Hepatitis C, Acute - Report Form Part 2: Fill & Download for Free

There are 7 known types of viral hepatitis A to G there are also many other forms of non viral hepatitis which are not listed hereTypes Of Viral HepatitisHepatitis A- Infectious HepatitisHepatitis A (HAV) is caused by the hepatitis A virusThe virus is excreted in the faeces of infected people and can be passed on when contaminated food or water is consumed by susceptible individuals. Hepatitis A is most commonly transmitted by person to person contact via faecal contamination but epidemics can occur from sources of contaminated food, water or ice cubes. Poor sanitation and overcrowding facilitate transmission and outbreaks are common in institutions, prisons and the military.Many infections with hepatitis A do not produce any symptoms especially in children. When symptoms occur around 30 days after infection they are usually mild and last for around 1-2 weeks. The symptoms are characterised by sudden onset of fever, malaise, nausea, anorexia, and abdominal discomfort, followed in several days by jaundice. Occasionally, the symptoms are severe and convalescence can take several months due to being chronically tired. Occasionally hepatitis A can be fatal. These rare deaths usually occur in the elderly.Once recovery from hepatitis A is complete you have life long immunity and cannot contract the virus again. Milk Thistle has been reported to reduce the recovery time following Hepatitis A infection.A vaccination made from inactivated hepatitis A virus is now available and consists of an initial vaccination followed by a booster that is effective 94-100% of the time.Hepatitis B - Serum HepatitisHepatitis B is caused by the hepatitis B virus. The virus is very common in Asia, China, Philippines, China, Africa and the Middle east. In Europe and North America the incidence of known carriers is about 1 in a 1000 people. World wide, it is estimated that there are over 350 million hepatitis B carriers which represents 5% of the worlds population and it is estimated that 10 to 30 million people become infected with the virus each year.Hepatitis B (HBV) is transmitted by the exchange of body fluids e.g. Blood, Semen, Breast Milk and in some circumstances saliva. People most at risk include:Anyone who has unprotected sexual intercourse.IV drug users who share needles and syringes.Health care workers in contact with potentially contaminated blood or body fluids.Babies born to mothers with the virus.Anyone in intimate contact with an infected person.Many cases of acute hepatitis B occur sporadically with no known source and studies have shown that prior unrecognised infection is common.It is possible to be infected with the hepatitis B virus (HBV) and experience no illness or symptoms whatsoever. Commonest is an acute attack of hepatitis during which you may feel unwell, tired and lose your appetite. Sometimes there is the characteristic yellowish colour of jaundice best seen in the whites of the eyes. This can last from a few days to a few months. Itching skin and pale stools may also occur. In some cases hepatitis B can be fatal, especially in the elderly where mortality rates may be as high as 10 - 15%.Around 90% of people infected with hepatitis B recover completely and become immune to the virus. Blood tests will show antibodies to hepatitis B indicating you have had hepatitis B but are now immune and cannot get hepatitis B again. However 10% of people infected with hepatitis B develop chronic infection, may have ongoing symptoms and they continue to be infectious for a variable length of time. Chronic infection is defined as having hepatitis B present for 6 months or more.People with a chronic hepatitis infection are at risk of liver damage and around 20-30% of these progress to cirrhosis.A safe and effective genetically engineered vaccine for hepatitis B is available. It is given in 3 intramuscular subcutaneous injections (just under the skin) generally over a period of 6 months and conveys immunity in 90 to 95% of people treated. At the end of the course of injections a blood test is taken to see if you have developed the required antibodies. For the 5 - 10% of people who do not respond some new research has shown that a repeat course of injections given intramuscularly can create an immune response in between 62-98% (depending on several factors) of those who did not respond or whose response did not last when given subcutaneously.In the UK it is now recommended that the 3 injections are now given into the deltoid muscle to improve the likelihood of a response to the vaccine.Once vaccinated it is important to be periodically tested to ensure that the body has sufficient levels of antibodies to prevent infection and a single booster dose may be required every 5 to 10 years to ensure immunity from infection.If an unvaccinated individual is exposed to the virus accidentally, hepatitis B Immune globulin can be given. Ideally within 24 hours of exposure and no later than 7 days after exposure, a repeat dose is necessary 28 - 30 days later. Hepatitis B Immune globulin is generally given where there is a known risk of infection, e.g. via needle stick injury or to new-born infants born to Hepatitis B surface antigen positive mothers. In many cases hepatitis B immune globulin can prevent initial infection with hepatitis B but there are also a significant number of cases where it has not prevented infection after exposure.Hepatitis C - Non A - Non B hepatitisTaken from the HEPV-L Hep C FAQHepatitis C, formerly Non A - Non B hepatitis is caused by the hepatitis C virus. Hepatitis C is believed to cause between 150,000 and 250,000 new cases in the United States each year. Haemophiliacs and drug abusers are at the greatest risk, but anyone, of any status or age and in any walk of life, is at risk for acquiring the hepatitis C virus. Researchers have found that many people infected with hepatitis C don't even know it. From 20 to 40 percent of patients in inner-city hospitals are infected, as are 80 percent of drug users.Most people with hepatitis C contracted it either through a blood transfusion or receiving blood products (plasma, etc.) that was contaminated with hepatitis C, or by sharing needles with intravenous drug users that were infected with hepatitis C. Prior to 1990 blood could not be screened for HCV. Thanks to HCV testing with modern sensitive methods, the risk of acquiring hepatitis C from blood transfusion is now less than 1%. The other means of acquiring hepatitis C include health care and laboratory workers that may get stuck with an infected needle or instrument, people receiving medical/dental procedures or people that had tattoos that were performed with poorly sterilised equipment. Infected mothers can pass the virus to the foetus in utero but this occurs less than 1% of the time. It may occur more readily if the mother is also infected with the human immuodeficiency virus (HIV) that causes AIDSCases of hepatitis C with no evidence of exposure through blood transfusions, needle stick or needle sharing are called "sporadic". How these individuals became infected is unknown.The risk of sexual transmission of hepatitis C virus has not been thoroughly investigated but appears to be minimal with general sexual contact. However with rough or traumatic sex (E.g. fisting) or when multiple partners are involved and body parts or toys etc are shared and not disinfected between partners then risks can increase substantially.Some people experience no symptoms after initial infection with the hepatitis C virus, however many people have a flu-like illness with fatigue, fever, muscular aches and pain, nausea and vomiting. Around 10% of patients become jaundiced but in the majority of cases these symptoms resolve. The acute phase of hepatitis C if rarely fatal.Although symptoms resolve, around 80% of people infected with hepatitis C become chronically infected. Although frequently showing no symptoms the hepatitis C virus continues to reproduce and damage liver cells and after may years this may lead to liver disease including cirrhosis.The is currently no vaccination available against hepatitis C.As Hepatitis C and other diseases can be spread by using something with infected blood on it (even though it may not be visible) you can reduce the risk of infection by not sharing items of personal hygiene that may be contaminated such as razors, nail clippers, scissors, tooth brushes etc.Hepatitis C is a large and complicated subject The majority of information contained within this document on hepatitis C and some general hepatitis information is taken from the HEPL-V Hepatitis C FAQ.Hepatitis DThe Hepatitis D Virus (HDV) is a unique, defective RNA virus that can only infect an individual in the presence of hepatitis B. It occurs either as a co-infection with acute hepatitis B or as a superinfection in people with chronic hepatitis B. Hepatitis D is mostly found among IV drug users, but transmission by other routes is possible.Infection with hepatitis D can make the acute phase of hepatitis B unusually severe. It can cause an acute "exacerbation" in chronic hepatitis B carriers (superinfection), or cause a relatively aggressive course of chronic hepatitis B.Some recent research as shown that hepatitis D can exist without Hepatitis B being present. But the presence of hepatitis B is required for the initial infection to take place.(?)Hepatitis EThe hepatitis E virus is transmitted in the same manner as hepatitis A and produces similar symptoms. Hepatitis E does not cause chronic infection and has a similar prognosis to hepatitis A infection.There is currently no vaccine available against hepatitis E.More hepatitis E information...Hepatitis FHepatitis F appears to be transmitted by the oral fecal route in a similar manner to hepatitis A and E although the epidemilogy of the virus has not yet been fully established.In several cases of non-A-E hepatitis reported in western Europe, the United States and India, virus-like particles were observed in stool samples using an electron microscope. The virus called HAF consists of double-stranded DNA and is substantially different from HAV and HEV, both of which are RNA based.Currently there is no serological test for diagnosing hepatitis F in cases of acute hepatits but electron microscopy of stool samples may be of assistance after tests for other viruses have failed.Hepatitis GAvailable studies demonstrate that HGV-infection is a blood transfusion and parenterally transmitted disease; HGV-infection is relatively mild in most cases; among transfusion recipients, HGV-infection is about as frequent in those formally diagnosed with hepatitis as in those with only mild ALT elevations; HGV and hepatitis C virus can be transmitted simultaneously and result in persistent co-infection; HGV-infection can be persistent and cause chronic hepatitis. ; the prevalence of HGV is higher than that of hepatitis C virus and unrelated to the ALT status of the blood donor; and the role of HGV in fulminant hepatitis and hepatocellular carcinoma has not been delineated.The viruses that cause hepatitis G (GBV-A, GBV-C and GBV-C) are RNA based and in the same family as hepatitis C.As a relatively 'new' disease there is still much research to be performed and information is relatively scarce. At the time this was written it appears that HGV has uncertain pathogenic potential.

Let’s simplify this:HEPATITIS is an inflammation of the liver. Inflammation is caused when your autoimmune system rushes to help heal a part of your body that has some sort of infection. You see inflammation if you cut yourself and don’t clean the cut. There will be a red, swollen, and painful area around the cut as your body defense takes over. (itis is the medical suffix for inflammation and Hepa is the root basis for liver) So, Hepatitis refers to any illness that causes an inflammation in your liver and it can be caused by a specific bacteria, a virus, or a liver issue related to a congenital disease or the like.Because your liver does 4000 things for you each day, taking care of it and clearing any form of Hepatitis when noticed is highly important.From there, there are many types of attacks on your liver that can cause it to become inflammed. The letter attached to the word Hepatitis is the complete name of the attacking agent, itself.Hepatitis A is bacteria. This is where you ate something that had the specific Hepatitis A bacteria in it that attacks your digestive system and your liver. Since it has entered your digestive system, it also shows up in your bowel movements (feces) and can get on your hands. Thus it is the Health Department’s concern about santitation in the food industry to include washing your hands with soap and water. This is a serious potentially life-threatening illness that needs immediate medical treatment and notifications to the county health department to prevent further transmission once detected in any one person. It takes some time to recover, sometimes months and years.Hepatitis B through G are viral attacks on your liver. That means that a specific virus to that form of hepatitis entered your body and is inflamming your liver. Colds are viruses. Chicken Pox is a virus, as are measles and lots of other things that you get sick and clear relatively shortly in many cases. Each one is it’s own type of virus and each virus is different and can mutate different ways. Each can be a one time incident, whereas some can become chronic.However, with Hepatitis, it targets the liver and many illnesses that target the liver and cause inflammation share the starting name. For reasons to reduce confusion, they have named each of these viruses with an alphabetical letter to represent the specific virus for that particular illness. Thus the Hepatitis C illness and inflammation is caused by the Hepatitis C virus, it’s actual name. Additionally, there can be many strains (genotypes) of the same virus if it mutates, which is what makes developing a vaccine so difficult.Let’s break down the viral infections. Each one has it’s own type of virus.Hepatitis B is a virus that can be transmitted through contact with the fluids of someone who is infected… Thus, you can get it in contact with their blood, during sex, sharing IV needles, mother to child during delivery, sharing toothbrushes and razors where blood is present and so on. It is pretty serious and frequently causes a pretty serious illness when you are initially exposed. It is thought to clear up and your body makes antigens to prevent it from coming back in 90% of all cases. In 10%, it can develop into chronic Hepatitis B and you become a carrier who can expose others to the Hepatitis B virus during times of flare up. The virus dies fairly quickly in the open air.Before moving on, I would like to note that there is a vaccine to prevent both Hepatitis A and Hepatitis B. There is not a vaccine for C, though they are continuing to research that. Many healthcare and emergency response workers think that A/B virus protects them from C. It doesn’t not. However, it is wise to get the 2 that are available.Hepatitis C is a virus of its own that was endemic in the Vietnamese population during the Vietnam War, and as such, you may have heard that more Vietnam Vets should be tested, or baby boomers from that 1945 to 1965 who have a higer infection rate. Endemic means that it is a common health issue in that area and the people’s bodies have adapted to it. A VVA medic once listed 42 ways a soldier could have gotten it in country back during the war. VA testing has shown a higher incidence in their treatment populations.It is transmitted by blood-to-blood exposure and studies have not found it in sexual or uterine fluids. Thus, to transmit the HCV, you need a contaminated person’s blood to enter the bloodstream of another person. This can be by shared needles, blood splashes (eyes, nose, etc) during emergency or medical treatment, rough sex if skin is broken to cause bleeding and that gets into a partner’s blood, and contamination of equipment used for medical and dental purposes, tattoo and piercings and any other situation that causes contaminated blood to be exposed to anything put in your bloodstream, like shared razors or toothbrushes (broken skin and gums). Studies have shown that in the right condition, HCV can live on a counter for 3 weeks and resists alcohol. Thus, cleaning IV needles with alcohol doesn’t work. It’s one of the reason infectious disease precautions are so important. It is also one of the the reason healthcare workers have 3 times the infection rates of the normal population (Uni of V study).Unlike the norm of assuming that you contract a virus, get ill, get over it and are immune, in over 70%-85% of the cases, the actual Hepatitis C virus can stay in your blood or your cells for the rest of your life unknown to you. You can actually have such a mild initial case that you think you have a touch of the flu. In up to 20% of the cases, it can destroy your liver within 5 years, leading to death. In other cases, you can feel fine and discover after as many as 30 years that it has destroyed your liver and you need a transplant. Thus, particularly if you are of the baby boomer generation, you should be tested to be sure you weren’t exposed. And all Vietnam vets should be tested. With some people, the virus can make them constantly feel like they have a serious flu, which can lead to loss of their job and eventual homelessness. The homeless population had a very high rate of Vietnam Vets in my county in the ’90s - over 55%. Chronic HCV does a health dance with your body. Sometimes you are taking care to get the sleep, food, water, and diet that your body needs and you aren’t drinking too much alcohol or using too many prescription or illegal drugs, and this gives your body the tools to control the virus. They may not show up in the blood but may still lurk in tissues. Then you get busy and start ignoring your health and the virus starts replicating and attacking your liver. Or some other illness can drop your immune system’s resistance to the virus. In other words, life gets in the way.Anyone at risk should be tested and treated. In many states, firemen and emergency response personnel are presumed to have on the job infections if they come up positive after starting employment. Hopefully, the same will become true for hospital workers. It’s always good to get tested before taking a job in those industries. Regardless, you can work and live with Hepatitis C. However, they recently developed a treatment of pills that clears the virus in 95% of the patients who have no previous treatment history. I don’t know what the stats are beyond that. If you test positive for HCV, consider asking your doctor to be treated.Hepatitis D is also a virus but it can only infect you if you are infected already or concurrently get infected with Hepatitis B and it is also a bloodborne virus. It is much less common for that reason. If you have both viruses it is common to have much more severe complications during the initial infection. Although this can apparently live in your body chronically afterward, it is thought to be a more benign infection if you do not have an active case of Hepatitis B.Hepatitis E, also a virus, is spread through eating or drinking due to food and water contamination of a virus instead of a bacteria. It’s more common in developing countries and is endemic in many (more commonly, antigens are found in the blood with little or no problems). It can cause a serious issue with the liver during an initial acute infection and is generally transmitted through drinking water or food that has been contaminated by feces carrying the virus. Only one strain of the virus apparently develops into a chronic illness. The death rate is very low with the exception of pregnant women exposed during their third trimester. China has apparently developed a vaccine for use there. I find it interesting that the U.S. shows the antibodies in a decent percent of the population, thus indicating it might be endemic here.Hepatitis E Questions and Answers for Health Professionals (CDC HEV Page)Hepatitis F may be several different viruses. The jury is out. It is apparently becoming the catch all at the moment for any virus that isn’t on this list. Possibly like the old Non-A-Non-B Hepatitis, but the incidence of it is greatly reduced as Hepatitis C once represented the bulk of the cases that were defined that way.Hepatitis G is a virus that has been found in post-transfusion patients. It is still under study and it thought to possibly be related to HCV or HBV distantly. First described in 1996, most patients who have it also have the HCV or HBV infections chronically. It is considered to be its own virus, though. It is still in the hypothesis stage of what its all about. The blood supply wasn’t tested for Hepatitis C during blood donations until 1990. Some reports say 1992, but my husband/healthcare worker donated blood annually and tested negative by the blood bank in 1990 and 1991, thus giving him the baseline he needed when he was infected at work in 1992. As is true with Vietnam Vets, I am sure that they are being cautious about conclusions on this considering the difficulty dealing with important issues that put people at risk…. to include liability.Here’s the CDC website for further reading.Hepatitis C Information

Yes, a negative HBsAg (Hepatitis B surface antigen) blood test result isn't 100% reliable and this answer explains how that could happen. Escape is the outcome of multiple dynamic donor and recipient variables that intersect with each other in a highly unpredictable manner (below from 1) so pinning down its percentage in hard numbers isn't feasible.Occult describes cases of Hepatitis B (Hep-B) infection where HBsAg is undetectable while replication-competent HBV (Hepatitis B virus) DNA may or may not be detectable in the blood (below from 1, text modified as bullet points by me and table).“We have identified 25 published cases of recipient HBV infection acquired from donors in the HbsAg-negative window period and have summarized these data in Table 10. Cases (usually published as part of a case series) have been reported from the United Kingdom, Japan, and Germany and have been found either through donor-initiated lookback or via recipient-based surveillance systems that have captured and investigated cases of reported post-transfusion HBV infection.105-111In the large majority of cases reported in Table 10, the transmitting donation was found to be positive for HBV DNA if tested by ID NAT [Individual donation Nucleic Acid Amplification Technology];however, in three cases (Table 10, Case 1, and a single case in Case Series 3 and 5), HBV ID NAT was negative.In two of these cases (Table 10, Case 1, and Table 10, Case Series 3), transmission was proven by sequence homology between donor and recipient isolates.In one of these cases (Table 10, Case 1),105 the donor tested positive for HBsAg and HBV DNA 2 months after index donation. The recipient was under treatment for leukemia and when evaluated 12 weeks after transfusion tested HBV DNA positive despite the presence of passively transfused anti-HBs (from a HBV-vaccinated PLT [platelet] donor) at a concentration of 58 IU/L.In the other case (Table 10, Case Series 3),107 the donor was positive for HBsAg 6 weeks after index donation but HBV DNA results were not reported.In addition to the transmitting cases, several of these publications also included cases (one case in Case Series 2 and 11 cases in Case Series 4) 106,108 in which HBV DNA– positive components did not transmit infection to the recipient.”“OBI [occult Hepatitis B infection] is defined as the presence of HBV DNA in the absence of HBsAg in patients who are not in the HBsAg negative window phase of acute infection.38,40 Almost all such donors have detectable anti-HBc [anti-HBV core antibody] and about half have anti-HBs [anti-HBV surface antibody]. The majority of these OBIs are thought to represent past HBV infections that have been controlled but not completely cleared by the immune system, but some may represent chronic HBV carriers that lost detectable HBsAg over time. In either case, HBV DNA is generally present in low concentration (<100 IU/mL) and can fluctuate over time, being detectable only intermittently even with the use of highly sensitive NAT assays. Recent studies of OBI donors in Europe have shown that, at least in this location, most OBI donors harbored mutated HBV strains.47-49 Many of these mutations occurred in the S gene encoding the major immunodominant region of HBsAg and it is possible that in some OBI cases, an altered form of HBsAg could be present but not detectable by at least some commercial HBsAg assays.”In essence, OBI means HBV in liver but at much lower levels, and both its DNA and surface antigen, HbsAg, practically undetectable in blood (figures below from 2).A more recent 2019 study (3) better clarifies how transmission could be possible under such circumstances. It examined 3 repeat donors from Slovenia who were not only HBsAg negative but also had undetectable HBV DNA by highly sensitive NAT and yet transmitted HBV to 9 recipients who were transfused with various blood components from these donors.Long-term evaluation of these OBI donors showed that they alternated between phases where viremia (detectable virus in blood) was apparently absent and phases with very low but detectable virus loads. Blood products from these 3 OBI donors had been transfused into 47 patients and follow-up data was retrieved from 31 of them.Seven of them (22.5%) had anti-HBs antibodies and weren't infected.Nine (29%) were definitely infected; >99% donor-recipient sequence homology in 5, probable in 3 and possible in 1.Based on the specifics of the blood products transfused in these cases, this study revealed that OBI blood products such as ~200ml of fresh frozen plasma that presumably contained ~3200 virions or red blood cells containing ~20ml plasma (~320 virions) could transmit HBV to naive recipients. The study concludedTransmission was possible with a minimal dose of as few as ~3.0 IU/ml (~<16 copies/ml) of HBV DNA, far lower than the previous infectious dose of 20 IU/ml (~1017 copies/ml).The NAT sensitivity threshold necessary to prevent transmission needs to be lowered from the current 3.4 IU/ml to an even lower 0.15 IU/ml (or 0.8 genome equivalent/ml).Lowering these cut-off thresholds won't be easy to implement and aren't cost-free since they necessitate testing much larger volumes of single donations and would preclude minipool testing (small sample derived from a large group of blood donors).Another approach would be to treat blood donation components with specific pathogen reduction steps such as treatment with amotosalen, a Psoralen - Wikipedia, and UVA light.Bibliography1. Kleinman, Steven H., Nico Lelie, and Michael P. Busch. "Infectivity of human immunodeficiency virus‐1, hepatitis C virus, and hepatitis B virus and risk of transmission by transfusion." Transfusion 49.11 (2009): 2454-2489. http://www.academia.edu/download/46065816/Infectivity_of_human_immunodeficiency_vi20160530-32615-16m0xmb.pdf2. Raimondo, Giovanni, et al. "Update of the statements on biology and clinical impact of occult hepatitis B virus infection." Journal of hepatology (2019). Update of the statements on biology and clinical impact of occult hepatitis B virus infection3. Candotti, Daniel, et al. "Multiple HBV transfusion transmissions from undetected occult infections: revising the minimal infectious dose." Gut 68.2 (2019): 313-321. https://dl.uswr.ac.ir/bitstream/Hannan/57032/1/2019%20GUT%20Volume%2068%20Issue%202%20February%20%2817%29.pdfThanks for the R2A, Alec Bean.