Hepatitis: An Alphabet of Disease
 My doctor informed me that I am a hepatitis B carrier. I’m soon to be married, and worry about giving it to my wife. I understand that it can be transmitted by intimacy. What do you advise?
 Hepatitis means inflammation of the liver. The liver cells become infected, usually with a virus, and the resulting inflammation causes symptoms. The cells enlarge, blocking the flow of bile, and also do not process the breakdown products of blood efficiently. This results in a buildup of yellow pigment in the blood, or jaundice. Such a person feels ill, tired, nauseated, and may have a fever. He may notice his urine is dark and stools are lighter. Several viruses cause hepatitis. They are conveniently—but not very imaginatively—named A, B, C, and so on.
The most common is hepatitis A, which fortunately causes the mildest form of hepatitis. On rare occasions a patient with hepatitis A can have a severe attack, and die of the disease. It is spread from fecal matter to the mouth in situations of poor hygiene. We cannot emphasize too much the importance of hand washing, especially after using the toilet.
Hepatitis A is usually destroyed by the body’s immune system.
The virus of hepatitis B is a different virus.
The hepatitis B virus may not cause much more of a severe illness than hepatitis A, and may also pass undiagnosed. It does, however, have a habit of continuing in some people. Such persons are called carriers of the hepatitis B virus. People who are chronic carriers may have no problems, but a number may, after many years, develop liver tumors. The good news for your fiancÈe is that she can be immunized and, subsequently, will not get the infection.
A combination vaccine exists that immunizes for both hepatitis A and B in one injection. Persons who intend to travel to parts of the world in which they could be exposed to viral hepatitis are advised to be immunized.
A word about hepatitis C.
Like hepatitis B, it can be spread by sexual fluids, by blood and blood products, as well as by contaminated needles. In a single situation, in which needle electrodes were inadequately sterilized, more than 60 patients contracted hepatitis C. This emphasizes the exactness of the sterilizing techniques that it requires.
Many get hepatitis C (or B) from unsterile needles used by drug users. “Street drugs” are often administered through needles shared by more than one addict. Hepatitis C is a more serious infection in many people than either A or B. Fortunately, newer antiviral medications are proving to be very effective in controlling hepatitis C. To date, however, eradication has not been shown. The medication is extremely costly, and needs to be given long-term.
Other forms of hepatitis have been given names of other alphabet letters, but are much less common.
Blood transfusion in the past was a possible means of getting hepatitis. Now donors are screened much more carefully, and the risk of getting infection from blood is extremely small.
Needle exchange programs have reduced the transmission of hepatitis in the users of street drugs by trading new, sterile needles for used and possibly contaminated ones. These programs are an attempt to spare addicts yet another misery in their already sad lives.
Hepatitis B vaccine is routinely offered to young persons in North America. As yet, there is no suitable hepatitis C vaccine.
Our advice is that your fiancee receive the hepatitis B vaccine a few weeks or months before you marry. Fortunately, even as a carrier, you may enjoy good health free of problems for a lifetime. |
