By Dr. Kevin Wang
Hepatitis 101: Part Two
{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}
In today's column, let's continue on with the basics of the viruses that cause Hepatitis.
Hepatitis B is primarily spread through sexual contact and injection drug use. For those women out there, be forewarned that it can spread from mother to baby during delivery. For those that wish to breastfeed, your baby is mostly likely safe. Transmission by blood transfusions is much rarer these days with the new tests that check blood donors for the virus. Again, like with Hepatitis A, you can develop symptoms that include fatigue, nausea and loss of appetite. Others fall prey to fulminant hepatic failure where you skin turns bright yellow/orange, you develop altered mental status (translation: slightly crazy and out of it) and complications from liver failure (translation: very bad).
Unlike Hepatitis A, however, you can develop chronic hepatitis. Here, you may be completely free of symptoms and become a carrier of the disease, have a subclinical course where you feel just slightly sick but your liver cumulates a bit of damage every day from the virus. In the end, it becomes cirrhotic (translation: it shrivels up and pretty much scars over) and becomes nonfunctional. In the worse case scenario, you can develop liver cancer.
What other things can happen, you ask? You can end up with kidney disease or something called polyarteritis nodosa – an autoimmune disorder where your body basically damages itself and can cause weakness, fever, joint pain, nerve damage, skin, GI and muscle disease. Lovely, isn't it?
But things only get worse. Hepatitis B was awfully prevalent in the gay community, but thanks to the success of safer sex education, that has decreased significantly. The discovery of the Hepatitis B vaccine certainly helped out, too, as it's a requirement for school-aged children. Unfortunately, with the outbreak of HIV, especially in the gay community, HIV increases the risk of gay men developing chronic hepatitis by more than 300 percent (21 percent of HIV-infected patients developing chronic hepatitis versus the 7 percent of non-HIV infected patients).
Now on to Hepatitis C. Hepatitis C really isn't all that different from Hepatitis B except that there's a higher risk of developing chronic hepatitis that leads to cirrhosis of the liver (complete liver dysfunction) or liver cancer. It's also most commonly associated with injection drug use and blood transfusions. It's pretty rare to get it by sexual/household contact since it's harder for the virus to spread. Now don't get me wrong, it can still certainly happen but the risk is still low. People infected with HIV also tend to develop chronic hepatitis much more rapidly than people who are HIV negative.
Now that I seem to have run out of room again, I think I'll end this week's column here. In the next column, I'll talk about various forms of prevention as well as treatment. Again, if any health care professionals out there have any new information or updates, please feel free to e-mail me and I'll be sure to include them in the column with the appropriate credit. And, of course, if you have any other questions, please feel free to write them in and I'll respond to them in future columns. See you in a month!
To see part I, please visit https://www.pridesource.com/article.shtml?article=12735
