Today is National Hepatitis Testing Day. If it were up to me, I would call it National Hepatitis Testing and Vaccination Day.
The point of this day is to raise awareness of viral hepatitis, a condition that can lead to liver failure, liver cancer, and death. Early detection of hepatitis in the millions of people who have it but don’t know it can protect them from its harms and keep them from spreading it to others.
Hepatitis means that the liver is inflamed. Many things can cause this to happen. Some medications, for example, inflame the liver. But the most common cause is liver-attacking viruses. Sometimes the initial infection causes immediate symptoms (acute infection). Sometimes it causes few or no symptoms, but the virus stays active in the liver for years, with the potential of causing long-term damage.
There are five main types of viral hepatitis:
Hepatitis A can make you sick when you are first infected but does not cause long-term infection.
Hepatitis B can make you sick when you are first infected and can cause long-term infection. Of the approximately 1.1 million Americans who have been infected with the hepatitis B virus, more than half of them don’t know that they carry it.
Hepatitis C is a long-term infection, usually diagnosed many years after the initial infection. An estimated 3 million Americans are infected with the hepatitis C virus. Two-thirds of them do not know they are infected.
Hepatitis D is rare infection that happens only in people already infected with hepatitis B.
Hepatitis E can make you sick when you are first infected (acute infection) but rarely causes long-term infection. It is not common in the United States, but is common in developing countries with inadequate water supplies and poor sanitation.
There are two good reasons why it’s important to know if you are infected with a hepatitis virus:
- hepatitis B and C can be treated. Treatment greatly reduces the risk of cirrhosis, liver cancer, the need for liver transplant and death from liver failure. There are no specific treatments for hepatitis A, D, and E.
- knowing that you have viral hepatitis helps you take actions to avoid passing the virus to others.
In last week’s New England Journal of Medicine, two reports of treatment for the most common type of hepatitis C showed incredible success with antiviral drugs. The drugs cleared the hepatitis C virus from blood in 96% to 99% of infected people. I have to point out that clearing the virus from blood does not always mean cure. But it does greatly reduce the chance of ongoing liver damage and risk of liver cancer.
Who needs a hepatitis test?
If you are a baby boomer (born between 1945 and 1965) and have not been tested for hepatitis C, do it soon. It’s also a good idea to get the test if you are a post-boomer who:
- has injected or snorted drugs in the past
- currently injects or snorts drugs
- had a blood transfusion before 1992
- had surgery before the mid-1980s
- receives dialysis for kidney failure
- was born to a mother with hepatitis
- has served time in jail
- has gotten a tattoo in a shop that is not regulated by its state and lacks a high safety rating
Whether you should be tested for hepatitis B depends on your risk. Some groups for which this test is useful include men and women born in Asia, Africa, and other regions with moderate or high rates of hepatitis B, those who have sex or live with someone infected with hepatitis B, those with a condition that may suppress the immune system or taking a medication that does that, and women who are pregnant.
Testing for hidden hepatitis A, D, or E is not routinely done.
Vaccines that can guard against hepatitis A and B are available. It’s a good idea to talk with your doctor to see if these are for you.
All children should be vaccinated against hepatitis A around the time of their first birthday. For adults, the hepatitis A vaccine is recommended for those who live in an area with a high rate of hepatitis A, who work in or travel to countries with high rates of hepatitis A, who use so-called recreational drugs, who receive blood products to help their blood clot, or who have long-term liver disease.
All children and teens should be vaccinated against hepatitis B. For adults, the hepatitis B vaccine is recommended for those who:
- have sex with or live in the same house as a person with hepatitis B virus infection.
- have sex with more than one partner.
- have long-term liver disease.
- have diabetes and are under age 60.
- live or travel for more than 6 months a year in a region where hepatitis B is common.
- inject drugs.
- are on dialysis or have advanced renal disease.
- have HIV infection.
Vaccines aren’t yet available for hepatitis C, D, and E, but work is underway to develop them.
The outlook for infection with hepatitis B and C will continue to improve with the availability of the new, very effective drugs described in the New England Journal of Medicine. But treatment is extremely expensive. It’s estimated that a 12-week course of sofosbuvir (Sovaldi), a new hepatitis drug, will cost $84,000.
That’s why vaccination and other prevention efforts are so important. Here are a few tips from the National Institutes of Health:
- Wash your hands after going to the bathroom and before fixing food or eating.
- Use latex condoms, which may lower the risk of transmission.
- Avoid tap water when traveling to certain countries or regions. Ask your doctor about risks before you travel or call the Centers for Disease Control and Prevention at 877-FYI-TRIP.
- Don’t share drug needles.
- Don’t share personal items—such as toothbrushes, razors, and nail clippers—with an infected person.