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Hepatitis B and Hepatitis C Information

Hepatitis B information

The term "hepatitis" is used to describe a common form of liver injury. Hepatitis simply means "inflammation of the liver". There are many causes of hepatitis; examples include alcohol, certain drugs, poisonous mushrooms, and viruses

What do I need to do?

Do not share toothbrushes, razors, hair brushes
Avoid alcohol, herbs and panadol (paracetamol) in doses over 2gm a day
Cover all cuts or sores, wash your hands after touching your blood or body fluids
Do not donate blood, plasma, body organs, tissue, or sperm.
Carefully dispose of menstrual pads and tampons
Do not share syringes and needles
Hepatitis B is not spread by casual contact such as holding hands, kissing on the cheek, eating food prepared by a carrier; sneezing or coughing.

Can I Give the Disease to Others?

Hepatitis B can be transmitted through infected blood, instruments, needles, bodily fluids and sexual contact. Condoms are recommended during sex with a new partner but are not required if your long term partner has been vaccinated. The risk of transmitting hepatitis B during pregnancy may depend upon the level of virus in your blood stream. In general, the risk is about 5% (about 1 in 20) but is increased in people who are also infected with HIV

Immunisation with the vaccine is recommended for family & household contacts of individuals with Hep B.

What is the Natural History of Hepatitis B?

5% of adults (1 in 20) the virus makes itself at home in the liver, where it continues to make copies of itself for many years. People who continue to harbour the virus are referred to as "carriers" while liver damage associated with longstanding infection is referred to as "chronic hepatitis" 95% chance that Hep B virus will clear itself from your body within 6 months of acquiring it if acquired over 2 years of age. However there is a 95% chance of becoming a chronic carrier is acquired as a young child.

In general, however, chronic hepatitis B appears to be a slowly progressive disease that may gradually advance over 10-40 years.

Some patients develop NO significant liver disease or fibrosis (scarring)
Most patients develop mild to moderate liver disease variable fibrosis (scarring) over 10 - 20years
20% of patients develop severe liver disease with cirrhosis (scarring) in 5 years
20% of patients with cirrhosis develop liver cancer or liver failure in 5 years
A liver biopsy is typically done prior to treatment to determine the severity of liver damage and provide confirmation of the underlying disease. This involves obtaining a tiny sample of the liver tissue and looking at it under a microscope.

Is There a Treatment for Chronic Hepatitis B?

Treatment options currently include Lamivudine tablets or interferon injections.

Lamivudine has no side effects and is very effective in switching off viral replication in over 99% of patients. Approximately 20% of patients per annum are able to clear the virus. However 20% relapse after treatment has ceased.

Interferon therapy may cause side effects such as "flu-like" symptoms, depression, headache, and decreased appetite. In addition, interferon may depress immune system, increasing the risk of serious infections. Frequent blood tests are needed to monitor white blood cells, platelets and liver enzymes.

Hepatitis C

Hepatitis C is a blood borne virus that can cause long term inflammation of the liver. Approximately 240,000 Australians are living with the hepatitis C virus which is slow acting and for most people will not result in serious disease or death. A number of people may not experience symptoms whilst others will experience symptoms ranging from mild to severe. Many of these symptoms appear to be related to the immune system responding to the virus.

Transmission

The hepatitis C virus is transmitted by blood. Hepatitis C positive blood must get into your bloodstream before transmission can occur. Groups of people who have been most at risk of contracting hepatitis C in Australia are injecting drug users, male haemophiliacs who had blood product transfusions before 1990 and prisoners due to the high prevalence of injecting drug use.
Common ways that Australians have been infected with Hepatitis C include:

The sharing of injecting drug equipment
Recipients of blood transfusions or blood products prior to 1990 (highest in multiple transfused)

Tattoos, body piercing and skin penetration (when non sterilised equipment has been used)
A number of Australians contracted hepatitis C in other countries probably via non-sterile medical or dental injections or other procedures

Hepatitis C is not commonly transmitted during sex and is not classified as a sexually transmitted disease (STD). There is only a risk of transmission when there is potential for blood to blood contact during sex. The risk of blood to blood contact may increase when an STD such as herpes is present. The virus is present in menstrual blood of women who are hepatitis C positive and protective sex (using condoms, dams and/or gloves) should be practiced during menstruation.
The risk of mother to baby transmission of hepatitis C is approximately 5%. Women with hepatitis C are encouraged to have natural births and to breastfeed unless nipples are cracked and bleeding.
Hepatitis C is totally different to HIV and AIDS and one of these viruses cannot lead to the other.

Affects

Hepatitis C involves an initial (acute) phase of infection which often goes unnoticed and lasts about 2-6 months. Approximately 5-10% of people experience symptoms during this period. During this phase the levels of the virus rise dramatically until the body's immune response starts producing antibodies.
Based on the analysis of current literature on the progression of hepatitis C, it appears that 65-85% of people with Hep C infection will progress to chronic or long term infection. Among people with chronic infection, 5-10% will progress to cirrhosis by 20 years of infection, and possibly 20% by 40 years of infection. Progression to cirrhosis is more likely in people with heavy alcohol intake, co infection with HIV and chronic Hepatitis B infection, and those with already severe fibrosis on liver biopsy.

Antibody Tests

A hepatitis C positive antibody test result can leave many people feeling very distressed, anxious and depressed. Accessing accurate information and support at this point is very important and can help people cope through this difficult period.
A Hep C anti-body positive test result means that at some stage of your life you have been infected with the Hepatitis C virus. A liver function test is usually done to help determine if you have the virus. If your liver enzymes are elevated (particularly your ALT's) then there is a strong chance that you still have the virus. If you have had a Hep C positive antibody test and had normal liver function results for two consecutive tests six months apart you are eligible to have a Medicare covered PCR test. A qualitative PCR test will indicate if the virus is present or not (contact the Hepatitis C Council of SA Inc for specific details on all aspects of testing).

Hepatitis C is not a death sentence and with good medical advice, support and accurate information most people can manage the virus effectively in their lives. Call the Hepatitis C Council for details on information and support groups.

Symptoms

During the initial (acute) phase a small number of people may experience flu-like symptoms. Some people may develop nausea, abdominal pain, back pain and extreme tiredness. Most people do not experience any symptoms for the first ten years or more after their initial infection. Symptoms of chronic infection can range from mild to severe. These symptoms can occur continuously or in bouts.

The most common symptoms of chronic hepatitis C infection are:

fatigue or tiredness
lethargy
nausea and discomfort in abdominal region
feeling ill after drinking alcohol or eating fatty food
depression
Symptoms associated with cirrhosis appear to vary from mild to severe and are essentially similar to those of chronic hepatitis C. whilst many people with cirrhosis may experience no symptoms, others may experience profound lethargy and significant discomfort in the liver region. Cirrhosis is a serious and complex condition requiring specialised medical support.
Many people have found that some symptoms can be alleviated by reducing or stopping alcohol consumption, reducing fat in their diet and by using a variety of complementary therapies such as Chinese herbs, acupuncture and vitamin/ herbal supplements such as St Mary's Thistle (Silymarin) and dandelion root.

Treatment

It is essential that you feel well informed before deciding on any treatment path. Talk to your GP and/or specialist or contact the Hepatitis C Council to talk with people who have had a personal experience of treatment. Most people would be able to take their time when making a decision about whether to commence treatment or not. Gain a good understanding of the stage of progression for your Hep C, current treatment options and what's possibly going to be available in the future.

Combination Therapy

Many people are using complementary therapies to improve their health and general wellbeing. It is important to ensure that your practitioner is qualified and registered. It is also important to understand that some herbs can be toxic to the liver.

Liver Clinics

Albury/Wodonga
Telephone: 02 6024 5255

Alfred Hospital
Telephone: 9276 2223

Austin/Repatriation Medical Centre
Telephone: 9496 2787

Ballarat Liver Clinic
Telephone: 5332 9210

Ballarat North - Dr Jon Watson
Telephone: 5331 8289

Bayside Hepatitis Clinic
(through the Alfred Liver Clinic)
Telephone: 9276 2223

Box Hill Hospital
Telephone: 9895 3333

Epping - Northern Hospital Liver Clinic
Telephone: 9219 8335

Geelong Liver Clinic
Telephone: 5226 7111

Knox Private Hospital
(St Vincent's Hepatitis Clinic)
Telephone: 9210 7300

Maroondah Hospital
Telephone: 9871 3371

Monash Medical Centre
Telephone: 9594 5545

Peninsula Liver Clinic
Telephone: 9781 4434

Royal Melbourne Hospital
Telephone: 9342 7212

Sale - Fitzpatrick House
Telephone: 5144 4555

Springvale Liver Clinic
Telephone: 8558 9000

St Kilda - Barkly Street Medical Centre
(St Vincent's Hepatitis Clinic)
Telephone: 9534 0531

St Vincent's Hospital
Liver Clinic: 9288 2898
Hepatitis Clinic: 9288 3580

Footscray - Western Hospital
Telephone: 8345 6490

Werribee Mercy Hospital
(St Vincent's Hepatitis Clinic)
Telephone: 9216 8633

 
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