136 St Asaph Street
P O Box 22-176
Christchurch
New Zealand
Phone +64 3 366 9403
Fax +64 3 366 9405
Hepatitis

whoWhat is Hepatitis?
Hepatitis means inflammation of the liver or liver injury caused by a viral infection, a toxin (a harmful chemical substance), or a disorder of the immune system. There are various viruses which cause hepatitis. These have been simply named Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D and so on.

The most common forms of hepatitis are A, B and C. These are all different infections which cause similar symptoms if you become infected with them.

When hepatitis does cause symptoms, they may be flu like: feeling generally tired or ill, fever, muscle aches, loss of appetite, nausea, vomiting, or diarrhea.

As hepatitis progresses, the symptoms begin to point to the liver as the site of inflammation. Chemicals (such as bilirubin) normally produced by the liver begin to build up in the blood. This may result in jaundice, a yellowing of the skin and whites of the eyes, as well as bad breath with a bitter taste in the mouth. The urine may turn dark or "tea-colored," while stools become white, light, or "clay-colored." There can also be abdominal pain, which is usually located on the right side, below the ribs (over a tender, swollen liver).

Hepatitis A
Hepatitis A is caused by the hepatitis A virus (HAV), which is classified as an enterovirus and is present in the stool or shit of infected individuals. A person can become infected with HAV by transferring the virus from stool-contaminated hands to the mouth. This explains why it is easy for HAV to spread in overcrowded, unsanitary living conditions. HAV also spreads in contaminated water and food (especially shellfish).

Hepatitis A is usually a mild infection, particularly in young children, although it can be more severe in adults who may have liver damage from using alcohol.

Hepatitis B
Hepatitis B, also called "serum hepatitis," is caused by the hepatitis B virus (HBV). HBV is found in certain infected body fluids: blood, saliva, semen, tears, breast milk, and urine. Infections may result from having a blood transfusion contaminated with HBV, sharing contaminated needles or syringes for injecting drugs, or engaging in sexual activity with an HBV-infected person.

HBV-infected mothers can pass the virus to their babies prior to or during delivery or through breast-feeding (although an HBV-infected mother can safely breast-feed if her newborn receives protective treatment at birth).

Hepatitis C
This virus was originally called non-A, non-B hepatitis and was isolated and identified in 1988. Hepatitis C virus is an RNA virus which is particularly small, virulent, and resilient. Hepatitis C is very common amongst people who inject drugs with around 70% of ex-users, and 50% of current users in NZ already infected.

The Ministry of Health estimates that approximately 50,000 people, or 1.5% of people aged 15 or over, in New Zealand are infected with hepatitis C but only 25% have been diagnosed. Up to 90% of people have it as a result of sharing injection equipment. There is currently no completely effective treatment for this disease.

Around the world, it is estimated approximately 3% of the population is infected with hepatitis C, and between 130 and 210 million people are chronically infected with the virus. The World Health Organisation estimates between three and four million people become infected with hepatitis C each year.

The World Health Organisation suggests around 80% of people with the virus do not have symptoms. About one in four people recover and the rest become chronically infected. Chronic infection with hepatitis C can lead to years of ill health and reduced quality of life. Some people with chronic infection are at risk of developing cirrhosis, cancer of the liver and liver failure.

The best health advice is that people should not inject illicit drugs; however, if people are already injecting drug users, harm can be reduced by not sharing needles, syringes, and other injecting equipment and by attending needle and syringe exchange outlets for sterile equipment and good advice.

Unlike hepatitis A & B, hepatitis C attacks the liver slowly over a much longer timeframe and most people infected will experience no symptoms for many years from the time of infection. However during this time they remain carriers of the disease and are able to infect others. Hepatitis C is an extremely infectious disease and can be easily transmitted in any situation where blood is released from the body such as tattooing, body piercing, dental work and some medical procedures.

In terms of mother and baby, the virus does not cross the placenta and enter a child's body before birth. However there is significant risk of infection at the time of birth, particularly if a caesarean section is needed.

Testing for hepatitis C is a simple antibody blood test and is available from your doctor or local sexual health clinic. Testing is free and confidential.

Hepatitis C virus is difficult to kill; it appears to be heat resistant and cannot be killed by boiling. It can exist for up to 30 days outside the body and does not appear to be killed by chemicals like bleach or isopropyl alcohol.

For this reason bleaching or boiling used needles and syringes will not kill this virus. The only way to avoid infection is to use a new fit every time you inject and not to share fits between users.

Advice and information on hepatitis C can be sought from GPs, specialists, needle exchanges, and Hepatitis C Resource Centres.

More information
For more information about hepatitis C CLICK HERE.