Viral Hepatitis

The A, B, Cs of Viral Hepatitis

Viral hepatitis is an infection that affects the liver. There are at least six different types of
hepatitis (A-G), with the three most common types being hepatitis A, hepatitis B and
hepatitis C. Hepatitis A is an acute infection and people usually improve without
treatment. Hepatitis B and hepatitis C can cause a chronic, persistent infection, which can
lead to chronic liver disease. There is a vaccine to prevent hepatitis A and B, however
there is not one for hepatitis C.

The New York State Department of Health, along with the New York State County Health
Departments, offer ways to control and prevent the spread of hepatitis infection. Public
health clinics, located in each county, may offer testing and vaccination (hepatitis A,
hepatitis B) to those at risk for hepatitis. In addition, hepatitis counseling and educational
information is offered to individuals who may have been exposed to hepatitis, engage in
behaviors putting them at risk for developing infection, and to those who may already
know they are infected and want to learn about how they can protect others from
becoming infected.

For more information about hepatitis testing, counseling and education in your county,
please contact your county health department.

Hepatitis A

Hepatitis A is caused by the hepatitis A virus (HAV). The virus is found in the stool
(feces) of HAV-infected people. Hepatitis A can easily spread from one person to another
by putting something in the mouth (even though it may look clean) that has been
contaminated with the stool of a person with hepatitis A. This can happen when people do
not wash their hands after using the toilet and then touch or prepare other people’s food.

• Are you at risk for hepatitis A?

• Learn more about hepatitis A...

Hepatitis B

Hepatitis B is caused by the hepatitis B virus (HBV). The virus is found in blood and
certain body fluids. Hepatitis B is spread when a person who is not immune comes in
contact with blood or body fluid from an infected person. Hepatitis B is spread by having
sex with an infected person without a condom, sharing needles or "works" when
"shooting" drugs, needlesticks or sharps exposures in a health care setting, or from an
infected mother to her baby during vaginal birth. Exposure to blood in ANY situation can
be a risk for transmission.

• Are you at risk for hepatitis B?

• Learn more about hepatitis B...

Hepatitis C

Hepatitis C is caused by the hepatitis C virus (HCV). The virus is found in blood and
certain body fluids. It is spread when a person who is not immune comes in contact with
blood or body fluids from an infected person. Hepatitis C is spread through sharing
needles or "works" when "shooting" drugs, through needlestick or sharps exposures in a
health care setting, or sometimes from an infected mother to her baby during vaginal
birth. It is possible to get hepatitis C from sex, but it is uncommon.

• Are you at risk for hepatitis C?

• Learn more about hepatitis C...

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Who's at Risk for Hepatitis C

Hepatitis C Virus (HCV) is spread primarily by contact with blood and blood products.
Blood transfusions and the sharing of used needles and syringes have been the main
causes of the spread of HCV in the United States. With the introduction in 1991 of
routine blood screening for HCV antibody and improvements in the test in mid-1992,
transfusion-related hepatitis C has virtually disappeared. At present, injection drug use is
the most common risk factor for contracting the disease. However, there are patients who
get hepatitis C without any known exposure to blood or to drug use.

Those individuals most at risk for hepatitis C infection are:

• People who had blood transfusions, blood products, or organ donations before
June, 1992, when sensitive tests for HCV were introduced for blood screening.
• Health care workers who suffer needle-stick accidents.
• Injection drug users, including those who may have used drugs once many years
ago.
• Infants born to HCV-infected mothers.

Other groups who appear to be at slightly increased risk for hepatitis C are:
 • People with high-risk sexual behavior, multiple partners, and sexually transmitted
diseases.
• People who snort cocaine using shared equipment.
• People who have shared toothbrushes, razors and other personal items with a
family member that is HCV-infected.

Are you at risk?

Check to see if you are at risk for:

• Hepatitis A (PDF, 48KB, 1pg)

• Hepatitis B (PDF, 121KB, 1pg)
• Hepatitis C (PDF, 59KB, 1pg)

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Hepatitis A
Hepatitis A (HAV) is a highly contagious disease that attacks the liver. It is the most
common type of hepatitis reported in the US. Hepatitis A is spread by the fecal-oral route
by:

• putting something in the mouth, even though it may look clean, that has been
contaminated with the stool of a person with hepatitis A,
• through close person-to-person contact,
• or by eating or drinking contaminated food or water.

Symptoms include:

• fever,
• jaundice (yellowing of skin),
• fatigue,
• loss of appetite,
• nausea,
• abdominal discomfort and
• dark urine.

There is no specific treatment for HAV and most recover without complications. Once
you get hepatitis A you cannot be re-infected; you are protected for life. Fortunately, there
is an effective vaccine to protect against hepatitis A.

Related Information
• Hepatitis A information for consumers
 • What's the difference between hepatitis A, B and C? (PDF, 70KB, 1pg.)
• If you are a health care provider, learn more about hepatitis A and the
management of patients infected with hepatitis A.

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Hepatitis B
Hepatitis B is the most common serious liver infection in the world. It is caused by the
hepatitis B virus (HBV) which is 100 times more infectious than the AIDS virus. HBV is
most efficiently transmitted through contact with blood and body fluids of an infected
person. This can occur through direct blood-to-blood contact, sex, illicit drug use, and
from an infected mother to her newborn during delivery. HBV spreads because many
people are unaware they are infected with the virus and unknowingly pass it on to those
who are in close contact with them.

Most people are able to fight off an HBV infection and clear the virus from their blood.
However, 5-10% of adults, 30-50% of children, and 90% of infants will develop chronic
infection which can lead to liver failure, cirrhosis (scarring) or cancer of the liver.
Approximately 400 million persons worldwide are chronically infected with HBV,
including about 1.25 million in the United States. Between 5,000 and 6,000 Americans
die of hepatitis B-related liver complications including cirrhosis and liver cancer each
year.

Fortunately, there is a safe and effective vaccine to protect against hepatitis B infection. It
is recommended that all infants, children and adolescents up to the age of 18 receive the
hepatitis B vaccine. The vaccine is also recommended for adults who may be at high risk
for infection.

Related Information
• Hepatitis B information for consumers
• What's the difference between hepatitis A, B and C? (PDF, 70KB, 1pg.)
• If you are a health care provider, learn more about hepatitis B and the
management of patients infected with hepatitis B

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Perinatal Hepatitis B
One way to transmit hepatitis B virus (HBV) is from mother to infant during birth
(perinatal transmission). The risk of perinatal HBV infection among infants born to
mothers already infected with HBV ranges from 10% to 85%.
 • Hepatitis B Hospital Birth Dose Program
o Saving Lives With the Universal Hepatitis B Birth Dose - Fact Sheets for
Hospitals
o Medical Errors Put Infants at Risk for Chronic Hepatitis B Virus Infection
- Six Case Reports
• Perinatal Hepatitis B Manua

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Hepatitis C
Hepatitis C virus (HCV) causes liver disease and it is found in the blood of persons who
are infected. HCV is spread by contact with the blood of an infected person.

Hepatitis C infects about 25,000 people each year with most developing chronic
infection. However, many of those with chronic hepatitis C do not even know they are
infected. Those individuals with chronic infection are at risk for developing chronic liver
diseases such as cirrhosis and cancer of the liver. Individuals who injected drugs are at
highest risk for infection even if they injected only once many years ago.

Unlike hepatitis A and hepatitis B there is not a vaccine to prevent hepatitis C. Over the
years, the treatments for hepatitis C have become more effective. However, treatment is
not for everyone and a specialist should be consulted when determining if someone
should get treated.

Information for Providers

• Learn more about hepatitis C and the management of patients infected with
hepatitis C

Information for Consumers

• Learn more about hepatitis C
• What's the difference between hepatitis A, B and C? (PDF, 70KB, 1pg.)
• Locate a support group in your area:
o Western NY Area
o Greater NY, Long Island Area
o Other New York State Hepatitis C Support Groups
• Find a physici

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It's Time! Integrate Viral Hepatitis into
Your Work
A Comprehensive Training for Health and Human
Services Providers
• Training Content, Goals & Objectives (PDF, 141 KB, 4pg.)

The "It's Time: Integrate Viral Hepatitis into Your Work" training was developed under a
four year cooperative agreement with the Centers for Disease Control and Prevention.
The training was developed by a multi-disciplinary team with expertise in viral hepatitis,
program implementation, training curriculum development and evaluation. The training
offers non-physician health and human services providers the opportunity to:

• Examine basic information about the liver, hepatitis A, B and C;

• Build skills to provide client-centered counseling on viral hepatitis; and
• Learn strategies for incorporating viral hepatitis messages and services into their
busy work schedules.

Between January and August of 2005, the "It's Time" training was offered 15 times across
the country to specific audiences. The training was extensively evaluated and data
showed a positive impact on provider knowledge, attitudes, and practices as a result of
the training.

Training materials include:

1. a fully developed manual to guide a trainer through delivering the program,

2. a fully developed manual for participants,
3. slide sets,
4. interactive exercises, and
5. other resources

Training content was updated in 2007.

Target audience for the Training: Non-physician health and human services providers
who work in settings that serve people at risk for viral hepatitis including, HIV programs,
STD clinics, local health departments, substance use treatment programs and correctional
health care settings.

A CD with all training materials is available upon request.

Partners
This training center is a project of the New York State Department of Health in
conjunction with the New York City Department of Health and Mental Hygiene, the
AIDS Community Research Initiative of America and the New York State Office of
Alcoholism and Substance Abuse Services.

For more information

Richard Cotroneo
Director, HIV Education and Training Programs
Corning Tower, Room 244
Empire State Plaza
Albany, NY 12237-0658
Phone: 518- 474-3045
Fax: 518- 473-8814
Email: rac09@health.state.ny.us

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New York State Hepatitis C Continuity

Program
The New York State Hepatitis C Continuity Program is a program for New York State
Department of Correctional Services (DOCS) inmates who are under treatment for
hepatitis C (HCV). The program promotes treatment completion upon and after release to
the community.

This Program makes it possible for treatment to be initiated in DOCS regardless of the
incarceration time remaining, since arrangements for continuity of treatment after release
are possible. It enables inmates who initiate treatment prior to release to receive timely
referral to appropriate community-based health care providers for continuation of
treatment.

• Fact Sheet: "New York State Hepatitis C Continuity Program"

• Promotional Brochure: "New York State Hepatitis C Continuity Program" (PDF,
838 KB, 2pg.)
• Consumer Brochure: "Hepatitis C: What You Need to Know for Help on the
Outside" (PDF, 436 KB, 2pg.)
• Consumer Brochure: "Hepatitis C: Lo que debe saber para obtener ayuda afuera"
(Spanish) (PDF, 435 KB, 2pg.)

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