The word hepatitis, like many medical words, can be broken down into parts. The Greek term 'hepar' or ‘hepat’ means liver and the term ‘it is’ means inflammation. The term ‘Hepatitis’ means inflammation of the liver.
The Liver
Let us first look at what the liver does. Your liver is a large organ in the upper part of your abdomen. It has many jobs to do. Most importantly, the liver helps to clean the blood of harmful substances. We say that the liver ‘detoxifies’ the blood. As well, the liver can provide the body with glucose for energy when we need it. It also makes certain proteins that make up the blood itself.
The liver also has a job to do in digestion because it makes bile from waste products produced when old red blood cells are destroyed to make room for new ones. The bile is then used to break down fats that we eat. This is a unique and natural recycling program! The liver has many jobs, so it is important that your liver stays healthy.
What is Inflammation?
Body tissues become inflamed as a protection against a foreign substance or an injury. For instance, inflammation will happen if you cut yourself and the cut gets infected. The area around the cut will be red and swollen and hot. This helps to get the healing process underway, but it can also cause some damage in the area.
There are many ways by which the liver can become inflamed. We will go over some of the more common ones. Regardless of what causes inflammation of the liver (hepatitis), when the liver is inflamed it has a hard time doing the work it needs to do to keep the rest of the body healthy.
THe ABC's of Hepatitis
Hepatitis caused by viruses, called viral hepatitis, is the most well-known type of hepatitis. Hepatitis A, B, and C are the most common types of viral hepatitis. We will look at these types in detail. There are other types of viral hepatitis and other non-viral causes of hepatitis, but we will not go over those.
About Hepatitis A
The Hepatitis A virus is spread by the fecal - oral route. Poor washroom hygiene and lack of hand washing are often to blame. Usually Hepatitis A is spread between people in the same household or by close contact with someone with Hepatitis A. At times, a number of people may get sick with Hepatitis A if they have eaten at the same place. A restaurant worker infected with Hepatitis A may not have washed their hands well enough after going to the washroom and before going back to work.
In Canada, we have good sanitation and washroom facilities and we know about the importance of hand washing and safe food handling. This means that in Canada we have far less cases of Hepatitis A infection than in some other countries in the world. Way to go Canada!
What happens when a person has a Hepatitis A infection?
Hepatitis A infection will cause an acute (short term) illness, usually less than two months. People who get Hepatitis A will have a fever, feel tired and sick all over, lose their appetite, and feel sick to their stomach. Because some of the substances that the liver usually cleans out of the blood remain, the urine may look dark and the skin may turn yellowish. This yellowing of the skin and the whites of the eyes is called jaundice. In people who have naturally dark skin, jaundice is easiest seen in the whites of the eyes.
In order to tell whether a person has a hepatitis infection and to figure out what type of hepatitis infection they have, blood tests will be done. These blood tests can also show whether the liver is inflamed or damaged.
Hepatitis A usually goes away once the infection has run its course. Hepatitis A does not cause chronic (long term) infection. This means that once the viral infection is gone, the liver does not continue to be affected. While most people get over the infection, Hepatitis A can cause serious or life-threatening illness, but this is unusual.
If a person has a Hepatitis A infection, they will be advised to get enough rest, eat well, drink plenty of fluids, and to not drink alcohol. The person’s current medications will need to be looked at because some medications are hard on the liver. Certain herbal products and over the counter drugs, such as some pain killers, can also be hard on the liver, so it is important that the doctor, pharmacist, or nurse know about the person’s use of these.
People that are infected with Hepatitis A will also need to be careful that they do not spread the virus to others. If a person is told they have been infected with Hepatitis A, they will be advised about how to prevent spreading the infection.
Can Hepatitis A be prevented?
Most importantly, the spread of Hepatitis A can be prevented by good hand washing after using the washroom and by safe food handling. As well, Hepatitis A infection can be prevented by vaccine. If you want to know more about the Hepatitis A vaccine, especially if you are travelling to a country where more Hepatitis A infections happen, talk to your doctor, pharmacist, or public health nurse. The website Healthlink BC is a great place to go to for information. You can also call 8-1-1 anytime to talk to a nurse. If a person has had a Hepatitis A infection before, then their body has likely built up an immunity and they are protected against getting it again.
About Hepatitis B
The Hepatitis B virus is spread in different ways than the Hepatitis A virus. Hepatitis B is most commonly spread by sexual intercourse with an infected person, sharing needles used for injection of drugs, or sharing items such as razors and toothbrushes used by an infected person. Health care workers are at risk because of the possibility of injury with used needles or contact with blood or body fluids in other ways. Casual contact, such as hugging and shaking hands with an infected person, does not spread the infection.
In Canada, infection with Hepatitis B is decreasing because vaccination against Hepatitis B is given to children in schools. Health care workers and other people at risk will also get vaccinated. This is good news. The bad news is that there are many people infected with Hepatitis B in Canada that do not know they are carrying the virus. As well, there are countries that do not vaccinate against Hepatitis B routinely, so people from those countries who come to Canada could be a source of infection. These people may not even know that they are carrying the virus.
What happens when a person has a Hepatitis B infection?
A person can be infected with Hepatitis B and not feel sick. Or the person might feel like they have a bad flu, not unlike described above for Hepatitis A. The symptoms, if they happen, can take months to appear. Hepatitis B infection may or may not cause yellowing of the skin (jaundice). The Hepatitis B infection will often go away on its own, but the infection can hang on and cause a chronic (long-term) infection. In this case, the chronic infection can damage the liver. This may lead to liver disease or liver cancer. The person who is infected may not know it until serious problems happen years later.
If a person finds out that they have a Hepatitis B infection, treatment will depend on whether the infection is acute (short term) or chronic (long term). An acute Hepatitis B infection may go away on its own, so medical advice will be much like for Hepatitis A. It is particularly important that the person knows how to help their body fight the infection and knows how to prevent the spread to others.
If a person finds out that they have a chronic hepatitis B infection, they may receive treatment with virus-fighting medicines or medicines that boost the body’s ability to fight the infection. This can reduce damage to the liver, liver disease, or liver cancer. The treatment can also help prevent the spread to others. Unfortunately, once a person has a chronic Hepatitis B infection they cannot be cured of it. In some cases, people may receive a liver transplant if their liver is not working due to liver disease.
Can Hepatitis B be prevented?
It is not always easy to prevent the spread of Hepatitis B because people may not know that they are infected. The best prevention is vaccination. You can ask your doctor, pharmacist, or public health nurse about the Hepatitis B vaccine.
If you or others in your family are concerned that they may be infected with the Hepatitis B virus because they have not been vaccinated, or they have been in close contact with someone that has Hepatitis B, then talk to your doctor or a public health nurse. You can learn more about Hepatitis B and the risk of infection from the Healthlink BC website or by calling 8-1-1 to speak to a nurse.
About Hepatitis C
According to the information on the Healthlink BC website, about one in 100 people are infected with the Hepatitis C virus. The Hepatitis C virus is usually spread by direct entry into the blood. A common way for this to happen is sharing of needles when people use drugs that go right into a vein. As well, dirty tattoo and body piercing equipment can spread the infection. Health care workers are at risk for Hepatitis C infection due to needle stick injuries. Years ago, blood transfusions could spread the infection. In Canada now blood is screened carefully and the chance of this is slim.
What happens when a person has a Hepatitis C infection?
People infected with Hepatitis C will often not know that they have the infection until serious problems arise due to liver damage. Some people can fight the infection and get rid of it, but unfortunately in most cases the infection will become chronic (long term). Treatment for Hepatitis C, while not easy for the infected person, can help clear the virus from the body and prevent further spread. If a person has a chronic Hepatitis C infection, liver damage can be severe over time.
Can Hepatitis C be prevented?
Unfortunately, there is currently no vaccine for Hepatitis C. Prevention of spread is most important. People who use injection drugs must be especially careful as do those people who handle needles and other sharps. If people who are infected are treated successfully, the spread of the virus will decrease.
So now you know the ABC’s of hepatitis. We need to keep our livers healthy so they can do the jobs they were designed to do. The more we know about our bodies, the healthier we will be.
Quick facts on Hepatitis:
- ‘Hepatitis’ means inflammation of the liver.
- One of the ways the liver can become inflamed is when it is infected with a virus.
- Hepatitis A, B, and C are the most common types of viruses that cause hepatitis.
- Hepatitis A is spread via the fecal-oral route; good washroom hygiene and sanitation are important.
- People usually get over Hepatitis A after an acute (short term) illness much like the flu.
- Hepatitis B and C are spread via blood and body fluids.
- Hepatitis B and C can cause chronic (long term) infection which may cause serious liver damage.
- People with chronic Hepatitis B or C infections may not know that they are infected.
- There is a vaccine for Hepatitis A and B, but not for Hepatitis C .
- In Canada, children are vaccinated against Hepatitis B in school.
- Ask your doctor, pharmacist, or public health nurse about the Hepatitis A or B vaccine.
- Healthlink BC website is a great place to get more information; or you can talk to a nurse by phoning 8-1-1.
The Author: Catherine Bock believes in helping people take control of, and improve their health by understanding risks and ways to decrease those risks. She teaches pathophysiology in the B.Sc of Nursing program at Kwantlen Polytechnic University. For more information or references for this article, please contact Catherine at: catherine.bock@kpu.ca
