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Hepatitis Information

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Hepatitis means inflammation of the liver. There are different forms of hepatitis which have different effects on the liver and are transmitted in different ways.  Below is information relating to Hepatitis A, Hepatitis B and Hepatitis C.

A guide to Hepatitis services offered by GOSHH is available here – GOSHH Hepatitis Services 2017

Testing is available for FREE from in a variety of testing locations across Ireland. For more information of testing centers in your area click HERE

Hepatitis A 

Hepatitis A, (Hep A or HAV) is a viral infection.

Symptoms

Around 50% of people infected with hep A have no symptoms at all.

There are many potential symptoms and these include:

  • Flu-like symptoms
  • Fever
  • Nausea (feeling sick)
  • Exhaustion (feeling tired)
  • Weight loss

A change in the taste of fatty foods, tobacco and/or alcohol

The most well known symptom of hepatitis is a yellow discoloration of the skin (jaundice) which appears after infection and lasts for up to three weeks, you may be infectious during this period of time.

Transmission

Hepatitis A is transmitted by contaminated food or drink and commonly occurs when sanitation is poor (poor hygiene).

Hep A can also be transmitted through contact with infected faeces (shit). So although it is not normally a sexually transmitted infection, it can be transmitted through sucking and/or licking of the anus (oral to anal play).

Prevention

If you have been diagnosed with hep A, it is best to avoid any form of anal play which may involve traces of faeces getting into the mouth.

It is important to wash all areas of the body and any sex toys used, that may have come into contact with faeces after all forms of anal play.

Barriers such as glyde dams, gloves, condoms and female condoms can be used during all forms of sexual activity to reduce the risk of hepatitis A transmission.

Control

If you think you have been at risk, you can have a sexual health screen in your local STI clinic to receive treatment and to be examined for other possible infections.

Your sexual partner(s) may also need testing as they may be infected even if they do not have symptoms.

There is now a vaccine available against hepatitis A. Get a free vaccination from your local STI clinic.

The hep A vaccine is usually also available to people who are travelling abroad to countries where sanitation is poor and/or hepatitis A is common.

Remember – Regular screening at your local STI clinic is recommended to maintain your sexual health.

Treatment

There is no treatment for hepatitis A. If you have been diagnosed with hep A, you should rest and avoid alcohol until your body clears the infection. This may take a few weeks.

 

Hepatitis B

Hepatitis B, (hep B or HBV) is a viral infection.

It is a serious infection but in the majority of cases a person fully recovers within 6 months after diagnosis. In a minority of cases it can cause chronic liver disease.

Symptoms

Most people who are infected with hep B experience mild symptoms which progressively worsen.

This illness is characterised by:

  • Tiredness
  • Loss of appetite
  • Unexplained weight loss
  • Darkened urine
  • Stomach pains
  • Pale faeces
  • Yellowing of the eyes and skin

 

The most well known symptom of hepatitis is a yellow discoloration of the skin (jaundice) which appears 4-6 weeks after infection; you are infectious during this period of time.

Transmission

Hep B is present in blood and other body fluids.

The most common route of infection is sexual transmission particularly unprotected sexual activity including water sports (if urine gets in the eyes and mouth) and oral to anal play. If you are fingering both yourself and your partner or sharing sex toys, this could also lead to transmission.

Hepatitis B can also be transmitted by sharing drug using equipment, (syringes, straws, spoons, filters, water and needles) with an infected person or receiving a tattoo/piercing with un-sterilised equipment. It may also be transmitted from mother to baby in the womb or during labour.

Environmental transmission is usually a result of contaminated food or drink and commonly occurs when sanitation is poor (poor hygiene).

Prevention

A hepatitis B vaccination is available from your doctor or local STI clinic. Getting this vaccine is a very practical step in maintaining sexual health.

It is administered in three shots:

  • Shot 1 -Today
  • Shot 2 – One month from today
  • Shot 3 – Six months from today

You will need to return after the third injection for an antibody test to check that the vaccination process was successful. In some cases a fourth injection will be necessary.

Men who have sex with men and intravenous drug users are particularly advised to get vaccinated.

Barriers such as glyde dams, gloves, condoms and female condoms can be used during all forms of sexual activity to reduce the risk of hepatitis B transmission.

The hepatitis B vaccine is usually also available to people who are travelling abroad to countries where sanitation is poor and/or hepatitis B is common.

Other groups of people who are advised to get vaccinated include health workers, carers, youth workers, teachers, cleaners, bar/restaurant staff, and anyone concerned about their general health.

Control

If you think you have been at risk, you can have a sexual health screen in your local STI clinic to receive treatment and to be examined for other possible infections.

There are two definitions of hepatitis B diagnosis:

Acute: meaning lasting less than six months and then the body spontaneously clears the virus. Most people will feel better after a few weeks, although they may feel and not have much energy for a few months.

Chronic: meaning when the infection last longer than six months.

Following a Hepatitis B diagnosis:

90% of people will clear the virus, develop life-long immunity, and no longer be infectious

10% of people will not clear the virus, remain infectious, and may develop chronic liver disease

Your sexual partner(s), or other people you may have regular contact with, (family members and children or housemates) may also need testing as they may be infected even if they do not have symptoms. Even if they do not receive a Hepatitis diagnosis, they can receive the Hepatitis vaccine.

Remember – Regular screening at your local STI clinic is recommended to maintain your sexual health.

Treatment

There is no treatment for hepatitis B but some people will be offered the hepatitis B vaccination to help recovery. You will need to build up your immune system in order to allow your body to overcome the virus.

If you have been diagnosed with Hepatitis B, you need complete rest initially which may require a week or two in hospital. Your recovery may take a few months; during this time you need to take it easy, eat really healthy food and avoid alcohol until your body clears the infection.

For the minority who remain carriers of the virus there are now anti-viral drugs available which are successful in suppressing the virus in some cases.

Hepatitis C

Hepatitis C, (hep C or HCV) is a viral infection. There are many different types of hepatitis C.

Symptoms

It is a progressive infection which means it will take years from initial infection before you experience symptoms.

This illness is characterised by:

  • Tiredness
  • Loss of appetite
  • Unexplained weight loss
  • Darkened urine
  • Stomach and/or lower back pains
  • Pale faeces
  • Yellowing of the eyes and skin

Transmission

Hepatitis C is present in blood and other body fluids.

Hepatitis C is mainly transmitted by sharing drug using equipment with an infected person. It can also be transmitted by receiving a tattoo or piercing with un-sterilised equipment.

It may also be transmitted from mother to baby in the womb or during labour.

If you are having sex with an infected person where blood may be present then you may be able to contract hepatitis C.

Prevention

Sharing works for intravenous drug use (injecting) with an infected person is the most common route of transmission. This can be through re-using a needle (spike), barrel (body of) the syringe. Use a full set of clean or sterilised equipment (works) when injecting.

Barriers such as glyde dams, gloves, condoms and female condoms can be used during all forms of sexual activity to reduce the risk of hepatitis C transmission, especially when blood is present.

Hepatitis C transmission has occurred when people received a blood transfusion or blood

products which had not been adequately screened. This should no longer be the case in Ireland.

Control

If you think you have been at risk, you can have a sexual health screen in your local STI clinic to receive treatment and to be examined for other possible infections.

Your sexual partner(s) are advised to get tested for hep C if you have received a positive result.

If you are infected with hepatitis C you can use condoms, female condoms, glyde dams, gloves and other barriers during sexual activity to reduce the risk of transmission.

If you are an injecting drug user with a hepatitis C diagnosis then your drug use partner(s) are also advised to get tested which they can do at their local STI clinic.

Remember – Regular screening at your local STI clinic is recommended to maintain your sexual health.

Treatment

There is a course of tablets available that can cure most cases of hepatitis C in 12 weeks.

There is another course of treatment that takes 24 weeks or one that takes 48 weeks. Talk to your hepatitis specialist about treatment options.

Remember – regular screening at your local STI clinic is recommended to maintain your sexual health.

A guide to the Hepatitis C Services on offer at GOSHH is available here – GOSHH HCV Leaflet 2017 

A guide to living with Hepatitis C is available here – GOSHH – Living with Hep C

A detailed history of Hepatitis Services at GOSHH (previously Red Ribbon Project) is available here – Case Study – Peer Development HCV 2017

 

Hepatitis Conference 2017

Correlation Network, together with a number of partners, organised a Hepatitis C Community Summit in April 2017 in Amsterdam, because this is a historic moment for Hepatitis C treatment. With the advent of direct-acting antivirals (DAAs) we can now massively reduce the harm from an infectious disease that affects millions of people and causes hundreds of thousands of unnecessary deaths every year. Interferon-free DAA regimes are short, highly tolerable, and simple to deliver, with cure rates of over 90%.

Hepatitis C elimination will on the one hand require an enormous scale-up in testing and treatment, along with comprehensive harm reduction services including in prisons, and on the other hand a sustained collaborative effort to combat the stigma, discrimination, and criminalisation faced by people who inject drugs, as well as other priority communities, like migrants and men having sex with men.

Communities, harm reduction, and community representatives must participate in formulating and implementing Hepatitis C prevention, testing, and treatment strategies because these stakeholders have unique knowledge about what will be accessible, acceptable, and effective. Without their close and ongoing involvement, the effort to eliminate Hepatitis C is likely to fail.

The video highlights the most important aspects of the Community Summit and relevant topics to address for Hepatitis C elimination.