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Living with Hepatitis B Living With Hepatitis C Living With Chronic Hepatitis Living With Cirrhosis 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 Back to top 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 reported in HFI's newsletter, HEPATITIS ALERT. 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?
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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