Hepatitis B and C
The Liver
The liver is the largest organ in the body. It is found high in the right upper abdomen, underneath the ribs. It is a very complex organ and has many functions. They include:
- Storing energy in the form of sugar (glucose)
- Storing vitamins, iron, and other minerals
- Making proteins, including blood clotting factors, to keep the body healthy and help it grow
- Processing worn out red blood cells
- Making bile which is needed for food digestion
- Metabolizing or breaking down many medications and alcohol
- Killing germs that enter the body through the intestine
The liver is subject to illnesses, such as hepatitis B, which may lead to serious liver damage.
Hepatitis B
HBV carriers recover from the infection completely and feel healthy. They have no ongoing hepatitis or liver damage. However, their blood tests show they still have the virus and have not developed hepatitis B antibodies. Therefore, they can pass on the virus. This is called an HBV carrier, because carriers do not develop symptoms or feel sick, thousands of people who become carriers of HBV never know it. There may be as many as one million Americans carrying HBV.
There is no treatment presently available for this situation. Carriers have a responsibility to practice safe lifestyle habits that will prevent their passing the virus on to others. This especially includes protected sex.
Hepatitis C
Certain people infected with HCV have a positive HCV blood test, but a normal liver enzyme test. These individuals are often called HCV carriers, and they can pass the virus on to others.
Although they appear not to be seriously ill, there is recent evidence that even these people may have chronic hepatitis. Therefore, each should be evaluated by a liver specialist.
The risk of transmitting HCV sexually is low compared to hepatitis B and AIDS. In marriages and long-term relationships with monogamous partners, it is often the case that one person is HCV positive and the partner is HCV negative. The current medical recommendation is that in these circumstances, sexual practices need not be changed. However, when people have multiple sex partners or new partners, they should never engage in unprotected sex.
It appears that in pregnancy, HCV is passed on to the fetus less than 5% of the time. It may depend on how high the mother’s blood virus level is during pregnancy. Therefore, hepatitis C infected women should always consult with their physicians before becoming pregnant.
Hepatitis B
There is a safe and effective vaccine to protect or immunize a person against hepatitis B. The vaccine usually offers protection for about 10 years or more. However, it is of no use to those already infected with HBV. Persons who have not been vaccinated and who know they have been exposed to HBV should receive an injection of hepatitis B immune globulin within two weeks of exposure to the virus. This is called a passive immunization. It gives immediate short-term protection for 3-6 months. The Hepatitis B vaccine is active immunization. Active immunization provides long-term (sometimes lifelong) protection. Therefore, people who are at risk of coming in contact with the virus, and especially newborn infants and sexually active teenagers, should be immunized. In the U.S., pediatricians now recommend that all children be actively vaccinated.
There are other precautions people should take to protect themselves against hepatitis B. Since the virus is most often spread through sexual contact, it is most important to avoid unprotected sex with those who have or are likely to have the infection. Precautions must be taken to avoid coming in contact with blood or body fluids from an infected individual. For those living in households with infected patients, surfaces which may hold the virus should be cleaned with one part household bleach to 10 parts water. Items such as razors, toothbrushes, IV needles or pierced earrings should never be shared. People should also avoid such practices as tattooing and ear piercing in places where sterile conditions are questionable. Women who are pregnant should be tested for HBV and follow their physicians’ advice to protect their unborn children.
Hepatitis C
There is no vaccine currently available to protect against hepatitis C, as there is with hepatitis A and hepatitis B. People can prevent getting hepatitis C by not sharing anything that is likely to hold and transmit blood—razors, manicure tools, toothbrushes, and especially IV drug needles. Practices such as ear piercing and tattooing should be avoided in places where sterile conditions are questionable. Until all circumstances under which HCV can be transmitted have been thoroughly identified, it should be assumed that every person with hepatitis C can pass the virus on to others. Therefore everyone, especially health care workers, should avoid coming in contact with blood and body fluids from infected individuals.