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‘Be #HepAware’ during May, Hepatitis Awareness Month

May is Hepatitis Awareness Month, an annual observance to emphasize the elimination of viral hepatitis through raising awareness, capacity building, policy and advocacy, and increased access to care. The Centers for Disease Control and Prevention (CDC) encourages populations at risk, especially those born between 1945 and 1965, to become more aware of viral hepatitis. The hashtag “Be #HepAware” aims to bring awareness to the impact of viral hepatitis and promote an online risk assessment tool that will help guide a person’s decision to be tested for hepatitis C or vaccinated for hepatitis A and B.

Hepatitis means “inflammation of the liver” and is often caused by a virus. The three common viruses seen in the U.S. are hepatitis A, B, and C. Hepatitis A (HAV) is usually transmitted via fecal–oral route from person to person or consumption of contaminated food or water. HAV is an acute infection and is highly contagious. The best way to prevent transmission is by getting vaccinated.

Some common ways Hepatitis B (HBV) is transmitted include sexual contact of a person who is infected; sharing needles, syringes, or other drug preparation equipment; or from mother to infant at birth. For some, HBV is a short-term illness. However, it can become a long-term, chronic infection. Chronic HBV can lead to serious health problems. The CDC recommends children and unvaccinated at-risk adults get vaccinated.

Hepatitis C (HCV) is perhaps the most notable because the vast majority of people with the virus are unaware they have it and are undiagnosed. While anyone can get HCV, more than 75 percent of adults infected are people in the baby boom generation (born between 1945 and 1965). Baby boomers are five times more likely to have HCV than others are. The reason for their high rates of HCV is not completely understood. Most boomers are believed to have become infected in the 1970s and 1980s when rates of HCV were the highest.

Since people with HCV can live for decades without symptoms, many people who are now in their fifties and sixties are unknowingly living with an infection they got many years ago. The longer people live with the disease, the more likely they are to develop serious, life-threatening liver disease. HCV is spread primarily through contact with blood from an infected person. Many baby boomers could have become infected from contaminated blood and blood products before widespread screening of the blood supply in 1992 and universal precautions were adopted. Others may have become infected from injecting drugs, even if only once in the past. Still, many baby boomers do not know how or when they were infected.
Getting tested can help everyone learn if they are infected and get them into lifesaving care and treatment. For many people, treatments are available that can cure HCV and prevent liver damage, cirrhosis, and even liver cancer.

Breakthroughs of new curative treatments have helped to make some progress towards elimination of the virus, but HCV remains a serious health problem.

Today, people sharing needles or other equipment to inject drugs get most new HCV infections. For some, it is a short-term illness, but for 70 to 85 percent of people who become infected with HCV, it becomes a long-term, chronic infection which can result in death. Most people might not be aware of their infection because they are not experiencing symptoms and there is no vaccine to prevent HCV. The best way to prevent it is by avoiding behaviors that can spread the disease, especially injecting drugs.

Generally, when a person comes in contact with viral hepatitis he or she may have very few symptoms or no symptoms at all. If symptoms develop they can include the following:

  • Flu-like symptoms
  • Vomiting
  • Nausea
  • Loss of appetite
  • Fatigue
  • Fever
  • Gray-colored stool
  • Abdominal pain
  • Jaundice
  • Joint pain

Chronic HBV and HCV account for more than half of new cases of chronic liver disease—a leading cause of death. At least 4.4 million people in the U.S. are estimated to be living with chronic HBV and HCV and most do not know they are infected. The year 1989 marked the discovery of HCV. After implementation of CDC guidelines such as screening of blood products and donated organs via organ donors, rates of HCV decreased between 1990 and 2009. However, the nation experienced a rise in HCV rates during 2009-2013. In Alabama, reported rates of acute HCV increased by 200 percent during this time period.1

Routine medical checkups do not include testing for viral hepatitis, so persons at risk are urged to talk with their medical provider about getting tested. A medical provider can determine if a person has HAV by discussing symptoms and evaluating a blood sample for immunoglobulin M (IgM) antibody to HAV. HAV does not become chronic, and if a person comes in contact with the disease after initial contact, he or she will not be reinfected. The individual will develop IgG antibodies that provide lifelong protection against the disease.

Several antiviral medications are available to treat chronic HBV, and today many people can benefit from curable treatment for HCV. The Alabama Department of Public Health Bureau of Communicable Disease aims to inform Alabamians about risks associated with transmission of viral hepatitis.

To assess risk, visit Hepatitis Risk Assessment or adph.org/hepatitis and take the online risk assessment to get a personalized report.

Thomas M. Miller, M.D.
State Health Officer

(May 2016)

1 CDC National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, 2015 State Health Profiles

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