May 16, 2014
News Review From Harvard Medical School -- CDC Highlights Need for Hepatitis Testing
U.S. health officials have released research on hepatitis testing and care as a prelude to National Hepatitis Testing Day on Monday, May 19. May is also Hepatitis Awareness Month. There are several types of hepatitis caused by viruses. Hepatitis B and C can cause long-term illness and liver damage. The Centers for Disease Control and Prevention (CDC) did the research. The CDC said one project was able to strengthen primary care for hepatitis C in rural areas of Arizona and Utah. Programs in three other states focused on hepatitis B testing. They targeted people born in countries where at least 2% of the population is infected. The CDC said expansion of programs like these will help prevent the spread of hepatitis B and C. The journal Morbidity and Mortality Weekly Report published results of the two studies May 9.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
This coming Monday, May 19, is National Hepatitis Testing Day. If it were up to me, I would call it Hepatitis Testing and Vaccination Day.
We have seen remarkable progress during the last 50 years in the testing, treatment and prevention of viral hepatitis.
The term hepatitis means that liver inflammation is present. The liver can be inflamed from multiple causes, not just viruses. For example, many drugs cause liver inflammation. This is called drug-induced hepatitis. And many different viruses can inflame the liver. But in general, we use the term viral hepatitis to identify five specific types:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hepatitis D
- Hepatitis E
The reason for recognizing Hepatitis Month and Hepatitis Testing Day is to raise awareness of these types of viral hepatitis, especially hepatitis B and C. At first, infection with either of these two viruses often causes few or no symptoms. But the virus stays active in the liver, with the potential of causing damage over many years.
An estimated 3 million people in the United States are infected with the hepatitis C virus. But 65% of them do not know they are infected. Of the 1.1 million people who have hepatitis B, 55% are not aware of being infected.
There are two very good reasons to know if you are infected with one of the hepatitis viruses:
- Knowing you are infected helps you take actions to avoid passing the virus to others.
- Hepatitis B and C can be treated. And treatment greatly reduces the risk of cirrhosis and liver cancer, the need for liver transplant, and death from liver failure.
Two reports in the May 15 issue of the New England Journal of Medicine show incredible success with antiviral drugs in treating the most common type of hepatitis C. The drugs cleared the virus from blood in 96% to 99% of infected people. Clearing the virus from blood does not always mean cure. But it does mean the chance of liver damage and risk of liver cancer are greatly reduced.
What Changes Can I Make Now?
Get tested. If you are a baby boomer and have not been tested for hepatitis C, do it on Monday. Baby boomers include the generation born between 1945 and 1965.
The blood test for hepatitis C also is recommended for people who:
- Injected or "snorted" drugs in the past
- Currently inject or "snort" drugs
- Had a blood transfusion before 1992
- Had surgery before the mid-1980s (when surgeons adopted more rigorous sterile precautions)
- Receive dialysis treatments for kidney failure
- Were born to a mother with hepatitis
- Have served time in jail
- Got a tattoo in a shop that was not regulated by its state and did not have a high safety rating
Testing for hepatitis B depends on your risk. Get tested if:
- You are pregnant
- You were born in Asia, Africa or another region with moderate or high rates of hepatitis B
- Your parents are from regions with high rates of hepatitis B
- You have sex or live with a person infected with hepatitis B
- You are a man having sex with other men
- You have advanced kidney disease or you are on dialysis
- You have HIV infection or another condition that may impair your immune system
- You will be taking a drug that might impair your immune system
- You have served time in jail
Get vaccinated. All children should be vaccinated against hepatitis A at age 1 year. For adults, the hepatitis A vaccine is recommended if:
- You live in a community with a high rate of hepatitis A
- You are a man and have sex with other men
- You use street drugs
- You work or travel to countries with high rates of hepatitis A
- You have long-term liver disease
- You receive blood products to help your blood clot
All children and teens should be vaccinated against hepatitis B. For adults, the hepatitis B vaccine is recommended if:
- You have sex with or live in the same house as a person with hepatitis B virus infection
- You have sex with more than one partner
- You have long-term liver disease
- You have diabetes and are under age 60
- You live or travel for more than 6 months a year in a country where hepatitis B is common
- You are a man who has sex with other men
- You inject drugs
- You are a dialysis patient or have advanced renal disease
- You have HIV infection
Hepatitis D is rare. Hepatitis E rarely causes long-term infection. It is uncommon in the United States.
What Can I Expect Looking to the Future?
The outlook for infection with hepatitis B and C will continue to improve as these new, very effective drugs become more available. But treatment is extremely expensive.
That's why vaccination is so important. All children and at-risk adults should get the hepatitis B vaccine. There is no vaccine yet for hepatitis C. But we can expect that one will be developed.