Hepatitis: three viruses you should look out for

Do you know about hepatitis? The term “hepatitis” refers to any acute or chronic liver inflammation. The inflammation can have different causes: it can be brought on by a virus or alcohol, or be the result of an immune system disorder or of taking certain types of medication. The following text deals specifically with viral hepatitis. In these cases, when the virus enters the liver, it starts to multiply, which causes inflammation as well as the signs and symptoms of hepatitis. The condition is called “chronic” if it lasts for more than six months after the start of the infection. Before that, it is called “acute” hepatitis.

What does the liver do?

The liver is a gland that performs many essential functions, which include producing enzymes that flow into the intestine to ensure digestion. The liver also helps control our metabolism and supports the immune system in combating harmful cells and substances.

Viral hepatitis infections are most commonly caused by the hepatitis A, B or C viruses. These three viruses cause approximately 90 percent of acute hepatitis cases in Canada.

Hepatitis A

This hepatitis virus is transmitted when we eat contaminated foods. The virus may be present in raw or undercooked foods, foods handled by persons who have not washed their hands, and water contaminated by human or animal waste. This is most common in countries where hygiene is lacking and where the virus is widespread. Therefore, travellers who visit popular sun destinations like Mexico or South American countries, even for short stays, are at risk for contracting this virus. And beware the faulty notion that staying in a five-star hotel eliminates the risk of infection!

A hepatitis A infection usually resolves on its own, without any further repercussions. While the infection is not usually life-threatening, it is momentarily bothersome: it normally manifests approximately four weeks after contamination, through general symptoms such as fatigue, nausea, loss of appetite, vomiting, headaches and pain in the liver area. These symptoms usually persist for two months. Antiviral drugs have no effect against hepatitis A. In pregnant women, however, the infection can lead to complications. Young children may be asymptomatic, but they can spread the infection to other members of the family.

Preventing the spread of hepatitis A

- Washing your hands carefully is one of the best ways to prevent hepatitis A.
- Watch what you eat. When travelling, choose sufficiently cooked seafood, as well as fruits and vegetables that are either cooked or that you can peel yourself. Avoid salads, as the lettuce may have been washed with contaminated water.
- Before travelling abroad, you can get a hepatitis A vaccine (not covered by the RAMQ) in travellers’ clinics, from your family doctor or even by pharmacists. Getting vaccinated could be a good investment – something to consider!

Hepatitis B

Hepatitis B is the most common hepatitis infection in the world. It is transmitted through sexual contact or through blood and other body fluids. In many parts of the world, the virus is primarily spread from mothers to their babies, while in North America it is most commonly transmitted through sexual contact and shared syringes in intravenous drug use.

Most infected individuals have an acute form of the disease and their immune system is able to rid their body of the infection in a few months, but others are not so lucky. Hepatitis B can then become a chronic disease that eventually leads to cirrhosis or liver cancer. Since the virus’ constant multiplication causes liver lesions, medication can be taken to try to slow that proliferation of the virus and therefore prevent additional lesions.

There is also a vaccine to effectively prevent the spread of the hepatitis B virus. In Quebec, children are currently vaccinated in grade 4 of primary school with a vaccine that combines the hepatitis A and B viruses. It is administered in two doses.

Hepatitis C

The hepatitis C virus is transmitted through contact with contaminated blood, usually when sharing needles used for injecting illicit drugs. Infected individuals do not experience any symptoms in the early stages of infection. Most discover they have the virus decades after the original infection, upon routine testing. Therefore, in Canada, in 2020, 6,736 new diagnoses of hepatitis C were made. There is currently no vaccine against this type of hepatitis. In the long term, they may develop diseases such as chronic fatigue syndrome, cirrhosis and liver cancer. When the liver is severely damaged, liver failure may occur, which leaves the liver unable to function. A transplant may then be the only therapeutic option to save the individual’s life. However, there are treatments for hepatitis C and they can help rid the body of the virus. These cure more than 95% of people with hepatitis C, but be careful, even if you have had this disease in the past, you can contract it again if the virus is found in your blood. 

Living with hepatitis

For people with chronic viral hepatitis, various lifestyle changes can help improve their quality of life and life expectancy:
- Eliminating alcohol consumption (or keeping it at a minimum), as it speeds the progression of the disease.
- Avoiding medication that can damage the liver. Consult a pharmacist before taking any over-the-counter medication.
- Eating a healthy diet, getting enough sleep and being more physically active are also measures that can help keep the body healthy.

Preventing the spread of hepatitis B and C

- If you use illicit drugs, don’t share needles. Many pharmacies will take back used syringes and can supply sterile ones at minimal cost.
- Beware of tattoos and piercings: look for reputable shops and make sure the employees use sterile needles.
- Practice safe sex. If you have more than one partner (or you only have one partner but he or she hasn’t been tested for sexually transmitted infections), always use a condom.
- Avoid sharing personal items such as razors, toothbrushes, tweezers and manicure or pedicure instruments, as they may be contaminated with infected blood.
- If you think you may have been exposed to the virus, see a doctor without delay.

Questions? Consult your pharmacist!