Viral Hepatitis

Brad Spellberg, MD

What's the first thing you think of when you hear the expression "Bottom-feeder?" Lawyers? What about oysters?

Raw oysters are infamous for being a source for Hepatitis A virus. This is because oysters and other mollusks often live in areas where sewage settles as it runs into the sea from city pipes. Ingestion of food that has been in contact with feces-either from having been exposed to sewage run-off (as in oysters) or from food handlers failing to wash their hands after using the bathroom-is the major mode of Hepatitis A transmission.

What is Hepatitis?
Hepatitis means inflammation of the liver. Although alcohol abuse is a common cause of liver inflammation, there are three major kinds of virus that cause it as well: Hepatitis A, B, and C virus. The initial symptoms, or "acute hepatitis," caused by these viruses are very similar. They include

  • generalized body aches
  • fatigue
  • fevers
  • nausea and vomiting
  • pain in the right side of the abdomen
  • jaundice (yellowish eyes and skin)
  • dark urine
  • clay-colored stool

Acute hepatitis tends to resolve within several weeks without treatment. While Hepatitis A only causes a single episode of illness, Hepatitis B and C viruses are capable of evading the body's immune system and causing persistent infection. Hepatitis B and C can occasionally result in "chronic hepatitis" some time after the acute episode. The virus establishes itself in the liver, causing a chronic inflammation that over a period of years can lead to liver cancer or liver cirrhosis. Liver cancer is almost invariably fatal unless caught very early, and the only treatment for liver cirrhosis is liver transplantation. The bottom line is that these are horrible conditions that should be avoided if at all possible.

How Do You Get Hepatitis?

Virus type Mode Transmission
Hepatitis A
  • fecal-oral, major route
  • sexual ("rimming" or anal-oral contact)
Hepatitis B
  • sexual, major route
  • exposure to body fluids (semen, tears, saliva, breast milk, urine, blood)
  • mother-to-child (during pregnancy, childbirth or breast feeding)
  • exposure to blood (IV drug use, direct exposure or transfusion)
Hepatitis C
  • exposure to blood (blood transfusion, IV drug use), major route
  • sexual, possible
  • mother to child, possible

How Do I Know I'm Infected?
Often you won't. Usually you will have symptoms when you first acquire the virus, but this can seem like just another cold or flu, especially if jaundice (yellow eyes or skin) never develops. After the initial symptoms go away, there are often no symptoms of chronic disease. Some people develop joint aches, kidney disease, or other problems, but most go along for many years completely unaware that their liver is severely compromised.

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