effects. Currently, there is no way to predict who will or won't respond. However, the best responses are seen in those patients with HCV variants (genotypes) 2 and 3, less severe fibrosis, and who are female or are under the age of 40 years. It is important to note that genotype 1, which predominates in this country, is least responsive to treatment.

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