Hepatitis

Menstuff® has compiled information and books on the issue of Hepatitis.

What is Hepatitis?

How Viral Hepatitis is Transmitted
Being Free of Hepatitis C Six Months After Treatment May Mean You're Cured. Six-Month Blood Test Accurately Predicts Outcome
Living with Hepatitis C: Who Needs Treatment?
Hepatitis C: Who's at Risk?
Firefighters in Philly say they're infected with hepatitis C at twice the national rate. What's going on?
Frequently Asked Questions About HCV Transmission
HIV-1 Test Kit
Is Thimerisol in vaccines safe?
Twinrix: first vaccine for HAV and HBV
Reduction in hepatitis among Aleuts and Native Americans
VAQTA vaccine approved for 2 - 18s
Prevention of hepatitis A through active or passive immunization
Newsbytes

Resources
Free or Low-Cost Hepatitis Clinic Near You
- www.hepclinics.com
Related issues:
Talking With Kids About Tough Issues, AIDS, Bacterial Vaginosis, Blue Balls, Chancroid, Chlamydia, Condoms, Contraception, Crabs, Genital Herpes, Genital Warts, Gonorrhea, Hepatitis A, B, C, D, E, Impotency, Nongonococcal Urethritis, Pelvic Inflammatory Disease, Reproduction, STDS, Syphilis, Trichomoniasis, Yeast Infection

What is hepatitis?


Hepatitis is an inflammation of the liver that can be caused by a group of viruses. There are five major types of viral hepatitis: A, B, C, D, and E.

When hepatitis viruses damage liver cells, scar tissue is formed and those cells can no longer function. With fewer healthy liver cells, the body begins to show symptoms ranging from mild (such as fatigue) to more severe symptoms (such as mental confusion).

Although many cases of hepatitis are not a serious threat to health, the disease can sometimes become chronic (long-lasting) and may lead to liver failure and death. In many cases, viral hepatitis is a self-resolving illness.

Sexual activity poses a different level of risk for each type of viral hepatitis, but is most closely associated with HBV. Blood transfusion, IV needle sharing and organ transplants may also pose a risk for transmission.

Hepatitis A and B are preventable through vaccination, though no vaccination currently exists for hepatitis C or E. Since hepatitis D only infects persons with active hepatitis B, the vaccine for hepatitis B prevents hepatitis D. For more information, see HAV, HBV, HCV, HDV and HEV sections.

How Viral Hepatitis is Transmitted



Source: American Liver Foundation

Being Free of Hepatitis C Six Months After Treatment May Mean You're Cured. Six-Month Blood Test Accurately Predicts Outcome


Good news for people with hepatitis C who respond to treatment. If you're free of the hepatitis C virus six months after treatment ends, the chances are you will remain that way and may even be considered cured.

French researchers have found that people who respond to hepatitis C treatment and have no evidence of the virus in the blood six months after their therapy is stopped are likely to have a complete recovery.

Previous studies have shown that about 40% of patients remain free of disease six months after their treatment has ended. However, the researchers wanted to take this information a step further and find out whether a negative test for hepatitis C at six months after treatment could accurately predict a complete recovery.

Hepatitis C is a liver disease caused by a virus that typically is spread by contact with the blood of an infected person, although there are many cases of people getting hepatitis C without any known contact with someone with the virus. Despite extensive research, hepatitis C is still not well understood, and doctors are doing many studies on the disease to help improve treatment.

The virus will clear up on its own, without any type of medication, in about 15% of the adults who are infected, says Bennet Cecil, MD, a gastroenterologist and corporate medical director of Hepatitis C Treatment Centers in Kentucky. "The other 85% stay infected unless they are treated with antiviral therapy." Cecil was not involved in the study.

But more than 80% of people infected each year get what is known as chronic hepatitis C, which means that the person's liver enzymes have remained elevated for more than six months. In its chronic form, hepatitis C can sometimes progress to more severe liver disease, such as cirrhosis.

Led by Stanislas Pol, MD, of the Unité d'Hépatologie et INSERM, the research team examined information from 45 patients who had been treated for hepatitis C. All of them had received interferon alfa and ribavirin, two drugs which are commonly used to treat this virus.

onths after their treatment ended, all of them were free of hepatitis C, according to blood tests. After 12 months, all of them were still negative except for one patient.

"This suggests that if they don't relapse within six months, they probably are not going to," says Ramsey Cheung, MD, an assistant professor of medicine at Stanford University School of Medicine in California. Cheung was not involved in the study.

The researchers believe that their study shows that the virus is unlikely to return in the majority of hepatitis C patients who respond to the treatment. "If they're free of the virus after six months, they're very likely to stay that way indefinitely," says Cecil.

Cheung says the study would be more interesting if the patients were followed for a longer period of time. Finding out if these patients were still free of disease in two years or even longer would give more information, he says.

For more information, visit our Diseases and Conditions Hepatitis C page or read our QuickFacts on the disease.

Vital Information:

Hepatitis C is a liver disease that can be difficult to treat. It can become a chronic disease in 80% of infected patients.

Often, people are treated for the virus but relapse soon after the medication is discontinued.

New research shows that if people test negative for hepatitis C six months after they have finished treatment, they are likely to be rid of the disease for good. Roxanne Nelson, RN my.webmd.com/content/article/1728.59024

Living with Hepatitis C: Who Needs Treatment? By Bob Calandr


When Fran Kee learned he had been infected with the hepatitis C virus, he decided to start the grueling, yearlong treatment process, even though doctors said he could wait. His blood tests showed extremely low levels of the virus, and all but one of his liver enzyme readings were normal.

"I just wanted it gone," says Kee, 46, a longtime member of the Philadelphia Fire Department.

A few months later he began a 48-week course of ribavirin and interferon, antiviral medications that are the standard, though often ineffective, hepatitis C treatment. Every morning and evening he had to swallow three ribavirin pills, and three times a week his wife injected him with interferon. The treatment left him feeling perpetually ill, and deeply depressed.

"It wasn't too bad in the beginning, but it got to be hell," Kee says. "You can't sleep, you can't relax, you feel like you have a bad flu off and on. I didn't know what depression was until I was on this treatment. It was the worst year of my life."

Ineffective Therapy

The combination therapy devastates most people, says Leonard Seeff, MD, a pioneering hepatitis researcher now at the National Institutes of Diabetes and Digestive and Kidney Diseases. And as if the ordeal weren't bad enough, more than half of patients aren't virus-free when it's over. Kee was fortunate; his hepatitis C is currently in remission.

While hepatitis C can be fatal if it progresses and causes liver disease, many infected people can go all their lives without symptoms. And since the only available treatment can take such a toll, doctors look at several variables to decide whether, when, and how to treat someone who tests positive for the virus. When lab tests show persistently elevated liver enzymes and the presence of hepatitis C in the blood, doctors typically order a liver biopsy to check for inflammation or scarring. If biopsy results indicate damage, the patient is a prime candidate for the combination therapy.

Watchful Waiting

If the biopsy is negative, what to do is less clear-cut. But lately some experts have advised against the medication, instead recommending regular monitoring with blood tests and liver biopsies to see if the disease has progressed. "In these patients, observation, including [liver enzyme] measurements and a liver biopsy every three to five years, may be an acceptable alternative to treatment with interferon because progression to cirrhosis is likely to be slow, if it occurs at all," wrote three hepatitis specialists with the Centers for Disease Control and Prevention, Linda A. Moyer, RN, Eric E. Mast, MD, MPH, and Miriam J. Alter, PhD, in a January 1999, article for the journal American Family Physician. If six to 12 months of blood tests show liver enzymes have remained normal, they said, patients' blood could then be tested once a year.

How well treatment works depends partly on which type of the virus the patient has. Researchers have pinpointed three genotypes (versions) of the hepatitis C virus. Unfortunately, genotype 1 -- the most common form in the United States -- is the hardest to treat successfully.

With all three genotypes, some doctors begin treatment incrementally, using interferon alone; in those cases only 15% to 25% of patients remain virus-free after one year. That's not counting African-American patients, who for some reason -- researchers aren't sure why -- remain virus-free only about 5% of the time, according to an NIH study presented in 1998 before the American Association for the Study of Liver Diseases. Black Americans also progress much more slowly to end-stage liver disease than people of other races. The combination therapy is slightly more effective against genotype 1, with a 30% success rate (again except for African-American patients, who respond more poorly). "The response rate is low, but it is getting better," says Seeff.

Patients generally are treated with the combination therapy for six months, then retested. If blood tests show no hepatitis C, those with genotype 1 stay on the regimen another six months to increase the odds of successful remission. But if the virus is still present, doctors usually decide the treatment isn't working and discontinue it.

Hope for the Future

Scientists do hold out hope, however, as they continue to research new and improved weapons against hepatitis C. One promising drug in development is pegylated interferon, which is less readily excreted from the kidneys than the interferon now in use, so it remains at consistently higher levels in the blood. That means patients will need to be injected only once a week, which may make treatment more physically and psychologically tolerable.

Preliminary data suggest pegylated interferon, used with ribavirin, can be just as helpful as the current combination treatment -- possibly even 10% to 15% more effective, says Seeff.

The ideal solution would probably be a vaccine, so that everyone could be protected against this mysterious and insidious disease. But experts don't expect to have one anytime soon. "The virus undergoes mutations," Seeff says. And it mutates so quickly that an inoculation given today wouldn't work against an evolved strain a few years later. "There may be other ways of dealing with hepatitis C" still to discover, he says. "But there is no conventional vaccine on the horizon."

Bob Calandra is a freelance writer whose work has appeared in People and Life magazines, among others. He lives in Glenside, Penn.

For More Information From WebMD:

Hepatitis C

The Philadelphia Mystery

Frequently Asked Questions About HCV Transmission

Being Free of Hepatitis C for Six Months After Treatment May Mean You're Cured

my.webmd.com/content/article/1678.50486

Hepatitis C: Who's at Risk? By Bob Calandra


If not for a routine blood test, Gerard Kahn wouldn't have known that the hepatitis virus he was diagnosed with 15 years ago was active. A 51-year-old veteran affairs consultant on Long Island, he had no symptoms and was feeling fine. But his liver enzymes were high, a sign that the virus could be poised to do serious damage.

Kahn's doctors recommended the most effective treatment available today: thrice-weekly injections of the antiviral medication interferon and daily doses of ribavirin, an antiviral pill. It's an imperfect option at best: The yearlong treatment can have devastating physical and emotional side effects. What's more, researchers with the National Institutes of Health (NIH) have found it works for only 40% of patients.

Yet people with hepatitis C now face a more promising future than many would have believed a few years back. According to the latest research, most of those who test positive for the virus -- perhaps as many as two-thirds -- may never develop serious liver problems. In fact, many have a better-than-even shot at living long, symptom-free lives.

"Much of the data indicates that a majority of people won't die or even have liver disease," says Leonard Seeff, MD, a pioneering hepatitis C researcher who now oversees the hepatitis C program at the National Institutes of Diabetes and Digestive and Kidney Diseases. "About one-third of individuals who are infected have the potential for disease progression [into illness], and two-thirds will do fine." Miriam Alter, PhD, chief of the epidemiology section of the hepatitis branch at the Centers for Disease Control and Prevention (CDC), agrees. "Many individuals with hepatitis C will not need new livers," she says. The majority will not have the severe form of the disease."

New Research Questions the "Silent Epidemic"

That fact flies in the face of alarming predictions that have gathered momentum since the virus was first identified in 1989. Nicknamed "the "silent epidemic" because people can go for decades never knowing they're infected, hepatitis C quickly raised concerns among medical experts as they began recognizing its potentially lethal effects. Though some patients have no symptoms, the virus can cause severe chronic fatigue and eventually lead to cirrhosis of the liver and liver cancer. People with severely damaged livers must have a liver transplant or they will die. Since the blood-borne virus was clearly linked to intravenous drug use and sexual intercourse, a whole generation of post-psychedelic baby boomers suddenly seemed at risk. As a result, some scientists became convinced we are on the brink of an unprecedented epidemic that could bring an explosion of liver disease in the decades ahead.

"We are really looking at an emerging public health crisis," says Allan P. Brownstein, MPH, president and CEO of the American Liver Foundation, a nonprofit devoted to health education and research. "If people think we have a shortage of livers [for transplant] now, they ain't seen nothing yet." To combat the problem, Brownstein and other advocates have been calling for the government to launch a major nationwide hepatitis C testing and awareness campaign, similar to what has been done for AIDS. "Hepatitis C is not something someone else gets," he says. "Hepatitis C mirrors America, and many people are affected by it or know people affected by it."

But some scientists now think such a sweeping (and expensive) approach may be uncalled for -- especially because findings suggest the virus may not be quite the time bomb many once thought. One piece of evidence is a recent study published in the January 2000 issue of the Annals of Internal Medicine. Seeff and colleagues with the Veterans Affairs department retroactively found the hepatitis C virus in 17 out of 8,568 blood samples taken from young Korean War recruits between 1948 and 1954 -- long before anyone knew the disease existed. The virus occurs in about the same proportion in young American recruits today. Of the 17 with the virus, only one has died of liver disease -- 42 years after his blood was drawn. And seven are still alive with no detectable symptoms of liver disease.

"They still have the virus 50 years later and don't seem to be having a problem," says Seeff. What's more, in a report presented by Seeff in 1995 at an NIH Consensus Conference, he noted that many international studies over the past 20 years have shown that only 10% to 20% of people with hepatitis C had developed cirrhosis of the liver, and few had died of liver failure.

Most doctors agree that hepatitis C is a serious, widespread disease warranting serious study and concern. Already it is the most common chronic blood-borne infection in this country: An estimated 3.9 million Americans -- roughly 1.8% of the general population -- carry the virus, according to the CDC, and an estimated 2.7 million have the active disease, meaning their liver enzymes are affected. That's not counting the prison population, where infection among high-risk inmates is believed to be as high as 40% to 50%.

Most experts also agree that there will be some sort of increase in hepatitis C-related liver disease in the next 10 to 20 years. Experts still point to the drug culture of the 1960s and 1970s as one key reason: Intravenous drug use now accounts for half of all hepatitis C cases, according to Greg Armstrong, MD, an epidemiologist with the CDC, while perhaps 10% to 20% are attributed to sexual contact. The remaining cases stem from a combination of other factors, including infection passed from pregnant women to newborns.

Where the experts disagree is just how much more liver disease we can expect. Brownstein of the Liver Foundation predicts a big increase: "We already have 15,000 on the waiting list [for liver transplants], and 1,500 die every year waiting for a liver," he says. Moreover, in a January 1999 article in the journal American Family Physician, researchers with the CDC noted that end-stage hepatitis C-related liver disease is already the most frequent reason for liver transplants among adults, and deaths from this "could increase substantially during the next 10 to 20 years."

Scientists like Alter and Seeff expect much less of an increase, based on their data. But they emphasize that there are still far more questions than answers regarding this virus. The biggest challenge is determining which people with hepatitis C will eventually suffer serious liver disease, and why.

The Veterans Who Didn't Get Sick

The study of Korean War veterans who appear to be outliving the virus could hold clues: It may be that if infected while still robust and healthy, the body can contain the virus before it can become a threat. "It is possible that the younger you are when you become infected, the less likely you are to develop consequences," Alter says.

And it may be that the older you are when infected, the faster the infection progresses, says Seeff. Several studies suggest that people infected after age 40 are at higher than average risk for severe liver disease; the risk also seems greater for men than women, and alcohol consumption probably plays a role. Genes may also affect susceptibility, according to one British study published in the Dec. 18, 1999, Lancet, although more research is needed to determine its role.

As researchers study and speculate, advocates like Brownstein remain worried. In his view, agencies like the CDC and the NIH could be grossly underestimating the scope of the problem and the number of people walking around undiagnosed. Hepatitis C can go undetected in routine blood tests that test liver enzymes, he says, since doctors know that many different variables can cause high readings. And by the time people have symptoms, they're usually acutely ill -- and typically won't get better with treatment. By Brownstein's estimates, annual hepatitis C-related deaths could triple to 30,000 over the next 10 to 15 years, and "ground zero" for these deaths, he says, will be men ages 35 to 55.

That would put Gerard Kahn, at 51, squarely in the crosshairs. After six months of injections and pills, he has suffered significant weight loss and severe depression, two common side effects of the treatment; worse, the drugs haven't wiped out the virus. "They got my liver enzymes back to normal," he says, "but according to my last blood test, the infection hasn't gone away."

His doctors are considering another round of treatment, and though he dreads it, Kahn says he's willing. "I have a 4-year-old son," he says. "For me, I guess the pain is worth it if I can be around longer with him."

No one knows what will happen to patients like Kahn in the decades ahead. Yet even as scientists explore new treatments and try to chart the puzzling course of this disease, some things are certain. A person should get tested for the virus if any of the known risk factors apply: previous use of intravenous illegal drugs or shared needles (even only once); a blood transfusion before 1992, when reliable screening began; unsafe sex with possibly infected partners; or any other exposure to potentially infected blood. But beyond testing, some scientists worry that discussion of this disease has turned needlessly sensational and shrill. "Hepatitis C is extraordinarily common, and a serious illness," Seeff says. "But there is an utter panic being created in this country, and that is of great concern."

Even with the diagnosis, "you do not have to go out and write your will tomorrow," he says. "The greater likelihood is you will die from something else other than liver disease."

Bob Calandra is a freelance writer whose work has appeared in People and Life magazines, among others. He lives in Glenside, Penn.

For More Information from WebMD:

The Philadelphia Mystery

Living with Hepatitis C

Frequently Asked Questions about HCV Transmission

Being Free of Hepatitis C for Six Months after Treatment May Mean You're Cured my.webmd.com/content/article/1678.50480

Firefighters in Philly say they're infected with hepatitis C at twice the national rate. What's going on?


Philadelphia firefighter Fran Kee well remembers working "swoop and scoop" ambulance calls as a rookie in 1978, in a tough, drug-and crime-ridden section of the City of Brotherly Love.

"If someone was bleeding, you'd put a towel around the wound and try to get them to the hospital," says Kee, a 22-year veteran with the department. "We didn't have gloves or goggles back then."

Kee never gave those episodes a second thought -- until two years ago, when a friend from his rookie class was diagnosed with hepatitis C. Kee decided during a routine physical to get tested. He was stunned when the virus showed up in his blood.

"It felt like being diagnosed with terminal cancer," Kee says. "It was tough to take."

Kee's diagnosis makes him one of 150 Philadelphia firefighters who have tested positive for hepatitis C -- arousing concern in their counterparts nationwide. That's because, according to figures from the Philadelphia Firemen's Union, an astounding 6% of its active and retired members who were tested also have the virus. If those numbers are accurate, it suggests Philadelphia firefighters are being infected with hepatitis C at a rate of more than three times the general United States population (1.8%) and twice that of American men aged 30 to 59 years old (3%).

Sounding the Alarm

The findings have galvanized local and national politicians to come to the firefighters' aid. In June, Philadelphia Mayor John Street allocated $3 million in city funds to help the union offset the cost of testing and treatment. And U.S. Rep. Robert A. Brady has introduced a bill that would designate $10 million for training, testing, and treatment for firefighters infected with the disease.

Philadelphia union president George Casey has heard from firefighters in New Jersey, Rhode Island, San Francisco, Chicago, Miami, and Hawaii. All have the same question: Could they, too, be at abnormally high risk for hepatitis C?

Most experts say no. "There is no reason to believe that first responders" -- fire, rescue, and emergency medical workers -- "have higher rates of infection than other health care workers or even individuals in other occupations," says Miriam Alter, PhD, chief of epidemiology in the hepatitis branch of the Centers for Disease Control and Prevention (CDC).

The danger may even be lower than the general population's. Several studies have consistently reported that surgeons and other health care workers have hepatitis C infection rates of under 1%, Alter says. These include 1993 research by the Division of Infectious Disease at Johns Hopkins School of Medicine, a 1995 CDC study of hospital-based surgeons, and a 1996 a study of orthopedic surgeons by the CDC's National Center for Infectious Diseases. And a June 1995 study published in the Journal of Emergency Medicine that specifically focused on firefighters and paramedics in Anne Arundel County, Md., found that only 2.2% tested positive for hepatitis C -- about the same risk as the general public's.

"The preliminary data so far indicates that firefighters are not at higher risk than the general public," says Greg Armstrong, MD, an epidemiologist who studies the virus at the CDC.

So What's Going On in Philadelphia?

It may be that firefighters there are routinely more exposed to what medical experts call a high-risk population: Intravenous (IV) drug use is a major means of hepatitis C transmission. "In communities with high IV drug use, say, the old major cities -- those firefighters will be more apt to have hepatitis C," says Allan P. Brownstein, MPH, president and CEO of the American Liver Foundation.

Age may be another factor: All but a few of the Philadelphia firefighters testing positive are 45 or older. That means they were working "swoop and scoop" long before gloves and goggles were mandatory on the job -- unlike, for example surgeons, who have always worn gloves and masks. And hepatitis C is known to incubate as long as 20 to 30 years, Brownstein says.

Or the problem may lie with the union's data. Hepatitis C testing is done in two parts, Armstrong says. Reviewing the Philadelphia figures, he found the test results may have included false positives and results that were positive in the first stage of testing but negative after the second. "The preliminary results show that the infection rate isn't 6%," he says. ''We believe 3.1% are true positives." Compare that to data for men in the same age bracket in the general public, he says, and there's not much difference in the infection rate.

Whatever the numbers, Philadelphia firefighters are now faced with disturbing evidence of a much more empirical sort. Since the testing, one of their colleagues has died from liver disease; another recently had a liver transplant. Kee is luckier than most: After a year of treatment, his infection is in remission.

As for the union, Casey will keep advising firefighters to protect themselves and get tested for the virus. "We're taking care of our people and letting the rest of the United States emergency service workers know to be aware of hepatitis C," he says. ''Hep C is a killer that is infecting those on the front lines. We have to raise awareness of this problem and direct some resources toward fighting this disease."

Bob Calandra is a freelance writer whose work has appeared in People and Life magazines, among others. He lives in Glenside, Penn.

my.webmd.com/content/article/1678.50487

Frequently Asked Questions About HCV Transmission


Nearly 4 million people in the U.S. alone are infected with the hepatitis C virus (HCV), and approximately 30,000 new Americans are infected each year. HCV can cause acute hepatitis or can establish itself as a chronic infection damaging the liver over many years. HCV is currently the number one reason for liver transplants in the U.S.

Q: How is HCV transmitted?

A: HCV is transmitted from person to person similar to the way AIDS spreads: by direct contact with infected blood. For instance, HCV can be passed from one IV drug user to another when one carries HCV and they share needles.

Before 1990, the virus readily spread through transfusion with tainted blood and blood products. Since 1990, however, HCV screening techniques have been refined. HCV is now rarely transmitted through blood transfusions; current estimates indicate a 1 in 100,000 chance of getting transfused with an HCV-infected unit of blood.

Contaminated medical devices and supplies can spread HCV infection. For example, the virus can be transmitted from one hemodialysis patient to another when the dialysis equipment that filters the blood is not properly sterilized between uses.

Health care workers may acquire the virus through needle-stick accidents. Transmission from an infected health care worker to a patient is possible, but rare.

The virus may spread through contaminated needles used in body piercing and tattooing, though there are no confirmed reports of this kind of transmission in the U.S. Contaminated needles used for acupuncture treatment could also transmit the virus.

HCV has also been known to spread by sharing intranasal devices used for cocaine.

Infected mothers have approximately a 6 percent chance of passing the virus to their newborns. This risk increases with a concurrent HIV infection.

However, in about 10 percent of people with HCV the mode of transmission is unknown.

Q. Can HCV be sexually transmitted?

A. Sexual transmission of the virus is possible, but it is not an efficient or easy route of transmission for HCV. Studies conducted at sexually transmitted disease clinics suggest that the risk of sexually transmitted HCV is low for people with multiple partners and concurrent sexually transmitted diseases, and even lower for monogamous partners.

It is not known whether HCV can spread via semen or saliva.

Q. How Can I Avoid Spreading HCV?

A. Get tested. The National Institutes of Health recommend that people at risk, including spouses and close contacts of infected people, be tested for HCV infection.

People with HCV should not donate blood, semen, organs, or tissue. They should not share needles, toothbrushes, razors, nail files, tweezers, or other instruments that can become tainted with blood. In addition, open wounds should be covered.

Sex partners of infected people should be informed about the possible risk of infection. Safe sex practices, including using latex condoms, may be recommended, though this is an area of controversy among health professionals since sexual transmission - especially between long-term, monogamous partners - is low.

Q. If the risk of sexually transmitting HCV is low, how do I figure out what degree of precaution to take?

A. Sexual transmission of HCV is a relatively new area of research, and the information available often conflicts.

A new study estimates the risk of HCV transmission to be 1 percent for heterosexual partners. In this study, transmission of the virus occurred only when the HCV-infected patient had active liver disease.

Another study indicated that spouses of HCV-infected individuals were two times as likely as other relatives to acquire HCV. This study also found a higher incidence of transmission in couples married more than 20 years (19.8 percent), compared to those married less than 20 years (8 percent).

Currently the National Institutes of Health (NIH) recommend safe sex practices, including the use of latex condoms, for sexually active people with multiple partners. The NIH cites insufficient data to make the same recommendation to monogamous partners. However, they do advise partners to get tested for the HCV antibody.

Q. What about casual contact?

A. There is no evidence that the HCV virus can be spread through casual contact such as hugging, sharing meals or utensils. There is also no evidence that HCV is transmittable from mother to infant through breast milk.

Sources

NIH Consensus Statement Online 1997 March 24-26; 15(3): in press.

"Evidence of Sexual Transmission of HCV-Infection," N. Caporaso, et al, AASLD Abstracts, Hepatology, October 1996.

"Immune Globulin Protects Against Sexually-Transmitted HCV," Reuters Health Information Services, July 28, 1997.

my.webmd.com/content/dmk/dmk_article_4961668

HIV-1 Test Kit


Home Access offers the only FDA approved, confidential home testing services available. Our tests are safe and accurate, and we offer a range of counseling services to help you interpret your results.

HIV-1 Test (Results in 3 business days.) $55.00 You should receive your order in approximately 1 week. If you need your test sooner or have any other questions, please call 800 HIV-TEST, 800.448.8378. We will be happy to direct you to a local drug store that carries this test and offer any other assistance we can.

HIV-1 Test (Results in 7 business days.) $44.00 You should receive your order in approximately 1 week. If you need your test sooner or have any other questions, please call 800.HIV.TEST, 800.448.8378. We will be happy to direct you to a local drug store that carries this test and offer any other assistance we can.

Hepatitis C Check SM, Hepatitis C Test, $69.95 You should receive your order in approximately 1 week. If you need your test sooner or have any other questions, please call 888.888.HEPC, 888.888.4372. We will be happy to direct you to a local drug store that carries this test and offer any other assistance we can.

Priority Health Care Corporation, 250 Technology Park, Lake Mary, FL 32746 77.HEP-AWARE or HepAware@hepatitisneighborhood.com or www.cdc.gov/nip/news/iom-thimQA10-1-01.htm

Is Thimerisol in vaccines safe?


The IOM Immunization Safety Review Committee's most important conclusions were: 1) that the evidence is inadequate to accept or reject a causal relationship between exposure to thimerosal from vaccines and the neurodevelopmental disorders of autism, attention deficit hyperactivity disorder (ADHD), and speech or language delay, and 2) that although the hypothesis that exposure to thimerosal-containing vaccines could be associated with neurodevelopmental disorders is not established and rests on indirect and incomplete information, primarily from analogies with methyl mercury and levels of maximum mercury exposure from vaccines given in children, the hypothesis is biologically plausible. Learn more: www.cdc.gov/nip/news/iom-thim10-1-01.htm#Overview

Twinrix: first vaccine for HAV and HBV


Twinrix¨ is a combined hepatitis A and hepatitis B vaccine recently approved by the Food and Drug Administration for persons over 18 years of age. Primary immunization consists of three doses, given on a 0-, 1-, and 6- month schedule, the same schedule as that used for single antigen hepatitis B vaccine. This means that a person can be fully vaccinated against both hepatitis A and hepatitis B with three injections compared to the five shots needed to complete the series using the single antigen formulations. Minimum time to complete the hepatitis A and hepatitis B series is the same. Twinrix is indicated for immunization of persons 18 years of age or older against hepatitis A and hepatitis B.

Source: http://www.cdc.gov/ncidod/diseases/hepatitis/twinrix.htm

 

Reduction in hepatitis among Aleuts and Native Americans


Viral hepatitis has historically been common in American Indian and Alaska Native communities. However, the number of viral hepatitis infections in these communities has been reduced with CDC's assistance. CDC has helped these communities reduce the number of viral hepatitis infections in American Indian and Alaska Native communities by: Recommending routine vaccination of children against hepatitis A and hepatitis B; Consulting with the Indian Health Service to integrate viral hepatitis prevention messages into existing HIV and sexually transmitted disease prevention programs; Developing programs to identify American Indian and Alaska Natives with viral hepatitis; Helping to improve access to medical care and treatment options; Funding education and prevention projects; Examining risk factors and co-factors for viral hepatitis; and Assisting in calculating the numbers of people with viral hepatitis and chronic liver disease in American Indian and Alaska Native communities.

Source: www.cdc.gov/ncidod/diseases/hepatitis/spotlights/ai_an.htm

VAQTA vaccine approved for 2 - 18s


CDC has been notified by Merck & Co. that effective November 1, 2000, the upper age usage for Merck's hepatitis A (pediatric) vaccine, brand name VAQTA¨, has been raised for usage through 18 years-of-age. The FDA's previous approval for use was only through 17 years-of-age. Both Merck and GlaxoSmithKline's hepatitis A (pediatric) vaccines now have the same age recommendations for administration, ages 2 years through 18 years. In addition, the new approval also extends the timing of the adult formulation booster dose of VAQTA¨ from six months following the initial dose to an interval of six to twelve months. Current supplies of VAQTA¨ in vaccine storage depots or clinic inventories may now be used in accordance with the new recommendations.

Source: http://www.cdc.gov/ncidod/diseases/hepatitis/a/vaqta.htm

 

Prevention of hepatitis A through active or passive immunization


Routine vaccination of children is the most effective way to reduce hepatitis A incidence nationwide over time. Since licensure of hepatitis A vaccine in 1995, this strategy has been implemented incrementally, starting with the recommendation of the Advisory Committee on Immunization Practices (ACIP) in 1996 to vaccinate children living in communities with the highest rates of infection and disease. These updated recommendations represent the next phase of this hepatitis A immunization strategy. Vaccination of children living in states and communities with consistently elevated rates of hepatitis A will provide protection from disease and is expected to reduce the overall incidence of hepatitis A.
Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4812a1.htm

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Hepatitis Viral Infection can Lead to Death


Although a hepatitis viral infection can be asymptomatic (cause no symptoms) or cause only a mild, flulike illness, it also can lead to liver failure, coma and death.
Source: www.intelihealth.com/IH/ihtIH/WSIHW000/8270/28970/195724.html?d=dmtHealthAZ

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