Hepatitis A, B, and C

What is hepatitis A?

Hepatitis A (hep A) is a contagious virus that affects the liver. Hep A can range from a mild illness lasting a few weeks, to a severe illness lasting months. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function properly.

What are the symptoms?

People infected with hep A can have a variety of symptoms. Some people do not get sick at all, but they can still spread the infection to others. Often, people with hep A develop the following symptoms 15 to 50 days after exposure to the virus:

  • Fatigue (feeling tired)
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Dark urine, pale stools
  • Abdominal pain, nausea, vomiting, poor appetite
  • Diarrhea
  • Fever

Symptoms are often mild, typically lasting 1 to 2 weeks. In severe cases, the symptoms can last several months. For pregnant women, hep A is more serious and can be fatal, particularly for women in their third trimester.

There is currently an approved vaccine for hep A. Once vaccinated, you are immune for life. If you have already had the virus, your body has developed a natural immunity.

How does someone get hepatitis A?

The hep A virus is spread from person to person through contact with infected feces (stool). People can carry the virus without showing any symptoms, then spread it to other people, foods or surfaces. Most commonly, the virus spreads through:

  • Sexual contact with an infected person (oral – anal contact)
  • Sharing needles and drug paraphernalia
  • A contaminated food handler
  • Hands that are not washed properly after using the restroom, or helping someone use the restroom
  • Contamination during harvest, manufacturing, and processing of food
  • Persons travelling to countries where hep A is common
  • Food sources of hep A include contaminated water, raw or undercooked shellfish, raw fruits and vegetables

How do I get tested for hepatitis A?

A blood test is used to diagnose hep A. This blood test can reveal if an individual currently has hep A, has had hep A in the past (resolved), or has previously received the vaccine.

How do I protect myself from hepatitis A?

The following tips will help protect you and your family from hep A:

  • Talk to your doctor about getting a hepatitis A vaccination
  • Wash your hands after using the restroom and changing diapers, and before preparing, or eating food
  • When travelling, especially to developing countries:
  • Only drink commercially bottled water or boiled water
    • Avoid ice cubes in drinks
    • Eat only freshly cooked food
    • Avoid non-peelable raw fruit or vegatables
  • Cook food to a safe internal temperature using a digital thermometer

If you think you have been exposed to hep A, see your physician immediately. Vaccination can prevent the onset of symptoms if given within 2 weeks of exposure

If you’ve been exposed to hep A, or any other gastrointestinal illness, do not prepare food for other people

What is Hepatitis B?

Hepatitis B (hep B) is a virus that affects the liver. Someone can live with hepatitis B for a long time (20-30 years) before they develop any symptoms, feel sick, or see any sign of liver damage. Without testing, treatment, or follow-up from a provider, the liver can become scarred and cause people to become ill.

Hepatitis B can be very common in certain parts of the world, such as sub-Saharan Africa, East Asia, and parts of Central and South America.

What are the symptoms?

Most people have no signs or symptoms of hepatitis B. People who have hep B may have some or all of the following symptoms:

  • Fatigue (feeling tired)
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Dark urine, pale stools
  • Abdominal pain, nausea, vomiting, poor appetite

How does someone get Hepatitis B?

Hepatitis B is passed through blood, semen (pre-ejaculate), vaginal fluids, rectal fluids, and saliva from someone who has the virus. The main ways that hep B is passed between people are:

  • Anal or vaginal sex, oral sex, sharing sex toys
  • Maternal transmission (during pregnancy or childbirth)
  • Sharing needles/syringes or other equipment used to inject drugs (such as cookers, filters, etc) or equipment to snort or smoke drugs such as stems, bills/straws, etc
  • Tattoos, body piercing/modifications, acupuncture, manicures, or pedicures where non-sterile equipment is used
  • Sharing personal hygiene articles such as razors, toothbrushes, or nail clippers
  • Medical/surgical procedures where infection prevention and control practices are inadequate

Hepatitis B cannot be passed through:

  • Shaking hands
  • Hugs or kisses
  • Coughs or sneezes
  • Food or water
  • Sharing eating utensils
  • Breastfeeding

How do I get tested for hepatitis B?

Hepatitis B is diagnosed with a blood test. This blood test can reveal if an individual currently has hepatitis B, has had hepatitis B in the past (resolved) or has previously received the vaccine. Most tests are accurate within four weeks of exposure but some people may take as long as 3 to 6 months to test positive. You may be encouraged to return for repeat testing.

What happens if I have a positive hepatitis B result?

Your body may clear the virus on its own without treatment within the first 6 months:

  • The majority of adults are able to clear the virus and develop lifelong immunity. However, the majority of infants and children who contract hepatitis B will develop chronic hepatitis B.
  • There is no cure for hepatitis B, but there are treatment options that can help prevent further damage to your liver.
  • To reduce the risk of passing the hepatitis B virus on to your baby, you doctor will ensure that your baby receives an immune globulin injection and hepatitis B vaccine at birth
  • Your healthcare provider or public health nurse will provide you with resources, counselling, support, and information to help guide your care, including linking you to community services and/or social workers.
  • Your healthcare provider or a public health nurse will help you notify household contacts, sexual and/or drug-equipment sharing partners to encourage them to be tested for hepatitis B, assess their immune status and/or provide vaccine protection to those who are not immune. They can get free hepatitis B vaccination through Ottawa Public Health.

What is Hepatitis C?

Hepatitis C (hep C) is a virus that affects the liver. Someone can live with hepatitis C for a long time (20-30 years) before they start to develop any symptoms, feel sick, or see any sign of liver damage. Without testing, treatment, or follow-up from a provider, the liver can become scarred and cause people to become ill. Hepatitis C can be very common in certain parts of the world, such as Central, East, and South Asia, Australia and Oceania, Eastern Europe, sub Saharan Africa, North Africa, and the Middle East.

What are the symptoms?

Most people have no signs or symptoms of hepatitis C. People who have hepatitis C may have some or all of the following symptoms:

  • Fatigue (feeling tired)
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Dark urine, pale stools
  • Abdominal pain, nausea, vomiting, poor appetite

How does someone get Hepatitis C?

Hepatitis C is passed through blood-to blood-contact with someone who has the virus.

The main ways that hepatitis C is passed between people are:

  • Sharing needles/syringes or other equipment used to inject drugs, such as cookers, filters, stems, bills/straws, etc.
  • Having received blood and/or blood products, or immunoglobulin before 1992
  • Tattoos, body piercing/modifications, acupuncture, manicures, or pedicures where non-sterile equipment is used
  • Sharing personal hygiene items such as razors, toothbrushes, or nail clippers
  • Maternal transmission (during pregnancy or childbirth)
  • Condomless sex where there is a higher risk of blood transmission, such as anal sex, rough sex, party and play, menses, etc

How do I get tested for Hepatitis C?

Hepatitis C is diagnosed with a 2-step blood test: an antibody and an RNA test. Within 6 months after becoming infected, almost everyone has antibodies in their blood that can be measured by the hepatitis C antibody test. If antibodies are found, an RNA test is ordered to determine if you currently have the hepatitis C virus. Hep C antibodies will remain positive in the blood for life, even after somebody has cleared the virus. Even if someone clears the virus (on their own or with treatment), they can get hepatitis C again.

What happens if I have a positive RNA result?

Hepatitis C is a treatable infection. About 1 in 4 (25%) people clear hepatitis C without treatment, but most people need treatment to cure hepatitis C. If your RNA test is positive, you will be referred to a hepatitis specialist. Treatment is usually 3 months long and decided with your specialist.

How do I keep my liver healthy?

  • Decrease or eliminate alcohol, drug, and/or tobacco use
  • Get vaccinated for Hepatitis A & B
  • Talk to your healthcare provider/pharmacist before starting new medications or natural remedies

How do I practice safer sex?

  • Use an internal or external condom, every time you have oral, vaginal, and/or anal sex
  • Use water-based or silicone-based lubricants
  • If you share sex toys, cover the toy with a condom and clean after each use
  • Get tested for sexually transmitted infections (STIs) regularly

How do I practice safer drug use?

  • Use new equipment every time you use, including pipes, needles, syringes, and all other supplies (like cookers, filters, and water)
  • Never share equipment with anyone, including your sex partner(s)
  • Access Needle and Syringe Programs or Supervised Consumption Services for new equipment and harm reduction services

For more information:

Canadian Liver Foundation - www.liver.ca, or call 1-800-563-5483

Health Canada www.phac-aspc.gc.ca

Ontario Ministry of Health - www.hepcontario.ca

www.catie.ca (Canada’s source of HIV and hepatitis C information) or call their toll-free telephone line at 1-800-236-1638

Call the Sexual Health Infoline Ontario at 1-800-668-2437 if you have questions or need help.

www.sexandu.ca

 

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