What is Viral Hepatitis?
Hepatitis means inflammation of the liver. The liver is an organ in the right upper quadrant of the abdomen that processes nutrients, filters the blood and fights infections. When the liver is inflamed or damaged, its function can be adversely affected. The most frequent cause of hepatitis is a virus. The most common types of viral hepatitis are hepatitis B virus (HBV) and hepatitis C virus (HCV ). It is estimated that in the United States as of 2019, 2.2 million to 4.7 million persons are infected with HCV and 850,000 to 2.2 million are chronically infected with HBV.
CDC Definition: Hepatitis is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus (HAV). It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water. Hepatitis A is a self-limited disease that does not result in chronic infection. Most adults with hepatitis A have symptoms, including fatigue, low appetite, stomach pain, nausea, and jaundice, that usually resolve within 2 months of infection; most children less than 6 years of age do not have symptoms or have an unrecognized infection. Antibodies produced in response to hepatitis A infection last for life and protect against reinfection. The best way to prevent hepatitis A infection is to get vaccinated.
CDC Definition: Hepatitis B is a liver infection caused by the Hepatitis B virus (HBV). Hepatitis B is transmitted when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth. For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection. Risk for chronic infection is related to age at infection: approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults. Chronic Hepatitis B can lead to serious health issues, like cirrhosis or liver cancer. The best way to prevent Hepatitis B is by getting vaccinated.
CDC Definition: Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV). Hepatitis C is a blood-borne virus. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. For some people, hepatitis C is a short-term illness but for 70%–85% of people who become infected with Hepatitis C, it becomes a long-term, chronic infection. Chronic Hepatitis C is a serious disease than can result in long-term health problems, even death. The majority of infected persons might not be aware of their infection because they are not clinically ill. There is no vaccine for Hepatitis C. The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs.
CDC Definition: Hepatitis D, also known as “delta hepatitis,” is a liver infection caused by the hepatitis D virus (HDV). Hepatitis D only occurs in people who are also infected with the hepatitis B virus. Hepatitis D is spread when blood or other body fluids from a person infected with the virus enters the body of someone who is not infected. Hepatitis D can be an acute, short-term infection or become a long-term, chronic infection. Hepatitis D can cause severe symptoms and serious illness that can lead to life-long liver damage and even death. People can become infected with both hepatitis B and hepatitis D viruses at the same time (known as “coinfection”) or get hepatitis D after first being infected with the hepatitis B virus (known as “superinfection”). There is no vaccine to prevent hepatitis D. However, prevention of hepatitis B with hepatitis B vaccine also protects against future hepatitis D infection.
CDC Definition: Hepatitis E is a liver infection caused by the Hepatitis E virus (HEV). Hepatitis E is a self-limited disease that does not result in chronic infection. While rare in the United States, Hepatitis E is common in many parts of the world. It is transmitted from ingestion of fecal matter, even in microscopic amounts, and is usually associated with contaminated water supply in countries with poor sanitation. There is currently no FDA-approved vaccine for Hepatitis E.
Perinatal Hepatitis C
Pregnant women who are HCV positive, have a 5% to 6% chance of passing the virus to their baby. In 2018, it was universally recommended that all pregnant women are screened for HCV during each pregnancy. Babies born to an HCV positive mother should be tested for HCV RNA between 2 and 36 months to determine if they are infected. Nearly 80% of perinatally infected persons will progress into chronic cases leading to severe disease as young adults. Treatment is available for children 3 years of age and older depending on current treatment recommendations and available medications.
Hepatitis positive organ transplants
Since 2017, several of Ohio’s transplant centers have been placing hepatitis C (HCV) positive organs into hepatitis negative patients with their informed consent since medication to cure HCV has become available. This has decreased the wait time for an organ and has saved lives due to an increased supply of useable organs.
According the current CDC case definitions, the organ recipient can be an acute hepatitis case if the pre-transplant negative hepatitis labs are within 6 months for hepatitis B or 12 months for hepatitis C of the post-transplant positive labs. Healthcare providers and/or transplant centers are asked to complete a transplant case collection form when this type of transplant is performed.
When the donor was negative for hepatitis and a post-transplant hepatitis infection is diagnosed, a UNOS (United Network for Organ Sharing) investigation is triggered and will be overseen by the CDC. More information can be found at https://www.cdc.gov/transplantsafety/index.html