Ask Dr. Wang

By |2017-10-31T06:26:18-04:00October 31st, 2017|Uncategorized|

By Dr. Kevin Wang

Hepatitis 101

{ITAL Dr. Wang,
Congratulations on your recent graduation and current residency in Family Medicine.
I have a topic for your column that you could perhaps address in a future article, considering HIV/AIDS is one of your particular interests in medicine.
With regard to the various types of Hepatitis can you please provide information as to the types/symptoms, percentages of infection and treatments, and perhaps the ratio of infections as compared to HIV? This would be valuable education for those who are sexually active, pregnant, and share needles when injecting drugs.
Thanks – and continued success in your career and featured column in Between The Lines.
Mark S.
St. Clair Shores}
Talk about a huge topic to discuss! What I plan on doing for this particular question is to break it down and discuss each section in successive columns. I only have half a page to work with, after all!
I’m sure everyone out there has heard about HIV/AIDS (I’ll discuss this in a later column), but hepatitis remains in that realm of, “I think I got some shots that protect me from getting hepatitis.” Hepatitis, when you take the root meanings of each part of the word, literally means inflammation of the liver. There are all kinds of ways to develop hepatitis – viral, alcohol, infectious, autoimmune (the body’s immune system actually goes after its own liver!) and drug-induced. I’m assuming that you’re talking about viral hepatitis so I’ll start there. If you have any questions about the other types of hepatitis, please feel free to write and inquire about those.
There are, as far as I know, six different viruses that carry the hepatitis name – aptly named Hepatitis A, B, C, D, E and G. Any of these can cause hepatitis and start off with the incubation period (can range from 2-26 weeks), a symptomatic period where you might just have some constitutional symptoms (fatigue, nausea, loss of appetite), another symptomatic period known as the icteric phase (yellowing of the skin called jaundice, stools become lighter or clay colored and dark colored urine) and ends with the convalescent phase (assuming you’re lucky enough not to go into the chronic phase).
Speaking of the chronic phase, chronic hepatitis is symptomatic or blood-test positive for any evidence of continuing or relapsing liver disease for more than six months. This sort of evidence can be as simple as some elevated liver enzymes in the blood to worsening of those constitutional symptoms I mentioned above to some major damage to the liver and other organs in the body.
Next, I’ll talk about the major types of Hepatitis: A, B and C.
Hepatitis A is spread through the feces and enters the person usually by mouth. Now don’t automatically assume it’s for those who like oral-anal sex – it can also be spread through contaminated water or food. Hepatitis A rarely goes into the chronic phase so this virus usually causes an acute (or self-limiting) form of hepatitis. Don’t be fooled! There is something called fulminant hepatic failure that results from liver disease and can lead to some major liver damage! The incubation period averages to about four weeks. Soon enough, you’ll start feeling those constitutional symptoms. Just as soon as these symptoms disappear, you’ll notice that you have the uncanny ability to glow in the dark (jaundice or yellowing of the skin). In terms of relating this to our community (for men at any rate), these has been no study relating the infection rate of Hepatitis A with HIV. There appears to be no suggestion that Hepatitis A is more severe in HIV positive individuals. Risk factors, however, include a high number of sexual partners, oral-anal or digital-rectal or just plain old anal sex.
Egads! I just ran out of room. But stay tuned for the next column where I’ll talk more about the other viruses that cause hepatitis, how it relates to the HIV positive population and what we can do to prevent any further infections. For those of you with any additional information, please feel free to send me some updates and I’ll gladly add them to my column with the proper credit, of course. And please don’t hesitate to send in other questions. I’ll get to them soon enough! Thanks for reading and look for the next installment!

About the Author:

BTL Staff
Between The Lines has been publishing LGBTQ-related content in Southeast Michigan since the early '90s. This year marks the publication's 27th anniversary.