According to the Department of Health and Human Services, as many as 3.5 million people in the U.S. are living with hepatitis C, one of several strains of the condition characterized by inflammation of the liver. We talked to Dr. Douglas Dieterich, director of the Institute of Liver Medicine at the Icahn School of Medicine at Mount Sinai, for some insight into the prevention and treatment of hepatitis A, B and C.
What is the difference between hepatitis A, B and C?
Hepatitis A is spread by water and food and a fecal-oral manner. It always causes acute infection but never becomes chronic and there's a very effective vaccine now for hepatitis A.
Hepatitis B is spread through blood and sex, and the majority of cases globally are spread at birth and maternal-fetal transmission. There's a very effective vaccine for hepatitis B, which all of our children and most of our healthcare workers have been receiving since 1991.
Hepatitis C is a different sort of virus all together. It is spread by blood contact through contaminated needles or blood supply. The important thing to remember is there's no vaccine for hepatitis C, but there is a cure available if you do have it.
What are the symptoms/warning signs?
The symptoms are all the same for anybody with liver disease: jaundice, yellowing of the eyes, itchiness of the skin. If it's really severe, it can cause confusion and swelling of the abdomen.
Who should be tested?
Frankly, I think everyone should be tested for hepatitis A, B and C, vaccinated if they are not immune to A and B, and of course treated if they have hepatitis C.
The CDC recommends all baby boomers (born between 1945 and 1965) be tested for hepatitis C. However, there is a new epidemic of heroin abuse, and the same number of people under 30 have hepatitis C now as the baby boomers, so we are suggesting universal screening for hepatitis C.
How is it treated? What are the outcomes for treatment?
Hepatitis C is easily treated now with all oral medication pills once a day for 8, 12, 16, or 24 weeks with very close to a 99% cure rate. Hepatitis B also is easily controlled and the virus suppressed, which reduces complications, but we don't have a cure yet. There is no treatment for hepatitis A.
What if left untreated?
If hepatitis B or C are left untreated they can result in cirrhosis, liver failure, liver cancer, liver transplant, or death.
How can it be prevented?
Vaccines can prevent hepatitis A and B, and the careful control of risky behavior can prevent acquiring hepatitis C.