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How to Live with
Hepatitis
Healthy
Travel and Hepatitis
Each year an estimated 30 million travelers visit destinations that
are considered high-risk for hepatitis A and B. Hepatitis
A and B are the most common vaccine-preventable diseases
in travelers, affecting more than 280,000 Americans. Clearly, many
thousands of travelers set out inadequately informed about the risks
of getting hepatitis while outside the U. S.
The good news is that there is now a combination vaccine that safely
and effectively prevents both of these potentially fatal diseases.
A new vaccine, will reduce the number of shots needed to protect against
both diseases from five to only three.
To find out more about your travel health risks visit
travelsafely.com
or www.cdc.gov/travel.
To find a travel medicine physician throughout the world visit www.istm.org
Living with
Hepatitis B
If you are a HBV carrier, it's your responsibility to take important
steps to care for yourself and prevent the spread of HBV. Here's what
to do:
Keep others healthy
Hepatitis B is transmitted by contact with infected blood, serum,
semen, and vaginal fluids. Wash your hands with soap after touching
your own blood or body fluids. Throw personal items such as tissues,
menstrual pads, tampons, or bandages away in a plastic bag.
All cuts and open sores should be covered with a bandage. Wipe up
your blood spills, then, re-clean the area with a solution of one
part household bleach to ten parts water.
Tell sexual partners you have hepatitis B. Partners should be tested
for HBV, and if not immune to the virus, they should receive the vaccination
series of three shots. Until protection from HBV has been guaranteed,
use a condom.
People living in the same household as a carrier should see their
doctor for hepatitis B testing and vaccination. If anyone is exposed
to the your blood or body fluids, hepatitis B immune globulin given
within two days to two weeks can prevent the infection.
Keep yourself healthy
Monitor the state of your liver at least once a year to determine
if the disease is progressing and if cirrhosis or liver cancer is
developing.
Review all medications with your physician. Even some over-the-counter
and alternative medicines can harm the liver.
Have periodic ultrasound and alpha-fetoprotein blood tests for liver
cancer.
If pregnant, be sure to tell your physician you are an HBV carrier
so your baby will receive live-saving treatments.
On routine visits, remind your doctor, dentist, and other healthcare
providers that you are an HBV carrier.
Things NOT to do
Avoid, or severely restrict, alcohol intake. Your liver may be further
damaged by alcohol. If you do drink alcohol, NEVER do so with acetaminophen,
found in Tylenol or other cold and headache remedies. Do not share
with anyone toothbrushes, razors, needles, syringes, nail files, clippers,
scissors, or any object that may come into contact with your blood
or body fluids.
Do not share food that has been in your mouth and do not pre-chew
food for babies.
Do not donate blood, plasma, body organs, tissue, or sperm.
Keep learning
Stay informed about research developments regarding treatments so
you are able to make the best decisions. Research is now being planned
and conducted to improve the treatment of chronic hepatitis C (HCV)
and hepatitis B (HBV) infections by immunotherapy, and development
of a vaccine for HCV.
Here's are two great places to start:
Center for Disease Control Viral Hepatitis Center:
http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm
Travel tips:
http://www.cdc.gov/travel/diseases.htm#hepa
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Living With
Hepatitis C
Frequently people learn that they have HCV from a blood test during
a routine physical or because they have donated blood. While testing
positive for HCV isn't good news, it's not all doom, gloom, or a death
sentence, either. Here are a some important things to remember:
Don't panic.
In most people the HCV infection does not disappear, so you'll probably
need to learn to live with it. Think positively – many people
live 20 to 40 years with the virus without becoming seriously ill
or having liver failure.
Get regular medical attention.
A physician who knows about HCV, a gastroenterologist or hepatologist,
can watch for signs of trouble, identify problems and keep you informed
about new treatments.
Avoid contact with blood.
HCV can be transmitted by blood. Cover open cuts, and don't share
razors, toothbrushes, manicure tools, tattoo needles, body piercing
instruments, or anything that might have even the smallest amount
of blood on it. Be wary of menstrual blood, as well.
Protect your liver.
Your liver is already stressed by the hepatitis virus. Omit or severely
limit alcohol use. Alcohol should not be taken with other drugs –
especially acetaminophen, the ingredient in Tylenol and a number of
other headache and cold remedies. The combination may damage your
liver that is already trying to fight off the virus. Check with your
doctor before using any medications, including over-the-counter drugs
or alternative (herbal) medicines.
Be concerned about sex partners.
While studies have shown the risk of sexual transmission is low between
long-term, monogamous couples, people with new or multiple sexual
partners should use latex condoms. Inform potential partners that
you have the virus. In addition, viral levels in the blood can vary
widely or rise in response to immunosuppressive drugs, which would
make HCV carriers more infectious at certain times. Virus levels increase
when certain medications such as corticosteroids or cyclosporine are
taken. People with HCV who take these drugs should discuss precautions
needed with their doctor.
Be informed.
Keep yourself updated on current research, information, and
treatment. Be aware of your own health status and what your various
options are. Updates on current breakthroughs are sent through our
email list serve. Much additional valuable information
can be found in Useful Links.
Living With
Chronic Hepatitis
Chronic hepatitis can cause added stress to a busy life. The physical
symptoms of hepatitis can increase the emotional toll of coping, so
finding ways to minimize physical distress – and to ease the
frustrations and complications caused by hepatitis – are critical.
Here are the best ones:
Coping with stress
In addition to physical symptoms, hepatitis often causes emotional
stress. It's important to have people you can count on for support
and encouragement. Talk to friends and loved ones about difficulties
you experience and what you need from them. People are not mind readers,
and open discussions can help minimize problems and misunderstandings.
Support from loved ones and friends makes coping easier. Try not to
set unreasonable standards for yourself or anyone else. You can also
participate in HFI's Patient Advocacy Support System (PASS). With
your written permission, HFI will share your name and phone number
with other hepatitis patients in your area. Sometimes it helps to
talk to someone experiencing similar problems caused by hepatitis.
E-mail
us or call and ask for a PATS registration form (800 891 0707).
Good communication with your doctor
Be sure to tell your doctor about all the symptoms you're experiencing.
They may indicate changes in the way your liver is functioning. Your
doctor may have suggestions or medications that can help you cope.
In between visits to the doctor, write down the questions or the symptoms
you have. It's too easy to forget specifics until the problem reappears.
With chronic liver disease your physician may suggest vaccinations
against pneumonia, hepatitis A, and possibly hepatitis B for those
not already infected or immune.
Coping with fatigue
Fatigue is a common problem so finding a happy balance between relaxation
and activities is essential. Frequently, short naps between activities
prevent overwhelming fatigue at the end of the day. Don't plan too
many activities for one day; instead, space them out over a full week.
Separate the activities requiring a lot of energy from the less strenuous
ones. Allow yourself time to regroup while still keeping busy. If
your workday is simply too tiring, try arranging flexible hours, job-sharing,
or tele-commuting options.
Coping with nausea
Nausea can turn mealtime into a dreaded activity. Ask your doctor
for medication to help fight that feeling. Eat and drink sensibly.
A well-balanced diet is important to maintaining a healthy body. Try
eating frequent, smaller meals (or snacks) instead of fewer, larger
meals. Plan meals at times when the nausea is the least troublesome.
While doctors' opinions differ about drinking alcohol, hepatitis patients
must remember that alcohol is a toxin and can cause problems for your
already compromised liver. Be careful with vitamins and supplements
Be careful not to take vitamins or nutritional supplements without
discussing it with your doctor first. Some vitamins, Vitamin A in
particular, can cause liver damage when taken in large doses.
Living With Cirrhosis
What is cirrhosis?
Cirrhosis is a condition in which normal, healthy liver cells are
damaged and replaced by scar tissue. This reduces the number of healthy
cells remaining to perform its many important functions. A cirrhosis-damaged
liver can cause widespread disruption of many body functions. Patients
with cirrhosis often lead full, healthy lives for many years. Most
of the side effects of the disease are treatable. Despite damage to
the liver, the liver can still perform some of its functions.
What are the symptoms of
cirrohsis?
- Fatigue (often
the first and only sign)
- Loss of appetite
- Nausea and vomiting
(accompanied by weight loss)
- Enlargement
of the liver; Itching (caused by a buildup of bile products in
the liver)
- Jaundice (yellowing
of the skin and the whites of the eyes)
- Formation of
gallstones (because of a lack of bile in the gallbladder)
- Accumulation
of water in the abdomen (called "ascites")
- Accumulation
of water in the legs (called "edema")
- Bruising or
bleeding easily
What causes cirrhosis?
Many things can cause cirrhosis including various liver diseases such
as hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency,
autoimmune hepatitis, and biliary atresia. A common cause of cirrhosis
is the excessive intake of alcohol. Some people have a severe reaction
to certain drugs and this can also cause cirrhosis. Hepatitis B (HBV)
and hepatitis C (HCV) are forms of viral hepatitis that can cause
inflammation of the liver leading to cirrhosis. HBV and HCV can go
undiagnosed for long periods of time because the liver is a non-complaining
organ. Blood tests that identify elevated liver enzymes are usually
the first indication of a problem.
Can cirrhosis be cured?
Currently, there is no cure for cirrhosis. However, doctors can delay
its progress, minimize liver cell damage, and reduce the complications
of the disease. One example is the use of a drug known as a beta blocker,
to reduce portal hypertension.1
Some doctors prescribe diuretics to remove excess fluid that has accumulated
in the ankles or the abdomen. Reducing salt in the diet can also be
helpful.
What are the treatment options?
If a person has cirrhosis as a result of hepatitis B or C, the doctor
may administer anti-viral drugs to reduce liver cell injury. Currently,
the only FDA-approved drug for chronic hepatitis B or C is an "anti-viral"
drug called interferon alfa-2b. This treatment is given by injection
and may have a number of side effects such as flu-like symptoms, headaches,
and nausea. Research has recently discovered some promising new treatments
which are being tested in clinical studies. A growing number of scientific
investigators are conducting liver research, providing hope for new
breakthroughs in treatment and cures for hepatitis and more than 100
known liver diseases.
How does cirrhosis progress?
Continued attack by the hepatitis virus increases the cirrhosis. This
causes the filtering process to slow down, allowing toxins to remain
in the blood stream. These toxins affect the brain causing mental
confusion ("encephalopathy"). The buildup of toxins dulls an
individual's
mental abilities, sometimes changing his/her personality. Because
the liver's filtering process is slowing down, its ability to process
medication is also affected. The liver does not remove drugs from
the blood at the usual rate, so prescription drugs act longer than
expected and can build up in the body. Be sure to report any drug
reactions you may get to your doctor. Always keep your doctor current
on all medications you are taking.
1) One serious result of
cirrhosis is portal hypertension. Normally, blood from the intestines
is pumped through the portal vein to the liver. Since the blood flow
is slowed down by cirrhosis that constricts the blood flow in the
portal vein, these blood vessels, under pressure, expand and become
greatly enlarged (called "varices" or "varicose veins") causing a
thinning of their walls. As the cirrhosis increases so does the pressure
in these vessels. If they burst, there will be serious bleeding in
the esophagus or the stomach with vomiting of blood and black stools.
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