Viral Hepatitis

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Overview

Hepatitis is an inflammatory disorder of the liver that may be caused by viruses, drugs, and toxins. Symptoms include jaundice (yellowing of skin and eyes) and fever-like symptoms. The three major viruses that affect the liver, hepatitis A, B, and C (HAV, HBV, HCV) differ according to mode of transmission, pathology, and prognosis. Generally, the virus is transmitted through feces, blood, or bodily fluid that contains blood. Fecal contamination of water and food, eating undercooked shellfish, and using contaminated intravenous drug needles are all common routes of transmission. Toxins like alcohol and anti-HIV drugs can lead to nonviral hepatitis.

Hepatitis is considered a sexually transmitted disease (STD) because it can be contracted and spread through intercourse, contact with genitals and the anus, semen, vaginal fluids, and saliva. It is over 100 times more infectious than HIV. Certain high-risk sexual behaviors have led to an increased prevalence of hepatitis in men who have sex with men (MSM). Recent outbreaks have occurred in large cities, like West Hollywood and Atlanta. Other people at greater risk include travelers (hepatitis is endemic in certain countries), day-care professionals, and prison inmates and workers. Hepatitis causes hundreds of millions of dollars in missed work and medical care each year. All forms of hepatitis are reportable to the state department of health.

Newest strains of hepatitis–D, E, F, and G–have emerged within the last 10 years. They are less common and less is known about them. Some, like HDV, require HBV to develop and others are similar to one or more of the three main strains.

Incidence and Prevalence
Hepatitis is a serious health concern worldwide. Countries with the greatest prevalence include Africa, South America, eastern European countries, and Asian countries, excluding Japan. Incidence and mortality rates vary with each type of the disease:

• Hepatitis A
  • Approximately 150,000 new cases in the United States each year
  • 10,000,000 new cases reported globally every year
  • 100 deaths in the United States yearly
  
  
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• Hepatitis B
  • Approximately 140,000 new cases in the United States each year
  • 300,000,000 people in the world chronically infected
  • 1,000 deaths a year in United States from HBV-related liver cancer

• Hepatitis C
  • Approximately 35,000 new cases in the United States each year
  • 4,000,000 people in the United States chronically infected
  • 9,000 deaths a year in United States from HCV-related liver disease

African Americans and Latinos have the highest rates of chronic hepatitis in the United States, especially in urban environments where limited access to health care, crowded housing, and intravenous drug use are prevalent.

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