The scale of our collective progress can be measured against a timeline of vaccine milestones. The polio vaccine brought hope to millions of families from America to Zambia. Up until the mid-Twentieth Century, few could imagine the eradication of smallpox, but a global vaccination campaign against the disease starting in the 1960s ushered in an era of new possibilities for billions. And the roll-out over the past week of the first-ever approved malaria vaccine may mark another landmark: the moment when children across Africa have been given hope in the form of a tool that can help them escape a plague that kills 500,000 of them each year.

A future where malaria is eliminated as a public health threat in the African continent may remain out of reach for the immediate future, but that shouldn’t stop us from working to fulfil our dreams of a malaria-free Africa. As it has with other diseases, the introduction of a new vaccine has the potential to catalyze innovation and create new opportunities for economic growth.

If the malaria vaccines enter the immunization schedule of most African countries over the next year, as planned, the steady stride of the region’s economic power may accelerate. When more children survive past their 5^th birthday and the strain on health systems is reduced, that’s not only intrinsically valuable, it’s a good thing for economic growth.

Healthy children fuel healthy economies

With the coming decades expected to see the ascendance of several African markets as global economic players, malaria vaccination could be a catalyst to sustained development in the region. This serves as a benefit for nations around the world, including the U.S.

Yet, one of the most immediate ways to derail Africa’s economic potential is to hamper the very immunization programs that have delivered the most impressive returns on health investments, both in Africa and globally. That’s what is on the line later this year when Gavi, the alliance responsible for financing the delivery of more than 19 different vaccines to low-and-middle-income countries, is set to have its funding reauthorized by the U.S. and several other governments.

Gavi has written the playbook for creating an investment-driven approach to providing emerging markets with the immunization infrastructure they need to thrive. In the 24 years since its founding, the alliance has vaccinated half of the world’s children. That alone is a remarkable achievement, but the alliance has matched humanitarian outcomes with powerful financial results: Its model has proven so successful that $1 of investment in Gavi yields $54 in health savings among its beneficiary countries. Peer-reviewed research has shown a strong link between child survival rates from vaccine-preventable diseases and GDP growth.

As investments of U.S. taxpayer funds go, few if any can rival the return that Gavi brings for the roughly $300 million committed to it by the American government each year. Looking beyond the direct impact on lives saved – nearly 18 million children and counting – global immunization programs supported by Gavi have strengthened health systems in many of the most vulnerable countries of the world. These are the very places where deadly disease outbreaks have the greatest chance of growing undetected until they are uncontainable.

Continuing support for routine immunization is essential

Gavi funding helps protect Americans by blunting the relentless pace of viruses and bacteria to evolve beyond our control. Better immunization against known threats, more sophisticated early-detection systems in disease hot zones, new vaccine manufacturing capacity closer to the likely sources of outbreaks, and hospital systems that are less burdened by increasingly preventable maladies like malaria – these are the building blocks that Gavi has helped put in place to foster a healthier future for all of us.

At a time when disinformation further erodes trust in the institutions tasked with protecting public health and the spread of disease is supercharged by climate change, the value of Gavi’s time-tested model deserves to be acknowledged through funding replenishment later this year. This would send an unmistakable message to the world that we can still fulfill the hopes and dreams of billions of people by providing the lifesaving vaccines they need to have a shot at a more prosperous, peaceful future.

The post A Gateway to Growth in Africa appeared first on Medika Life.

How worried should we all be? In New York City, the polio vaccination rate among children five and under is 86 percent. Most of us adults had vaccinations as children.

However, the New York Times offers this concerning statistic: In some city ZIP codes, fewer than two-thirds of children five and under have received at least three doses, a figure that worries health officials.

The story takes a concerning turn. The announcement of poliovirus in New York City sewage water comes three weeks after a man just north of the city presented with polio that left him paralyzed.

And this punctuation: Officials observe that polio has been circulating in the county’s wastewater since May.

Polio History

Polio was historically one of the most feared diseases, with annual outbreaks resulting in thousands of paralysis cases in the United States alone.

A man with a smaller right leg due to poliomyelitis. https://en.wikipedia.org/wiki/Polio

By the late 1940s, polio outbreaks in the United States progressively increased in size and frequency. More than 35,000 individuals experienced disability annually as a result of the virus. Parents kept their children indoors, especially in the summer when the poliovirus seemed most prevalent.

Public health officials sometimes imposed quarantines on homes and towns experiencing outbreaks.

Following the widespread adoption of the polio vaccine, US officials declared the eradication of polio in 1979 one of public health’s greatest triumphs. Still, polio cases occasionally appear, often in individuals who have traveled abroad.

Since 1979, we in the United States have had no cases of polio caused by wild poliovirus originating here. However, polio has been brought into the USA by travelers with the virus. The last reported case of imported polio occurred in 1993.

Polio transmission

The poliovirus is quite contagious, spreading through person-to-person contact. Polio can contaminate water and food in unsanitary conditions. The virus lives in an infected individual’s throat and intestines. Poliovirus enters humans’ bodies through the mouth.

Spread occurs via contact with an infected portion’s poop (feces). Less commonly, the spread can occur by droplets from the cough or sneeze of an infected person.

Infection can occur if you put infected objects (such as toys contaminated with feces) in your mouth. Alternatively, transmission can occur if you pick up tiny pieces of feces on your hands and touch your mouth.

The United States Centers for Disease Control (CDC) explains that:

An infected individual can spread the virus to others immediately before and up to two weeks after symptoms emerge. The virus can reside in an infected subject’s intestines for many weeks. Moreover, infected people without symptoms can still pass the virus to others.

Polio symptoms

Nerve cells (neurons). https://en.wikipedia.org/wiki/Neuron#:~:text=A%20neuron%20or%20nerve%20cell,do%20not%20have%20nerve%20cells

While most infected persons with polio do not get sick (or know that they are infected), an infection can lead to paralysis or even death. Here are symptoms by polio type:

• Non-paralytic polio. Those with this form of polio don’t develop paralysis but can experience mild, flu-like symptoms lasting up to ten days. Symptoms may include fever, headache, sore throat, vomiting, or generalized fatigue. Some report back, neck, or extremity discomfort or stiffness. Others suffer from muscle tenderness or weakness.
• Paralytic syndrome. Fortunately, this most serious form of polio is rare. Initial symptoms may include severe muscle aches or weakness, reflex loss, or loose and floppy limbs (flaccid paralysis). “Poliomyelitis” (or “polio” for short) is defined as a paralytic disease. Only those with the paralytic infection have the disease.
• Post-polio syndrome. Post-polio syndrome is a cluster of disabling symptoms affecting some people years after a polio infection. Selected symptoms may include fatigue, muscle wasting (atrophy), progressive muscle or joint weakness, and pain. Some experience challenges with breathing or swallowing, while others report sleep problems (for example, sleep apnea). Others report decreases in cold temperature tolerances.

Here are the incidences for these categories: Most people with a polio infection have no visible symptoms. Approximately one in four will have flu-like symptoms that typically last two to five days before resolving.

A smaller number develop more serious symptoms. For example, about one to five out of 100 will experience an infection of the brain or spinal cord covering (meningitis). Paralysis — an inability to move body parts) — or arm or leg weakness happens to about one in 200 to one in 2,000 people, depending on the virus type.

Between two and 10 out of 100 with polio-related paralysis die secondary to the virus affecting the muscles regulating breathing.

An electron microscope image of the polio virus. https://en.wikipedia.org/wiki/Polio

Polio prevention

The most effective means to prevent polio is vaccination. There are two forms of vaccine, including inactivated poliovirus vaccine. This form is given as an infection in a leg or arm, depending on the person’s age. Inactivated poliovirus vaccine is the only type that has been used in the United States since 2000. Some places in the world still use an oral poliovirus vaccine.

The polio vaccine is remarkably protective: Over 99 percent of those who get all the recommended doses of the inactivated vaccine have protection from polio.

In addition, please practice good hand hygiene and wash your hands with soap and water often; alcohol-based hand sanitizers do not kill poliovirus.

Adult vaccination

Adults do not routinely receive vaccines against polio in the USA, given most are already immune. Still, selected high-risk individuals should have a single booster shop of inactivated polio vaccine.

A single booster dose of inactivated vaccine reduces polio risk for a lifetime. Adults at risk include those who are traveling to parts of the world where polio still occurs or those who care for people who have polio.

If you have never had a vaccine or your vaccination status is undocumented, please get a series of primary polio vaccination shots — two doses of inactivated polio vaccine at four- to eight-week intervals and a third dose six to 12 months after the second dose.

Prevention is essential; there is no cure for poliomyelitis. If you think you or someone in your family has symptoms of polio, please call your healthcare provider immediately or go to an emergency room.

Who shouldn’t get the vaccine?

The US Centers for Disease Control asks that you tell the person who is giving the vaccine:

• If the person getting the vaccine has any severe, life-threatening allergies. Suppose the person receiving the vaccine had a life-threatening allergic reaction after a dose of an inactivated polio vaccine or had a severe allergy to any part of it. In that case, caregivers may advise that they not receive a vaccine. Ask your doctor for information about vaccine components.
• If the person getting the vaccine does not feel well. If the individual getting the vaccine has a mild illness (for example, a cold), they can probably get it today. The moderately or severely ill should probably wait until they recover. Your doctor can advise you.

For more information (including potential side effects of the vaccine), please go here:Polio Vaccination: What Everyone Should KnowUpdated August 11, 2022: In July 2022, CDC was notified of a case of polio in an unvaccinated individual from Rockland…www.cdc.gov

Polio risk is well, but vaccination is stunningly effective at preventing paralysis, even if it is not great at limiting transmission.

The virus is now endemic in only two countries, Pakistan and Afghanistan. Vaccines have kept the virus at bay everywhere, even though we will see sporadic cases in non-endemic regions.

In July 2022, an adult from north of New York City tested positive for polio. This finding raised alarms from residents and local officials, some of whom could not recall if they had a vaccine as a child. Health officials believe hundreds of people in the area could be infected.

How might the polio virus in wastewater affect you? According to the New York State Department of Health,

“Wastewater is not a concern in terms of having the ability to infect the general public as the general public does not interact with wastewater, which is based on samples from our sewage system via feces excreted.

“In areas where the wastewater is thoroughly treated before being released back into the environment, and there are good water purification practices, there is very, very, very little risk to the general population, but could be a risk for personnel working in wastewater facilities,” Dr. Marny Eulberg offers.

Fortunately, I had the polio vaccine as a child. We are blessed to have good water purification in the United States. I am not particularly worried about myself, but I wanted to provide information to you. Wastewater personnel may have some risks.

Thank you for joining me today.

The post Polio Arrives in New York City — How Worried Should You Be? appeared first on Medika Life.

It typically begins with the sudden onset of fever, chills, headache, and body aches. It then progresses to cause sore throat, cough, and nasal congestion. Redness of the eyes, abdominal pain, vomiting, and diarrhea can also be associated with influenza.

Influenza is spread from person to person by respiratory droplets created by coughing or sneezing. Contact with respiratory droplet-contaminated surfaces is another mode of transmission. Such surfaces include door knobs, elevator buttons, computer keyboards, and mobile devices like tablets and smartphones. Outbreaks of influenza typically begin in school aged children. This can then lead to transmission to adults, the elderly, and other children within the family.

Although the majority of children with influenza recover after about 7 days, some children even without prior medical problems can suffer serious adverse effects. Like all viral infections, influenza can weaken the immune system and make one susceptible to bacterial infections such as streptococcus and staphylococcus. These bacteria can cause co-infections such as pneumonia and sepsis — a serious sometimes life threatening bacterial infection of the blood.

Influenza can also invade the tissues of the heart and cause a dangerous condition myocarditis. Finally, neurologic complications from influenza can range from febrile seizures to viral infections of the brain called encephalopathy, which can lead to permanent cognitive impairment.

Some are at higher risk for serious complications

While these adverse effects can affect anyone, certain groups are at higher risk from serious complications of influenza than others.These include children under the age of 5 but especially younger than 2 years of age, pregnant women, adults over the age of 65, and those with chronic conditions like asthma, diabetes, heart problems, neurologic issues, or any major health condition.

Prevention is key

The best preventative measure to fight against influenza and its possible complications is vaccination with the annual flu vaccine. Flu season typically begins in October and November and peaks in January. It takes about 2 weeks for the body to generate a protective immune response after vaccination, so the time for vaccination is now. The flu vaccine is recommended for everyone 6 months of age or older but especially for those who fit the higher risk categories that were just mentioned above.

Children under 9 years of age who have never received a flu shot may need two doses usually given 4 weeks apart. There are specialized versions of the flu vaccine that are meant to be given to those who are 65 years of age or older. The flu vaccine is safe and has been shown to reduce influenza illness, doctor’s visits, trips to the emergency room, and missed work due to flu. The benefits affect all ages.

A recent study showed that flu vaccine reduced children’s risk of flu related pediatric ICU admissions by 74% during the flu seasons of 2010–2012. Another study showed that people 50 years of age and older who received the vaccine reduced their risk of flu-related hospitalization by 57%. Finally, other studies have shown that administering the flu vaccine to pregnant women (at any stage of pregnancy) can not only be beneficial to them, but it can also reduce the infant’s risk of getting the flu for several months after birth.

A common misconception about the flu vaccine is the thought that receiving the vaccine itself can cause the flu.

This is simply not true. The vaccine is compiled using an inactivated (dead) virus, so it is not possible to contract influenza from the vaccine. The live, intranasal version of the flu vaccine has not been recommended this year by the Center for Disease Control and Prevention due to its general lack of effectiveness noted during the last 3 flu seasons.

Some possible side effects from the flu vaccine include tenderness and pain from the injection site, headache, muscle aches, and chills. Fever can occur within 24 hours in 10% — 35% of children under the age of 2, but this rarely occurs in older children or adults. Generally speaking, side effects from the flu vaccine resolve within a few days.

Despite the safe and effective nature of the flu vaccine, there are a few contraindications to receiving it. As with all vaccines, if there has been a history of a severe allergic reaction — also known as an anaphylactic reaction — associated with flu vaccine, it should be avoided. Also if one has contracted the neurologic disease Guillain-Barre syndrome within 6 weeks of receiving a prior flu vaccine, one should not be vaccinated. Allergy to eggs used to be a contraindication to receiving flu vaccine, but that disqualifier has been removed recently. People with milder reactions like hives can receive the flu vaccine wherever it is available. Those with more severe reactions to eggs may need to receive the vaccine under the guidance of an allergist.

Tamiflu helps but can not cure

While the influenza vaccine is the most effective preventative measure to fight the flu, there are medications available that can shorten the course of the illness if one unfortunately becomes infected with the flu. Tamiflu (oseltamivir) remains an effective antiviral medication to treat people with influenza as young as 2 weeks of age. Another antiviral Relenza (zanamivir) is an inhaled medication that can be given to patients as young as 7 years of age. Administering these antivirals within 48 hours of symptoms can help to reduce the duration of fever and symptoms of influenza. They can also reduce the rate of severe complications especially in high risk patients.

Wash your hands

There are other preventative measures that can help one stay healthy during flu season.Frequent hand washing can help to limit exposure to germs. If soap and water are not nearby, alcohol based hand sanitizers (Purell) can be used. Avoiding close contact with those who are visibly sick can help reduce the risk of becoming sick. At the same time, staying home from work or school when you are sick can help prevent the spread of illness to other people. Covering your nose and mouth with a tissue while coughing or sneezing (or coughing/sneezing into your elbow) can also prevent those around you from becoming ill.

Also, while it can be difficult as it is second nature for a lot of us, avoid touching your eyes, nose, and mouth if possible. Germs are spread when someone touches a contaminated surface and then proceeds to touch his or her nose, eyes, or mouth. Disinfecting frequently touched surfaces at work or at schools such as keyboards, desks, and doorknobs can also be helpful. You may also want to think twice about touching another person’s tablet or smartphone who is visibly ill. As always, an ounce of prevention is worth a pound of cure. Staying active, getting sufficient rest, managing stress, drinking plenty of fluids, and making healthy diet choices can go a long way to ensuring a healthy and hearty holiday season.

The post Flu Shots Save Lives appeared first on Medika Life.

Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and can cause acquired immunodeficiency syndrome (AIDS).

• HIV is transmitted through close contact with a body fluid that contains the virus or cells infected with the virus (such as blood, semen, or vaginal fluids).
• HIV destroys certain types of white blood cells, weakening the body’s defenses against infections and cancers.
• When people are first infected, symptoms of fever, rashes, swollen lymph nodes, and fatigue may last a few days to several weeks.
• Many infected people remain well for more than a decade.
• About half of untreated people become ill and develop AIDS, defined by the presence of serious infections and cancers, within about 10 years.
• Eventually, most untreated people develop AIDS.
• Blood tests to check for HIV antibody and to measure the amount of HIV virus can confirm the diagnosis.
• HIV drugs (antiretroviral drugs)—two, three, or more taken together—can stop HIV from reproducing, strengthen the immune system, and thus make people less susceptible to infection, but the drugs cannot eliminate HIV, which persists in an inactive form.

HIV infections may be caused by one of two retroviruses, HIV-1 or HIV-2. HIV-1 causes most HIV infections worldwide, but HIV-2 causes many HIV infections in West Africa.

HIV progressively destroys certain types of white blood cells called CD4+ lymphocytes. Lymphocytes help defend the body against foreign cells, infectious organisms, and cancer. Thus, when HIV destroys CD4+ lymphocytes, people become susceptible to attack by many other infectious organisms. Many of the complications of HIV infection, including death, usually result from these other infections and not from HIV infection directly.

HIV-1 originated in Central Africa during the first half of the 20th century when a closely related chimpanzee virus first infected people. The global spread of HIV-1 began in the late 1970s, and AIDS was first recognized in 1981.

In 2016, about 36.7 million people, including 2.1 million children under age 15, were living with HIV infection worldwide. There were 1 million AIDS-related deaths, and 1.8 million people were newly infected.

Most (95%) new infections occur in the developing world. Almost 70% of new HIV infections occur in sub-Saharan Africa, with more than half occurring in women and 1 in 10 occurring in children under 15 years old. However, in many sub-Saharan African countries, the number of new HIV infections has greatly decreased, partly because of international efforts to provide treatment and strategies for prevention.

In the United States, over 1.1 million people aged 13 years or older were estimated to have HIV infection in 2015. About 15% of them do not know they have HIV infection. In 2016, 39,782 cases of HIV infection were diagnosed in the United States. Over two thirds of these infections occurred in gay and bisexual men. Among these men, most infections occurred in black men (10,223), followed by Hispanic/Latino men (7,425) and white men (7,390).

Acquired immunodeficiency syndrome (AIDS)

AIDS is the most severe form of HIV infection. HIV infection is considered to be AIDS when at least one serious complicating illness develops or the number (count) of CD4+ lymphocytes decreases substantially.

When people who are infected with HIV develop certain illnesses, AIDS is diagnosed. These illnesses, called AIDS-defining illnesses, include

• Serious infections that occur mainly in people with a weakened immune system (called opportunistic infections), including fungal infections (such as cryptococcosis and Pneumocystis jirovecii pneumonia) and severe herpes simplex infections
• Certain cancers, such as invasive cervical cancer, Kaposi sarcoma, and certain lymphomas
• Dysfunction of the nervous system
• A substantial loss of weight due to HIV infection (AIDS wasting)

Transmission of HIV Infection

The transmission of HIV requires contact with a body fluid that contains the virus or cells infected with the virus. HIV can appear in nearly any body fluid, but transmission occurs mainly through blood, semen, vaginal fluids, and breast milk. Although tears, urine, and saliva may contain low concentrations of HIV, transmission through these fluids is extremely rare, if it occurs at all.

HIV is not transmitted by casual contact (such as touching, holding, or dry kissing) or by close, nonsexual contact at work, school, or home. No case of HIV transmission has been traced to the coughing or sneezing of an infected person or to a mosquito bite. Transmission from an infected doctor or dentist to a patient is extremely rare.

HIV is usually transmitted in the following ways:

• Sexual contact with an infected person, when the mucous membrane lining the mouth, vagina, penis, or rectum is exposed to body fluids such as semen or vaginal fluids that contain HIV, as occurs during unprotected sexual intercourse
• Injection of contaminated blood, as can occur when needles are shared or a health care worker is accidentally pricked with an HIV-contaminated needle
• Transfer from an infected mother to a child before birth, during birth, or after birth through the mother’s milk
• Medical procedures, such as transfusion of blood that contains HIV, procedures done with inadequately sterilized instruments, or transplantation of an infected organ or tissues

HIV is more likely to be transmitted if skin or a mucous membrane is torn or damaged—even if minimally.

In the United States, Europe, and Australia, HIV has been transmitted mainly through male homosexual contact and the sharing of needles among people who inject drugs, but transmission through heterosexual contact accounts for about one fourth of cases. HIV transmission in Africa, the Caribbean, and Asia occurs primarily between heterosexuals, and HIV infection occurs equally among men and women. In the United States, fewer than 25% of adults who have HIV infection are women. Before 1992, most American women with HIV were infected by injecting drugs with contaminated needles, but now most are infected through heterosexual contact.

Transmission of HIV through its most common routes—sexual contact or sharing of needles—is almost completely preventable.

Through sexual activity

Risk of transmitting HIV is highest during vaginal or anal sex when a condom is not used or is used incorrectly. HIV transmission can also occur during oral sex, although transmission is less likely than during vaginal or anal sex.

Risk of HIV infection is increased when semen or vaginal fluids contain a large amount of HIV and/or when there are tears or sores, even small ones, in the skin or membranes lining the genitals, mouth, or rectum. Thus, transmission is much more likely during the following:

• The first weeks after people are infected because at that time, the blood and body fluids contain very large amounts of HIV
• Vigorous sexual activities that damage the skin or membranes lining the genitals, mouth, or rectum
• Sexual intercourse when either partner has a genital herpes infection, syphilis, or another sexually transmitted disease (STD) that can cause sores or tears in the skin or inflammation of the genitals

HIV (antiretroviral) drugs can reduce the amount of HIV in semen and vaginal fluids. Thus, treatment of HIV infection with these drugs can dramatically reduce the likelihood of transmission.

Sexual activities that can damage the membranes lining the genitals, mouth, or rectum include fisting (inserting most or all of the hand into the rectum or vagina) and using sex toys.

The risk of being infected with HIV during heterosexual intercourse is higher for young people partly because they have less control over their impulses and thus are more likely to engage in risky sexual behavior, such as having several sex partners and not using condoms.

Recent evidence shows that HIV infected people in whom antiretroviral therapy has reduced their viral load below the current detectable level (virally suppressed) do not sexually transmit the virus to their partners.

Through needles or other instruments

Health care workers who are accidentally pricked with an HIV-contaminated needle have about a 1 in 300 chance of contracting HIV unless they are treated as soon as possible after exposure. Such treatment reduces the chance of infection to less than 1 in 1,500. The risk increases if the needle penetrates deeply or if the needle is hollow and contains HIV-contaminated blood (as with a needle used to draw blood or to inject street drugs) rather than simply being coated with blood (as with a needle used to stitch a cut).

Infected fluid splashing into the mouth or eyes has less than a 1 in 1,000 chance of causing infection.

From mother to child

HIV infection in a large number of women of childbearing age has led to an increase in HIV infection among children.

HIV infection can be transmitted from an infected mother to her child in the following ways:

• To the fetus through the placenta
• To the baby during passage through the birth canal
• To the baby after birth through breast milk

If infected mothers are not treated, about 25 to 35% of their babies are likely to be infected at birth, and if they breastfeed, about another 10 to 15% of the babies are likely to be infected.

Treating infected women with HIV drugs can dramatically reduce the risk of transmission. Infected pregnant women should be treated during the 2nd and 3rd trimesters of pregnancy, during delivery, and during breastfeeding. Doing a cesarean delivery and treating the baby for several weeks after birth also reduce the risk.

Infected mothers should not breastfeed if they live in countries where formula feeding is safe and affordable. However, in countries where infectious diseases and undernutrition are common causes of infant death and where safe, affordable infant formula is not available, the World Health Organization recommends that mothers breastfeed. In such cases, the protection provided by breastfeeding from potentially fatal infections may counterbalance the risk of HIV transmission.

Because many pregnant women with HIV infection are treated or take drugs to prevent HIV infection, the number of children getting AIDS is decreasing in many countries.

Through blood transfusions or organ transplants

Currently, HIV infection is rarely transmitted through blood transfusions or organ transplants.

Since 1985 in most developed countries, all blood collected for transfusion is tested for HIV, and when possible, some blood products are treated with heat to eliminate the risk of HIV infection. The current risk of HIV infection from a single blood transfusion (which is carefully screened for HIV and other bloodborne viruses) is estimated to be less than 1 in about 2 million in the United States. However, in many developing countries, blood and blood products are not screened for HIV or are not screened as stringently. There, the risk remains substantial.

HIV has been transmitted when organs (kidneys, livers, hearts, pancreases, bone, and skin) from infected donors were unknowingly used as transplants. HIV transmission is unlikely to occur when corneas or certain specially treated tissues (such as bone) are transplanted.

Artificial insemination

HIV transmission is also possible when sperm from an infected donor is used to inseminate a woman. In the United States, measures have been taken to reduce this risk. Fresh semen samples are no longer used. Sperm from donors is frozen for 6 months or more. Then the donors are retested for HIV infection before the sperm is used.

If a sperm donor is known to have HIV infection, washing sperm is an effective way to remove HIV from sperm.

Mechanism of HIV Infection

Once in the body, HIV attaches to several types of white blood cells. The most important are certain helper T lymphocytes (T cells). Helper T lymphocytes activate and coordinate other cells of the immune system. On their surface, these lymphocytes have a receptor called CD4, which enables HIV to attach to them. Thus, these helper lymphocytes are designated as CD4+.

HIV is a retrovirus. That is, it stores its genetic information as ribonucleic acid (RNA). Once inside a CD4+ lymphocyte, the virus uses an enzyme called reverse transcriptase to make a copy of its RNA, but the copy is made as deoxyribonucleic acid (DNA). HIV mutates easily at this point because reverse transcriptase is prone to making errors during the conversion of HIV RNA to DNA. These mutations make HIV more difficult to control because the many mutations increase the chance of producing HIV that can resist attacks by the person’s immune system and/or antiretroviral drugs.

The HIV DNA copy is incorporated into the DNA of the infected lymphocyte. The lymphocyte’s own genetic machinery then reproduces (replicates) the HIV. Eventually, the lymphocyte is destroyed. Each infected lymphocyte produces thousands of new viruses, which infect other lymphocytes and destroy them as well. Within a few days or weeks, the blood and genital fluids contain a very large amount of HIV, and the number of CD4+ lymphocytes may be reduced substantially. Because the amount of HIV in blood and genital fluids is so large so soon after HIV infection, newly infected people transmit HIV to other people very easily.

When HIV infection destroys CD4+ lymphocytes, it weakens the body’s immune system, which protects against many infections and cancers. This weakening is part of the reason that the body is unable to eliminate HIV infection once it has started. However, the immune system is able to mount some response. Within a month or two after infection, the body produces lymphocytes and antibodies that help lower the amount of HIV in the blood and keep the infection under control. For this reason, untreated HIV infection may cause no symptoms or only a few mild symptoms for an average of about 10 years (ranging from 2 to more than 15 years).

HIV also infects other cells, such as cells in the skin, brain, genital tract, heart, and kidneys, causing disease in those organs.

CD4 count

The number of CD4+ lymphocytes in blood (the CD4 count) helps determine the following:

• How well the immune system can protect the body from infections
• How severe the damage done by the HIV is

Most healthy people have a CD4 count of 500 to 1,000 cells per microliter of blood. Typically, the number of CD4+ lymphocytes is reduced during the first few months of infection. After about 3 to 6 months, the CD4 count stabilizes, but without treatment, it usually continues to decline at rates that vary from slow to rapid.

If the CD4 count falls below about 200 cells per microliter of blood, the immune system becomes less able to fight certain infections (such as Pneumocystis jirovecii pneumonia). Most of these infections are rare in healthy people. However, they are common among people with a weakened immune system. Such infections are called opportunistic infections because they take advantage of a weakened immune system.

A count below about 50 cells per microliter of blood is particularly dangerous because additional opportunistic infections that can rapidly cause severe weight loss, blindness, or death commonly occur. These infections include

• Cytomegalovirus infections
• Mycobacterium avium complex infections

Viral load

The amount of HIV in the blood (specifically the number of copies of HIV RNA) is called the viral load.

Viral load represents how quickly HIV is replicating. When people are first infected, the viral load increases rapidly. Then, after about 3 to 6 months, even without treatment, it drops to a lower level, which remains constant, called the set point. This level varies widely from person to person—from as little as a few hundred to over a million copies per microliter of blood.

Viral load also indicates

• How contagious the infection is
• How fast the CD4 count is likely to decrease
• How fast symptoms are likely to appear

The higher the set point of the viral load, the more quickly the CD4 count decreases to the low levels (less than 200) that increase risk of opportunistic infections, even in people without symptoms.

During successful treatment, the viral load decreases to very low or undetectable levels (less than about 20 to 40 copies per microliter of blood). However, inactive (latent) HIV is still present within cells, and if treatment is stopped, HIV starts replicating and the viral load increases.

An increase in the viral load during treatment may indicate the following:

• The HIV has developed resistance to drug treatment.
• The person is not taking the prescribed drugs.
• Both

Symptoms

Initial infection

When initially infected, many people have no noticeable symptoms, but within 1 to 4 weeks, fever, rashes, sore throat, swollen lymph nodes, fatigue, and a variety of less common symptoms develop in some people. Symptoms of initial (primary) HIV infection usually last from 3 to 14 days.

Interval of mild or no symptoms

After the first symptoms disappear, most people, even without treatment, have no symptoms or only occasionally have a few mild symptoms. This interval of few or no symptoms may last from 2 to 15 years. The symptoms that most commonly occur during this interval include the following:

• Swollen lymph nodes, felt as small, painless lumps in the neck, under the arms, or in the groin
• White patches in the mouth (thrush) due to candidiasis (a yeast infection)
• Shingles
• Diarrhea
• Fatigue
• Fever sometimes with sweating
• Progressive loss of weight
• Anemia

Some people progressively lose weight and have a mild fever or diarrhea.

These symptoms may result from HIV infection or from opportunistic infections that develop because HIV has weakened the immune system.

More severe symptoms

For some people, the first symptoms are those of AIDS.

AIDS is defined as the development of very serious opportunistic infections or cancer—the ones that usually develop only in people with a CD4 count of less than 200 cells per microliter of blood.

The specific opportunistic infections and cancers that develop cause many of the symptoms. These infections occur more frequently or are more severe in people with HIV infection than in those without the infection. For example, an infection with the fungus Candida may cause white patches in the mouth and sometimes pain when swallowing (called thrush) or a thick, white discharge from the vagina that resembles cottage cheese (a vaginal yeast infection). Shingles (herpes zoster) may cause pain and a rash.

More serious opportunistic infections may cause various symptoms depending on the organ affected:

• Lungs: Fever, cough, or shortness of breath
• Brain: Headache, weakness, loss of coordination, or deterioration of mental function
• Digestive tract: Pain, diarrhea, or bleeding

HIV can also cause symptoms when it directly infects and damages organs such as the following:

• Brain: Brain damage with memory loss, difficulty thinking and concentrating, or both, eventually resulting in dementia if HIV infection is not treated, as well as weakness, tremor, or difficulty walking
• Kidneys: Kidney failure with swelling in the legs and face, fatigue, and changes in urination (more common in blacks than in whites), but often not until the infection is severe
• Heart: Heart failure with shortness of breath, cough, wheezing, and fatigue (uncommon)
• Genital organs: Decreased levels of sex hormones, which may cause fatigue and sexual dysfunction in men

HIV is probably directly responsible for a substantial loss of weight (AIDS wasting) in some people. Wasting in people with AIDS may also be caused by a series of infections or by an untreated, persistent digestive tract infection.

Cause of death

Usually, death is caused by the cumulative effects of opportunistic infections or cancers, wasting, and/or dementia.

Diagnosis

• Tests to detect antibodies to the HIV virus in a sample of blood or saliva
• Tests to detect HIV RNA in a sample of blood

Early diagnosis of HIV infection is important because it makes early treatment possible. Early treatment enables infected people to live longer, be healthier, and be less likely to transmit HIV to other people.

Doctors usually ask about risk factors for HIV infection (such as possible exposure in the workplace, high-risk sexual activities, and use of injected street drugs) and about symptoms (such as fatigue, rashes, and weight loss).

Doctors also do a complete physical examination to check for signs of opportunistic infections, such as swollen lymph nodes and white patches inside the mouth (indicating thrush), and for signs of Kaposi sarcoma of the skin or mouth.

Screening and diagnostic tests

If doctors suspect exposure to HIV infection, they do a screening test for HIV. Doctors also recommend that all adults and adolescents, particularly pregnant women, have a screening test regardless of what their risk appears to be. Anyone who is concerned about being infected with HIV can request to be tested. Such testing is confidential and often free of charge.

The current (4th-generation) combination screening test tests for two things that suggest HIV infection:

• Antibodies to HIV
• HIV antigens (p24 antigen)

Antibodies are proteins produced by the immune system to help defend the body against a particular attack, such as that by HIV. Antigens are foreign substances that can trigger an immune response.

The body takes several weeks to produce enough antibodies to be detected by the test, so results of the antibody test are negative during the first few weeks after the virus enters the body. However, results of the p24 antigen test can be positive as early as 2 weeks after the initial infection. The combination tests can be done quickly by a laboratory. Also, a version of these tests can be done in a doctor’s office or clinic (called bedside testing). If results are positive, doctors do a test to distinguish HIV-1 from HIV-2 and a test to detect the amount of HIV RNA in the blood (the viral load).

The newer combination screening test is quicker and less complex than older screening tests, which use enzyme-linked immunosorbent assay (ELISA) to detect HIV antibodies and then confirm positive results using a separate, more accurate, specific test such as the Western blot test.

Other, older rapid bedside tests are also available. These tests can be done using a sample of blood or saliva. If results of these rapid screening tests are positive, they are confirmed by ELISA (with or without Western blot) or by repetition of one or more other rapid tests.

If people at low risk have a negative test result, the screening test is not repeated unless their risk status changes. If people at the highest risk have a negative test result (especially if they are sexually active, have several sex partners, or do not practice safe sex), testing should be repeated every 6 to 12 months.

HIV RNA tests can confirm positive results of an antibody test or detect evidence of HIV infection when antibody test results are negative. HIV RNA tests often use techniques to produce many copies of an organism’s genetic material (called nucleic acid amplification). These tests can detect very small amounts of HIV RNA in blood and are very accurate.

Monitoring

If HIV infection is diagnosed, blood tests should be done regularly to measure the following:

• CD4 count
• Viral load

If the CD4 count is low, people are more likely to develop serious infections and other complications of HIV such as certain cancers. Viral load helps predict how fast the CD4 count is likely to decrease over the next few years.

These two measurements help doctors determine

• How soon to start antiretroviral drugs
• What effects treatment is likely to have
• Whether other drugs may be needed to prevent complicating infections

With successful treatment, the viral load falls to very low levels within weeks, and the CD4 count begins a slow recovery toward normal levels.

Diagnosis of AIDS

AIDS is diagnosed when the CD4 count falls below 200 cells per microliter of blood or when extreme wasting or certain serious opportunistic infections or cancers develop.

Diagnosis of HIV-related conditions

Various tests may be done to check for conditions that can accompany HIV infection. These tests include the following:

• Bone marrow aspiration and biopsy: To check for low blood cell counts (including anemia), which may be due to lymphomas, cancers, and opportunistic infections
• Computed tomography (CT) with a contrast agent or magnetic resonance imaging (MRI): To check for damage to the brain or spinal cord

Prevention

At present, there is no effective HIV vaccine to prevent HIV infection or slow the progression of AIDS in people who are already infected. However, treating people who have HIV infection reduces the risk of their transmitting the infection to other people.

Transmission of HIV through its most common routes—sexual contact or sharing of needles—is almost completely preventable. However, the measures required for prevention—sexual abstinence or consistent condom use and access to clean needles—are sometimes personally or socially unpopular. Many people have difficulty changing their addictive or sexual behaviors, so they continue to put themselves at risk of HIV infection. Also, safe sex practices are not foolproof. For example, condoms can leak or break.

Condoms made of latex provide good protection against HIV (as well as other common sexually transmitted diseases), but they are not foolproof. Oil-based lubricants (such as petroleum jelly) should not be used because they may dissolve latex, reducing the condom’s effectiveness.

Other measures can help. For men, circumcision, an inexpensive, safe procedure, reduces the risk of becoming infected during vaginal intercourse with an infected woman by about half. Whether circumcision reduces the risk of HIV infection in other circumstances is unclear. Because circumcision provides only partial protection against HIV infection, people should also use other measures to prevent HIV infection. For example, if either partner has a sexually transmitted disease or HIV infection, it should be treated, and condoms should be used correctly and consistently.

Universal precautions

People who are likely to come into contact with blood or other body fluids at their job should wear protective latex gloves, masks, and eye shields. These precautions apply to body fluids from all people, not just those from people with HIV, and are thus called universal precautions. Universal precautions are taken for two reasons:

• People with HIV may not know that they are infected.
• Viruses that cause other serious disorders (such as hepatitis B and C) can be transmitted by body fluids.

Surfaces contaminated with HIV can easily be cleaned and disinfected because HIV is inactivated by heat and by common disinfectants such as hydrogen peroxide and alcohol.

Because HIV is not transmitted through the air or by casual contact (such as touching, holding, or dry kissing), hospitals and clinics do not isolate HIV-infected people unless they have another contagious infection.

Preventing transmission by blood transfusions and organ transplants

In the United States, the following have almost eliminated transmission of HIV infection by organ transplantation or blood transfusion:

• Screening donors of organs or blood for risk factors for HIV infection
• Screening donated blood for HIV

Risk is reduced further by asking people with risk factors for HIV infection, regardless of their test results for HIV, not to donate blood or organs for transplantation.

However, developing countries have not consistently used sensitive HIV screening tests and have not restricted donors. Consequently, transmission by these routes is still a problem in these countries.

Preventing transmission from mother to newborn

Pregnant women infected with HIV can transmit the virus to the newborn.

The following can help prevent HIV transmission from mother to newborn:

• Testing pregnant women to determine whether they are infected with HIV
• If they are infected, treating them with antiretroviral drugs during pregnancy and labor (treatment during labor is especially important)
• Delivering the baby by cesarean rather than by vaginal delivery
• After birth, treating the newborn with zidovudine, given intravenously, for 6 weeks
• If possible, using formula instead of breastfeeding (HIV can be transmitted in breast milk)

Preventive treatment before exposure

Taking an antiretroviral drug before being exposed to HIV can reduce the risk of HIV infection. Such preventive treatment is called preexposure prophylaxis (PrEP). However, PrEP is expensive and is effective only if people take the drug every day. Thus, PrEP is recommended only for people who have a very high risk of becoming infected, such as people who have a partner who is infected with HIV.

PrEP may also be recommended for people who engage in high-risk sexual activities, such as the following:

• Men who have anal sex with men without using a condom
• Heterosexual men and women who do not regularly use condoms during sex with partners whose HIV status is unknown and who are at increased risk of HIV infection

People who use PrEP still need to use other methods to prevent HIV infection, including consistent use of condoms and not sharing needles to inject drugs.

Preventive treatment after exposure

People who have been exposed to HIV from a blood splash, needlestick, or sexual contact may reduce the chance of infection by taking antiretroviral drugs for 4 weeks. These drugs are more effective when they are started as soon as possible after the exposure. Taking two or more drugs is currently recommended.

Doctors and the person who was exposed typically decide together whether to use these preventive drugs. They base the decision on the estimated risk of infection and the possible side effects of the drugs. If they do not know whether the source is infected with HIV, they consider how likely the source is to be infected. However, even when the source of the exposure is known to be infected with HIV, the risk of infection after exposure varies, depending on the type of exposure. For example, risk from a blood splash is less than that from a needlestick.

Immediately after exposure to HIV infection, what is done depends on the type of exposure:

• If skin is exposed, it is cleaned with soap and water.
• Puncture wounds are cleaned with antiseptic.
• If mucous membranes are exposed, they are flushed with large amounts of water.

Immunization

People with HIV infection should have the following vaccinations (for more information, see CDC immunization recommendations):

• Conjugate pneumococcal vaccine (PCV13) and polysaccharide pneumococcal vaccine (PPSV23) if they have not had them before (PCV13 is given first, followed by PPSV23 at least 8 weeks later)
• Influenza vaccine every year
• Hepatitis B vaccine if they have not had the vaccine before or have not completed the series of 3 vaccinations
• Hepatitis A vaccine if they are at increased risk of or desire protection from hepatitis A
• Human papillomavirus (HPV) vaccine to prevent HPV-related cervical and anal cancers (given to females and males at the recommended ages)
• Meningococcal vaccine if adults have not had the vaccine before (doses are given at least 2 months apart)
• Tetanus-diphtheria vaccine (Td) with a booster every 10 years (if people have not previously received the tetanus-diphtheria-pertussis vaccine [Tdap], Tdap is substituted for one Td booster)

The herpes zoster vaccine may be useful. However, the original live-attenuated zoster vaccine is not given in people with a weakened immune system and if the CD4 count is below 200 cells per microliter of blood. However, recommendations regarding use of the newer recombinant zoster vaccine in people with HIV have not yet been made.

Treatment

• Antiretroviral drugs 
• Drugs to prevent opportunistic infections
• Drugs to relieve symptoms 

Treatment with antiretroviral drugs is recommended for almost all people with HIV infection because without treatment, HIV infection can lead to serious complications and because newer, less toxic drugs have been developed. For most people, early treatment has the best results. Research has shown that people who are promptly treated with antiretroviral drugs are less likely to develop AIDS-related complications and to die of them.

Treatment cannot eliminate the virus from the body, although the HIV level often decreases so much that it cannot be detected in blood or other fluids or tissues. The goals of treatment are

• Reducing HIV level to undetectable
• Restoring CD4 count to normal

If treatment is stopped, the HIV level increases, and the CD4 count begins to fall. Thus, people need to take antiretroviral drugs for their lifetime.

Before starting a treatment regimen, people are taught about the necessity of the following:

• Taking drugs as directed
• Not skipping any doses
• Taking the drugs for the rest of their life

Taking the drugs as directed for a life time is demanding. Some people skip doses or stop taking the drugs for a time (called a drug holiday). These practices are dangerous because they enable HIV to develop resistance to the drugs.

Because taking HIV drugs irregularly often leads to drug resistance, health care practitioners try to make sure that people are both willing and able to adhere to the treatment regimen. To simplify the drug schedule and to help people take the drugs as directed, doctors often prescribe treatment that combines two or more drugs in one tablet that can be taken only once a day.

Prognosis

Exposure to HIV does not always lead to infection, and some people who have had repeated exposures over many years remain uninfected. Moreover, many HIV-infected people remain well for more than a decade. A very few HIV-infected, untreated people have remained well for over 20 years. Why some people become ill so much sooner than others is not fully understood, but a number of genetic factors appear to influence both susceptibility to infection and progression to AIDS after infection.

If infected people are not treated, AIDS develops in most of them. How quickly the number of CD4 cells decreases and HIV infection progresses toward AIDS varies greatly from person to person. Generally, experts estimate that if untreated, people develop AIDS at the following rates:

• For the first several years after infection: 1 to 2% each year
• Each year thereafter: 5 to 6%
• Within 10 to 11 years: 50%
• Eventually: More than 95%, possibly all if they live long enough

However, with effective treatment, the HIV RNA level decreases to undetectable levels, CD4 counts increase dramatically, and people can continue to lead productive, active lives. The risk of illness and death decreases but remains higher than that of people who are of similar age and who are not infected with HIV. However, if people cannot tolerate or take drugs consistently, HIV infection and immune deficiency progresses, causing serious symptoms and complications.

Usually, HIV infection does not directly cause death. Instead, HIV infection leads to a substantial loss of weight (wasting), opportunistic infections, cancers, and other disorders, which then lead to death.

Cure has been thought to be impossible, although intensive research on how to eliminate all of the latent HIV from infected people continues.

The post HIV, The Human Immunodeficiency Virus and AIDS appeared first on Medika Life.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis E

Hepatitis E is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. The hepatitis E virus has different types that spread in different ways.

• Some types are spread by drinking contaminated water. These types are more common in developing countries, including parts of Africa, Asia, Central America, and the Middle East.
• Other types are spread by eating undercooked pork or wild game, such as deer. These types are more common in developed countries, such as the United States, Australia, Japan, and parts of Europe and East Asia.

Hepatitis E typically causes acute, or short-term, infection.

Acute hepatitis E

Acute hepatitis E is a short-term infection. In most cases, people’s bodies are able to recover and fight off the infection and the virus goes away. People usually get better without treatment after several weeks.

Chronic hepatitis E

Chronic hepatitis E is a long-lasting infection that occurs when your body isn’t able to fight off the virus and the virus does not go away. Chronic hepatitis E is rare and only occurs in people with weakened immune systems. For example, hepatitis E may become chronic in people taking medicines that weaken their immune system after an organ transplant, or in people who have HIV or AIDS.

How common is hepatitis E?

Hepatitis E is more common in developing countries, where sanitation is poor and access to clean water is limited.

Although experts used to think hepatitis E was rare in the United States, recent research suggests that about 20 percent of the population has had hepatitis E.

How serious is hepatitis E?

The types of hepatitis E that are common in developing countries are likely to cause severe infections, especially in pregnant women.

The types of hepatitis E that are common in developed countries are often mild and cause no symptoms. Many people don’t know they’ve had these types of hepatitis E.

Who is more likely to get hepatitis E?

Different types of hepatitis E are more likely to affect different groups of people. The types of hepatitis E that are more common in developing countries are more likely to affect adolescents and young adults.²⁶

In contrast, the types of hepatitis E that are more common in developed countries most often affect older men.²⁶

What are the complications of hepatitis E?

Acute hepatitis E complications

Most people recover from acute hepatitis E without complications. In some cases, acute hepatitis E may cause acute liver failure, a condition in which the liver fails suddenly. Acute liver failure due to hepatitis E is more common in

• pregnant women
• people who have other liver diseases

In pregnant women, hepatitis E can cause other complications for the mother and baby, such as stillbirth, premature birth, or low birthweight.

Chronic hepatitis E complications

Chronic hepatitis E—which is rare and only occurs in people with weakened immune systems—may lead to complications such as cirrhosis or liver failure.

What are the symptoms of hepatitis E?

Many people infected with hepatitis E have no symptoms. Some people have symptoms 15 to 60 days after they become infected with the virus.²⁷ These symptoms may include

• feeling tired
• nausea and vomiting
• poor appetite
• pain over the liver, in the upper part of the abdomen
• darkening of the color of urine
• lightening of color of stool
• yellowish tint to the whites of the eyes and skin, called jaundice

People with hepatitis E typically get better without treatment after several weeks.

What causes hepatitis E?

The hepatitis E virus causes hepatitis E. In developing countries, hepatitis E typically spreads through drinking contaminated water. In developed countries, such as the United States, hepatitis E typically spreads from animals to people, when people eat undercooked pork or wild game, such as deer.

Research suggests that hepatitis E can also spread through blood transfusion, but this is very rare.

How do doctors diagnose hepatitis E?

Doctors diagnose hepatitis E based on symptoms and blood tests. A health care professional will take a blood sample from you and send the sample to a lab. Blood tests can detect antibodies to the hepatitis E virus and show whether you have hepatitis E. The virus can also be detected in blood and in stool samples taken during acute hepatitis E infection.

How do doctors treat hepatitis E?

Treatment for acute hepatitis E includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis E.

See your doctor regularly to make sure your body has fully recovered.

Doctors may treat chronic hepatitis E with ribavirin or peginterferon alfa-2a (Pegasys).

How can I protect myself from hepatitis E infection?

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Also, make sure any pork or deer you eat is thoroughly cooked, both in developing countries and in developed countries such as the United States.

How can I prevent spreading hepatitis E to others?

Research suggests that it is uncommon for people to spread hepatitis E directly to other people. If you have hepatitis E, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before preparing food. Talk with a blood donation center before you donate blood.

Is a hepatitis E vaccine available?

No vaccine for hepatitis E is available in the United States. Vaccines have been developed and are used in China.

What should I eat and drink if I have hepatitis E?

If you have hepatitis E, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis E appeared first on Medika Life.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

SomSome forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis C

Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person’s blood.

Hepatitis C can cause an acute or chronic infection.

Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.

Acute hepatitis C

Acute hepatitis C is a short-term infection. Symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away.

Chronic hepatitis C

Chronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when your body isn’t able to fight off the virus. About 75 to 85 percent of people with acute hepatitis C will develop chronic hepatitis C.

Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer.

How common is hepatitis C in the United States?

In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.

Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C. Many people who have hepatitis C don’t have symptoms and don’t know they have this infection.

Since 2006, the number of new hepatitis C infections has been rising, especially among people younger than age 30 who inject heroin or misuse prescription opioids and inject them.

New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.

Who is more likely to get hepatitis C?

People more likely to get hepatitis C are those who

• have injected drugs
• had a blood transfusion or organ transplant before July 1992
• have hemophilia and received clotting factor before 1987
• have been on kidney dialysis
• have been in contact with blood or infected needles at work
• have had tattoos or body piercings
• have worked or lived in a prison
• were born to a mother with hepatitis C
• are infected with HIV
• have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
• are men who have or had sex with men

In the United States, injecting drugs is the most common way that people get hepatitis C.

Should I be screened for hepatitis C?

Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C don’t have symptoms and don’t know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.

What are the complications of hepatitis C?

Without treatment, hepatitis C may lead to cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of hepatitis C can prevent these complications.

Cirrhosis

Cirrhosis is a condition in which the liver slowly breaks down and is unable to function normally. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease, liver failure progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

Liver cancer

Having chronic hepatitis C increases your chance of developing liver cancer. If chronic hepatitis C causes severe liver damage or cirrhosis before you receive hepatitis C treatment, you will continue to have an increased chance of liver cancer even after treatment. Your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis C?

Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include

• dark yellow urine
• feeling tired
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea
• pain in your abdomen
• vomiting
• yellowish eyes and skin, called jaundice

If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.

What causes hepatitis C?

The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected person’s blood. Contact can occur by

• sharing drug needles or other drug materials with an infected person
• getting an accidental stick with a needle that was used on an infected person
• being tattooed or pierced with tools or inks that were not kept sterile—free from all viruses and other microorganisms—and were used on an infected person before they were used on you 
• having contact with the blood or open sores of an infected person
• using an infected person’s razor, toothbrush, or nail clippers
• being born to a mother with hepatitis C
• having unprotected sex with an infected person

You can’t get hepatitis C from

• being coughed or sneezed on by an infected person
• drinking water or eating food
• hugging an infected person
• shaking hands or holding hands with an infected person
• sharing spoons, forks, and other eating utensils
• sitting next to an infected person

A baby can’t get hepatitis C from breast milk.

How do doctors diagnose hepatitis C?

Doctors diagnose hepatitis C based on your medical history, a physical exam, and blood tests. If you have hepatitis C, your doctor may perform additional tests to check your liver.

Medical history

Your doctor will ask about your symptoms and whether you have any history of blood transfusions or injected drug use.

Physical exam

During a physical exam, your doctor will typically examine your body to check for signs of liver damage such as

• changes in skin color
• swelling in your lower legs, feet, or ankles
• tenderness or swelling in your abdomen

What tests do doctors use to diagnose hepatitis C?

Doctors use blood tests to diagnose hepatitis C. Your doctor may order additional tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood tests

Your doctor may order one or more blood tests to diagnose hepatitis C. A health care professional will take a blood sample from you and send the sample to a lab.

Blood tests for hepatitis C include the following:

• Screening test for antibodies to the hepatitis C virus. A screening blood test will show whether you have developed antibodies to the hepatitis C virus. A positive antibody test means you were exposed to the hepatitis C virus at some point. However, the virus may no longer be present in your blood if your body fought off the infection on its own or if you received treatment that cured the infection.
• Hepatitis C RNA test. If your antibody test is positive, your doctor will use a hepatitis C RNA test to detect RNA—a type of genetic material—from the hepatitis C virus. The hepatitis C RNA test can show whether you still have the hepatitis C virus and how much virus is in your blood. This information can help your doctor treat the infection. To see if you are responding to treatment, your doctor may order this test while you are undergoing treatment to find out if the amount of virus in your blood is changing.
• Genotype test. Your doctor can use this test to find out what strain, or form, of hepatitis C virus you have. At least six specific strains—called genotypes—of hepatitis C exist. Genotype 1 is the most common hepatitis C genotype in the United States. Your doctor will recommend treatment based on which hepatitis C genotype you have.

Additional tests

If you’ve had chronic hepatitis C for a long time, you could have liver damage. Your doctor may recommend additional tests to find out whether you have liver damage, how much liver damage you have, or to rule out other causes of liver disease. These tests may include

• blood tests
• transient elastography, a special ultrasound of your liver
• liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liver

Doctors typically use liver biopsy only if other tests don’t provide enough information about a person’s liver damage or disease. Talk with your doctor about which tests are best for you.

How do doctors treat hepatitis C?

Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.

Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.

Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:

• daclatasvir (Daklinza)
• elbasvir/grazoprevir (Zepatier)
• glecaprevir and pibrentasvir (Mavyret)
• ledipasvir/sofosbuvir (Harvoni)
• ombitasvir/paritaprevir/ritonavir (Technivie)
• ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak, Viekira XR)
• simeprevir (Olysio)
• sofosbuvir (Sovaldi)
• sofosbuvir/velpatasvir (Epclusa)
• sofosbuvir/velpatasvir/voxilaprevir (Vosevi)

Newer medicines are sometimes used along with these older hepatitis C medicines:

• ribavirin
• peginterferon alfa-2a (Pegasys) or peginterferon alfa-2b (PEG-Intron)

You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on

• which hepatitis C genotype you have
• how much liver damage you have
• whether you have been treated for hepatitis C in the past

Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.

Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.

For safety reasons, talk with your doctor before using dietary, such as vitamins, or any complementary or alternative medicines or medical practices.

Cost of hepatitis C medicines

The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.

Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. .

How do doctors treat the complications of hepatitis C?

If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound  test to check for liver cancer.

If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis C infection?

If you don’t have hepatitis C, you can help protect yourself from hepatitis C infection by

• not sharing drug needles or other drug materials
• wearing gloves if you have to touch another person’s blood or open sores
• making sure your tattoo artist or body piercer uses sterile tools and unopened ink
• not sharing personal items such toothbrushes, razors, or nail clippers

Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C. 

If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection. 

If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.

How can I prevent spreading hepatitis C to others?

If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Don’t donate blood or blood products, semen, organs, or tissue.

Is a hepatitis C vaccine available?

Researchers are still working on a vaccine for hepatitis C. If you have hepatitis C, talk with your doctor about vaccines for hepatitis A and hepatitis B. These vaccines can protect you from hepatitis A and hepatitis B infections, which could further damage your liver.

What should I eat and drink if I have hepatitis C?

If you have hepatitis C, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis C appeared first on Medika Life.

VirViruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis D

Hepatitis D is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can spread from person to person.

The hepatitis D virus is unusual because it can only infect you when you also have a hepatitis B virus infection. In this way, hepatitis D is a double infection. You can protect yourself from hepatitis D by protecting yourself from hepatitis B by getting the hepatitis B vaccine.

Hepatitis D spreads the same way that hepatitis B spreads, through contact with an infected person’s blood or other body fluids. The hepatitis D virus can cause an acute or chronic infection, or both. 

Acute hepatitis D

Acute hepatitis D is a short-term infection. The symptoms of acute hepatitis D are the same as the symptoms of any type of hepatitis and are often more severe. Sometimes your body is able to fight off the infection and the virus goes away.

Chronic hepatitis D

Chronic hepatitis D is a long-lasting infection. Chronic hepatitis D occurs when your body is not able to fight off the virus and the virus does not go away. People who have chronic hepatitis B and D develop complications more often and more quickly than people who have chronic hepatitis B alone.

How do hepatitis D and hepatitis B infections occur together?

Hepatitis D and hepatitis B infections may occur together as a coinfection or a superinfection. People can only become infected with hepatitis D when they also have hepatitis B.

Coinfection

A coinfection occurs when you get both hepatitis D and hepatitis B infections at the same time. Coinfections usually cause acute, or short-term, hepatitis D and B infections. Coinfections may cause severe acute hepatitis.

In most cases, people are able to recover from and fight off the acute hepatitis D and B infections and the viruses go away. However, in less than 5 percent of people with a coinfection, both infections become chronic and do not go away,

Superinfection

A superinfection occurs if you already have chronic hepatitis B and then become infected with hepatitis D. When you get a superinfection, you may have severe acute hepatitis symptoms.

Up to 90 percent of people with a superinfection are not able to fight off the hepatitis D virus, and develop chronic hepatitis D. As a result, these people will have both chronic hepatitis D and chronic hepatitis B.

How common is hepatitis D?

Hepatitis D is not common in the United States. Hepatitis D is more common in other parts of the world, including Eastern and Southern Europe; the Mediterranean region and Middle East; parts of Asia, including Mongolia; Central Africa; and the Amazon River basin in South America.

Who is more likely to have hepatitis D?

Hepatitis D infection occurs only in people who have hepatitis B. People are more likely to have hepatitis D in addition to hepatitis B if they

• are injection-drug users
• have lived with or had sex with someone who has hepatitis D
• are from an area of the world where hepatitis D is more common

What are the complications of acute hepatitis D?

In rare cases, acute hepatitis D can lead to acute liver failure, a condition in which the liver fails suddenly. Although acute liver failure is uncommon, hepatitis D and B infections are more likely to lead to acute liver failure than hepatitis B infection alone.

What are the complications of chronic hepatitis D?

Chronic hepatitis D may lead to cirrhosis, liver failure, and liver cancer. People who have chronic hepatitis B and D are more likely to develop these complications than people who have chronic hepatitis B alone. Early diagnosis and treatment of chronic hepatitis B and D can lower your chances of developing serious health problems.

Cirrhosis

Cirrhosis is a condition in which the liver slowly breaks down and is unable to work normally. Scar tissue replaces healthy liver tissue, partly blocking the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to work. As cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease, liver failure progresses over months or years. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

Liver cancer

Having chronic hepatitis B and chronic hepatitis D increases your chance of developing liver cancer. Your doctor may suggest blood tests and an ultrasound or other type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis D?

Most people with acute hepatitis D have symptoms, which may include

• feeling tired
• nausea and vomiting
• poor appetite
• pain over the liver, in the upper part of the abdomen
• darkening of the color of urine
• lightening of the color of stool
• yellowish tint to the whites of the eyes and skin, called jaundice

In contrast, most people with chronic hepatitis D have few symptoms until complications develop, which could be several years after they were infected. Some symptoms of cirrhosis include

• weakness and feeling tired
• weight loss
• swelling of the abdomen
• swelling of the ankles, called edema
• itching skin
• jaundice

What causes hepatitis D?

The hepatitis D virus causes hepatitis D. The hepatitis D virus spreads through contact with an infected person’s blood or other body fluids. Contact can occur by

• sharing drug needles or other drug materials with an infected person
• having unprotected sex with an infected person
• getting an accidental stick with a needle that was used on an infected person

The hepatitis D virus rarely spreads from mother to child during birth.

You can’t get hepatitis D from

• being coughed on or sneezed on by an infected person
• drinking water or eating food
• hugging an infected person
• shaking hands or holding hands with an infected person
• sharing spoons, forks, and other eating utensils
• sitting next to an infected person

How do doctors diagnose hepatitis D?

Doctors diagnose hepatitis D based on your medical history, a physical exam, and blood tests. If you have hepatitis D, your doctor may perform tests to check your liver.

Medical history

Your doctor will ask about your symptoms and about factors that may make you more likely to get hepatitis D.

Physical exam

During a physical exam, your doctor will check for signs of liver damage such as

• changes in skin color
• swelling in your lower legs, feet, or ankles
• tenderness or swelling in your abdomen

What tests do doctors use to diagnose hepatitis D?

Doctors use blood tests to diagnose hepatitis D. Your doctor may order tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood test

Your doctor may order one or more blood tests to diagnose hepatitis D. A health care professional will take a blood sample from you and send the sample to a lab.

Additional tests

If you have chronic hepatitis D and hepatitis B, you could have liver damage. Your doctor may recommend tests to find out whether you have liver damage or how much liver damage you have—or to rule out other causes of liver disease. These tests may include

• blood tests.
• elastography, a special ultrasound that measures the stiffness of your liver.
• a liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liver. A pathologist will examine the tissue under a microscope to look for signs of damage or disease.

Doctors typically use liver biopsy only if other tests don’t provide enough information about the liver damage or disease. Talk with your doctor about which tests are best for you.

How do doctors treat hepatitis D?

Doctors may treat chronic hepatitis D with medicines called interferons, such as peginterferon alfa-2a (Pegasys). Researchers are studying new treatments for hepatitis D. In addition, medicines for hepatitis B may be needed. These are usually medicines taken once daily by mouth.

How do doctors treat the complications of hepatitis D?

If chronic hepatitis D leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have a greater chance of developing liver cancer. Your doctor may order an ultrasound or other type of imaging test to check for liver cancer.

If acute hepatitis D leads to acute liver failure, or if chronic hepatitis D leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis D infection?

If you do not have hepatitis B, you can prevent hepatitis D infection by taking steps to prevent hepatitis B infection, such as getting the hepatitis B vaccine. If you do not get hepatitis B, you cannot get hepatitis D.

If you already have hepatitis B, you can take steps to prevent hepatitis D infection by

• not sharing drug needles or other drug materials
• wearing gloves if you have to touch another person’s blood or open sores
• not sharing personal items such as toothbrushes, razors, or nail clippers

How can I prevent spreading hepatitis D to others?

If you have hepatitis D, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they aren’t infected, get the hepatitis B vaccine. Preventing hepatitis B will also prevent hepatitis D.

You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis D. Don’t donate blood or blood products, semen, organs, or tissue.

Is a hepatitis D vaccine available?

No vaccine for hepatitis D is currently available. The hepatitis B vaccine can prevent hepatitis D by preventing hepatitis B.

Eating, diet, and nutrition for hepatitis D

If you have hepatitis D, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis D appeared first on Medika Life.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis B

Hepatitis B is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis B virus spreads through contact with an infected person’s blood, semen, or other body fluids.

The hepatitis B virus can cause acute or chronic infection.

You can take steps to protect yourself from hepatitis B, including getting the hepatitis B vaccine. If you have hepatitis B, you can take steps to prevent spreading hepatitis B to others.

Acute hepatitis B

Acute hepatitis B is a short-term infection. If you have symptoms, they may last several weeks. In some cases, symptoms last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away. Most healthy adults and children older than 5 years old who have hepatitis B get better without treatment.⁵

Chronic hepatitis B

Chronic hepatitis B is a long-lasting infection. Chronic hepatitis B occurs when your body isn’t able to fight off the virus and the virus does not go away.

Your chances of developing chronic hepatitis B are greater if you are infected with the virus as a young child. About 90 percent of infants infected with hepatitis B develop a chronic infection. About 25 to 50 percent of children infected between the ages of 1 and 5 years develop chronic infections. However, among people infected during adulthood, only about 5 percent develop chronic hepatitis B.

How common is hepatitis B?

Researchers estimate that about 850,000 to 2.2 million people in the United States have chronic hepatitis B. In 1991, doctors began recommending that children in the United States receive the hepatitis B vaccine. Since then, the rate of new hepatitis B infections has gone down 82 percent. Asian Americans and African Americans have higher rates of chronic hepatitis B. Many people in the United States who have chronic hepatitis B were infected before the vaccine became available.

Chronic hepatitis B is more common in Africa, Asia, and parts of the Middle East, Eastern Europe, and South and Central America than it is in the United States. Chronic hepatitis B infection has been especially common in some parts of the world, including sub-Saharan Africa, parts of Asia, and the Pacific Islands. Use of the hepatitis B vaccine has helped lower infection rates in some of these areas.

Who is more likely to get hepatitis B?

People are more likely to get hepatitis B if they are born to a mother who has hepatitis B. The virus can spread from mother to child during birth. For this reason, people are more likely to have hepatitis B if they

• were born in a part of the world where hepatitis B is more common
• were born in the United States, didn’t receive the hepatitis B vaccine as an infant, and have parents who were born in an area where hepatitis B was especially common

In the United States, 47 to 95 percent of people with chronic hepatitis B were born outside the United States, in parts of the world where hepatitis B is more common.

People are also more likely to have hepatitis B if they

• are infected with HIV, because hepatitis B and HIV spread in similar ways
• have lived with or had sex with someone who has hepatitis B
• have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
• are men who have sex with men
• are injection drug users
• work in a field, such as health care, in which they have contact with blood, needles, or body fluids at work
• have lived in or travel often to parts of the world where hepatitis B is common 
• have been on kidney dialysis
• are taking medicines that weaken the immune system, such as steroids or chemotherapy medicines
• have worked or lived in a prison
• had a blood transfusion or organ transplant before the mid-1980s

In the United States, sexual contact is the most common way that hepatitis B spreads among adults. Injection drug use is another important way that hepatitis B spreads. Since 2009, the number of acute hepatitis B infections has risen in some Appalachian states, especially among adults who inject drugs.

Should I be screened for hepatitis B?

Your doctor may recommend screening for hepatitis B if you

• are pregnant
• were born in an area of the world where chronic hepatitis B is more common
• didn’t receive the hepatitis B vaccine as an infant and have parents who were born in an area where chronic hepatitis B was especially common, such as sub-Saharan Africa, parts of Asia, or the Pacific Islands
• are HIV positive
• have injected drugs
• are a man who has sex with men
• have lived with or had sex with a person who has hepatitis B
• have an increased chance of infection due to other factors

Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis B. Many people who have hepatitis B don’t have symptoms and don’t know they have hepatitis B. Screening tests can help doctors diagnose and treat hepatitis B, which can lower your chances of developing serious health problems.

What are the complications of hepatitis B?

Chronic hepatitis B may lead to complications, including cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of chronic hepatitis B can lower your chances of developing these complications.

Cirrhosis

Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to function. As cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease, liver failure progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

Liver cancer

Having chronic hepatitis B increases your chance of developing liver cancer. Your doctor may suggest an ultrasound test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis B?

Some people infected with hepatitis B have no symptoms. Some people have symptoms of acute hepatitis B within 2 to 5 months after they come in contact with the virus. These symptoms may include

• dark yellow urine
• feeling tired
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea
• pain in your abdomen
• vomiting
• yellowish eyes and skin, called jaundice

Infants and children younger than age 5 typically don’t have symptoms of acute hepatitis B. Older children and adults are more likely to have symptoms.

If you have chronic hepatitis B, you may not have symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis B screening is important, even if you have no symptoms.

If you have ever had hepatitis B, certain medicines may cause the hepatitis B virus to begin damaging your liver and causing symptoms. These medicines include

• immunosuppressants—medicines that weaken your immune system—which doctors prescribe to treat many diseases, including cancer, rheumatoid arthritis, and inflammatory bowel disease
• hepatitis C medicines

Your doctor may test you for hepatitis B before you begin taking these medicines, even if you have no hepatitis B symptoms.

What causes hepatitis B?

The hepatitis B virus causes hepatitis B. The hepatitis B virus spreads through contact with an infected person’s blood, semen, or other body fluids. Contact can occur by

• being born to a mother with hepatitis B
• having unprotected sex with an infected person
• sharing drug needles or other drug materials with an infected person
• getting an accidental stick with a needle that was used on an infected person
• being tattooed or pierced with tools that were used on an infected person and weren’t properly sterilized, or cleaned in a way that destroys all viruses and other microbes
• having contact with the blood or open sores of an infected person
• using an infected person’s razor, toothbrush, or nail clippers

You can’t get hepatitis B from

• being coughed on or sneezed on by an infected person
• drinking water or eating food
• hugging an infected person
• shaking hands or holding hands with an infected person
• sharing spoons, forks, and other eating utensils
• sitting next to an infected person

A baby can’t get hepatitis B from breast milk.

How do doctors diagnose hepatitis B?

Doctors diagnose hepatitis B based on your medical and family history, a physical exam, and blood tests. If you have hepatitis B, your doctor may perform additional tests to check your liver.

Medical and family history

Your doctor will ask about your symptoms and about factors that may make you more likely to get hepatitis B. Your doctor may ask whether you have a family history of hepatitis B or liver cancer. Your doctor may also ask about other factors that could damage your liver, such as drinking alcohol

Physical exam

During a physical exam, your doctor will check for signs of liver damage such as

• changes in skin color
• swelling in your lower legs, feet, or ankles
• tenderness or swelling in your abdomen

What tests do doctors use to diagnose hepatitis B?

Doctors use blood tests to diagnose hepatitis B. Your doctor may order additional tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood tests

Your doctor may order one or more blood tests to diagnose hepatitis B. A health care professional will take a blood sample from you and send the sample to a lab.

Certain blood tests can show whether you are infected with hepatitis B. If you are infected, your doctor may use other blood tests to find out

• if the infection is acute or chronic
• whether you have an increased chance of liver damage
• whether you need treatment

If you have chronic hepatitis B, your doctor will recommend testing your blood regularly because chronic hepatitis B can change over time. Even if the infection is not damaging your liver when you are first diagnosed, it may damage your liver in the future. Your doctor will use regular blood tests to check for signs of liver damage, find out if you need treatment, or see how you are responding to treatment.

Blood tests can also show whether you are immune to hepatitis B, meaning you can’t get hepatitis B. You may be immune if you got a vaccine or if you had an acute hepatitis B infection in the past and your body fought off the infection.

Additional tests

If you’ve had chronic hepatitis B a long time, you could have liver damage. Your doctor may recommend additional tests to find out whether you have liver damage, how much liver damage you have, or to rule out other causes of liver disease. These tests may include

• blood tests
• transient elastography, a special ultrasound of your liver
• liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liver

Doctors typically use liver biopsy only if other tests don’t provide enough information about a person’s liver damage or disease. Talk with your doctor about which tests are best for you.

How do doctors treat hepatitis B?

Doctors typically don’t treat hepatitis B unless it becomes chronic. Doctors may treat chronic hepatitis B with antiviral medicines that attack the virus. Not everyone with chronic hepatitis B needs treatment. If blood tests show that hepatitis B could be damaging your liver, your doctor may prescribe antiviral medicines to lower your chances of liver damage and complications.

Medicines that you take by mouth include

• entecavir (Baraclude)
• telbivudine  (Tyzeka)
• tenofovir alafenamide (Vemlidy)
• tenofovir disoproxil fumarate (Viread)

Medicines that doctors can give as shots include

• interferon alfa-2b  (Intron A)
• peginterferon alfa-2a  (Pegasys)

The length of treatment varies. Hepatitis B medicines may cause side effects. Talk with your doctor about the side effects of treatment. Tell your doctor before taking any other prescription or over-the-counter medicines.

For safety reasons, you also should talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.

How do doctors treat the complications of hepatitis B?

If chronic hepatitis B leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.

If chronic hepatitis B leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis B infection?

You can protect yourself from hepatitis B by getting the hepatitis B vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.

Hepatitis B vaccine

The hepatitis B vaccine has been available since the 1980s and should be given to newborns, children, and teens in the United States. Adults who are more likely to be infected with hepatitis B should also get the vaccine. The hepatitis B vaccine is safe for pregnant women.

Doctors most often give the hepatitis B vaccine in three shots over 6 months. You must get all three shots to be fully protected.

If you are traveling to countries where hepatitis B is common and you haven’t received the hepatitis B vaccine, try to get all the shots before you go. If you don’t have time to get all the shots before you travel, get as many as you can. Even one shot may give you some protection against the virus.

Reduce your chance of infection

You can reduce your chance of hepatitis B infection by

• not sharing drug needles or other drug materials
• wearing gloves if you have to touch another person’s blood or open sores
• making sure your tattoo artist or body piercer uses sterile tools
• not sharing personal items such as toothbrushes, razors, or nail clippers
• using a latex or polyurethane condom during sex

Prevent infection after contact with the virus

If you think you have been in contact with the hepatitis B virus, see your doctor right away. A dose of the hepatitis B vaccine and, in some cases, a medicine called hepatitis B immune globulin (HBIG), may protect you from getting sick. You must get the vaccine dose and HBIG shortly after coming into contact with the virus, preferably within 24 hours.

How can I prevent spreading hepatitis B to others?

If you have hepatitis B, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they aren’t infected, get the hepatitis B vaccine. You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis B. Don’t donate blood or blood products, semen, organs, or tissue.

Prevent hepatitis B infections in newborns

If you are pregnant and have hepatitis B, tell the doctor and staff who deliver your baby. A health care professional should give your baby the hepatitis B vaccine and HBIG right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.

Eating, diet, and nutrition for hepatitis B

If you have hepatitis B, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

The post Hepatitis B appeared first on Medika Life.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis A

Hepatitis A is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis A virus typically spreads through contact with food or water that has been contaminated by an infected person’s stool.

Hepatitis A is an acute or short-term infection, which means people usually get better without treatment after a few weeks. In rare cases, hepatitis A can be severe and lead to liver failure and the need for an emergency liver transplant to survive. Hepatitis A does not lead to long-term complications, such as cirrhosis, because the infection only lasts a short time.

You can take steps to protect yourself from hepatitis A, including getting the hepatitis A vaccine. If you have hepatitis A, you can take steps to prevent spreading hepatitis A to others.

How common is hepatitis A?

In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked. However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness. Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.

Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.

Who is more likely to get hepatitis A?

People more likely to get hepatitis A are those who

• travel to developing countries
• have sex with an infected person
• are men who have sex with men
• use illegal drugs, including drugs that are not injected
• experience unstable housing or homelessness
• live with or care for someone who has hepatitis A
• live with or care for a child recently adopted from a country where hepatitis A is common

What are the complications of hepatitis A?

People typically recover from hepatitis A without complications. In rare cases, hepatitis A may lead to liver failure. Liver failure due to hepatitis A is more common in adults older than age 50 and in people who have another liver disease.³

What are the symptoms of hepatitis A?

Some people have symptoms 2 to 7 weeks after they come in contact with the virus. People with hepatitis A typically get better without treatment after a few weeks. In some cases, symptoms can last up to 6 months. These symptoms may include

• dark yellow urine
• diarrhea
• feeling tired
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea
• pain in the abdomen
• vomiting
• yellowish eyes and skin, called jaundice

Some people infected with hepatitis A have no symptoms, including many children younger than age 6. Older children and adults are more likely to have symptoms.

What causes hepatitis A?

The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected person’s stool. Contact can occur by

• eating food made by an infected person who did not wash his or her hands after using the bathroom
• drinking untreated water or eating food washed in untreated water
• placing a finger or an object in your mouth that came into contact with an infected person’s stool
• having close personal contact with an infected person, such as through sex or caring for someone who is ill

You cannot get hepatitis A from

• being coughed on or sneezed on by an infected person
• sitting next to an infected person
• hugging an infected person

A baby cannot get hepatitis A from breast milk

How do doctors diagnose hepatitis A?

Doctors diagnose hepatitis A based on symptoms and a blood test. A health care professional will take a blood sample from you and send the sample to a lab. A blood test will detect antibodies to the hepatitis A virus called immunoglobulin M (IgM) antibodies and show whether you have acute hepatitis A. If the blood test finds antibodies to the hepatitis A virus that are not IgM antibodies, then you are immune to hepatitis A, due to either past hepatitis A infection or hepatitis A vaccination.

How do doctors treat hepatitis A?

Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.

See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.

How can I protect myself from hepatitis A infection?

You can protect yourself from hepatitis A by getting the hepatitis A vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.

If you have had hepatitis A in the past, you cannot get hepatitis A again. You can still get other types of viral hepatitis though.

Hepatitis A vaccine

All children should receive the hepatitis A vaccine between 12 and 23 months of age. People who are more likely to be infected and people with chronic liver disease should also receive the vaccine.

Doctors give the hepatitis A vaccine in two shots. You should get the second shot 6 to 12 months after the first shot. You need to get both shots to be fully protected against the virus.

If you are traveling to a developing country where hepatitis A is common and you haven’t received the hepatitis A vaccine, talk with your doctor about how to prevent getting hepatitis A. If possible, try to get both shots of the hepatitis A vaccine before you go. If you don’t have time to get both shots, get the first shot as soon as you can. Most people gain some protection within 2 weeks of the first shot.

Reduce your chance of infection

You can reduce your chance of getting hepatitis A by washing your hands thoroughly with soap and warm water for 15 to 30 seconds

• after using the toilet
• after changing diapers
• before and after handling or preparing food

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Prevent infection after contact with the virus

If you think you have come in contact with the hepatitis A virus, see your doctor right away. A dose of the hepatitis A vaccine or a medicine called hepatitis A immune globulin may protect you from getting the infection. Your doctor may recommend a vaccine dose or medicine if

• you live with, have had sex with, or have had close contact with someone who has hepatitis A
• you shared illegal drugs with someone who had hepatitis A
• you ate food or drank water possibly containing the hepatitis A virus

You must get the vaccine dose or medicine shortly after coming into contact with the virus to prevent infection.

How can I prevent spreading hepatitis A to others?

If you have hepatitis A, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before fixing or eating food. While you are sick, avoid close contact with others, and don’t prepare food or serve food to others. Also, tell your doctor, dentist, and other health care professionals that you have hepatitis A.

Talk with a blood donation center before you donate blood. If you had hepatitis A when you were younger than 11, you may be able to donate blood. If you had hepatitis A when you were age 11 or older, you should not donate blood.

You are most contagious—able to spread the virus to others—during the 2 weeks before you have symptoms. You may be contagious for up to 3 weeks after you develop symptoms. Children are often contagious longer than adults.

What should I eat and drink if I have hepatitis A?

If you have hepatitis A, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

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