By Dr. Kevin Wang
Hepatitis 101: Part Three
{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 this final portion of our hepatitis discussion, we'll just wrap up some loose ends.
Previously mentioned, we learned that hepatitis can spread by contaminated food and water, anal sex, oral-anal sex, contaminated blood products, and injection drug use with dirty needles. Let's talk about some basic prevention and at the end of this column, we'll discuss treatment.
First off, let's talk about safer sex. I know that health professionals, ads, and volunteer health groups have talked ad nauseum about safer sex (note that I use safer sex and not safe sex É sex is never really 100% safe, right?). But, with the huge push to use condoms with the sudden onslaught of HIV, it also helped to decrease the incidence, or spread, of hepatitis A, B and C. Use of condoms, however, isn't always enough. For those who enjoy oral-anal sex, be weary since that's another mode of transmission we talked about earlier.
As for other lifestyle changes one can make, using clean needles (or not using drugs at all!) can help prevent the transmission of the viruses.
The next best thing involves the use of vaccines – available for only Hepatitis A and B.
The vaccine for Hepatitis A is usually given to people who are traveling to countries where Hepatitis is rampant. It involves a single injection in the arm. After receiving this dose, these travelers are protected after four weeks and will most likely require a booster dose at 6-12 months for long-term protection. For those that can't wait that 4 week period to wait for full protection, an injection containing another medication called immunoglobulin, is done in the other arm. For those that are allergic to anything in the vaccine, again, the immunoglobulin form may be given.
The vaccine for Hepatitis B is usually given in 3 doses – the first dose, the second 1-2 months later and the third dose at the 6 month interval. Who should receive this vaccine? Well, pregnant women should definitely be screened for and given the vaccine, as well as people born in areas where Hepatitis B is rampant, gay men, injection drug users, patients on dialysis, HIV infected people as well as family/household contacts of people infected with Hepatitis B. Another important group who should receive the vaccine is newly born babies!
Now what happens if one gets Hepatitis A/B?
Hepatitis A usually runs itself out since the course is usually what we call self-limiting (translation: only lasts for a short period of time). Most patients are treated with aggressive supportive care (fluids and rest) and depending on your risk group, patients are given the vaccine, the immunoglobulin injection or both.
Hepatitis B infected patients aren't so lucky. Before the whole burst of anti-retroviral agents, patients were given something called, "Interferon" therapy. This usually led to a 30-40 percent response and horrible side effects. But with the invention of anti-retroviral medications, it seems that there is some hope along the horizon to provide a better alternative.
As for Hepatitis C, there are no vaccines É yet. Treatments include, like Hepatitis B, medications to boost the immune system, interferon therapy, and experimental treatments that will attack the virus itself.
Well folks, that's Hepatitis in a nutshell. I hope I covered most of the important facts and if you have any other questions regarding Hepatitis, please feel free to contact me. In my next column, I'm going to discuss a topic that I have, much to my chagrin, neglected: lesbian health. I hope this column finds you in good health and spirits and see you in a month!
To see part I, please visit https://www.pridesource.com/article.shtml?article=12735
To see part II, please visit https://www.pridesource.com/article.shtml?article=13273
