Immunization Schedule, Adults (cont.)
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Hepatitis A and B
Hepatitis is inflammation of the liver. It may be caused by medications, toxins, alcohol, or viruses. The inflammation results in injury to liver cells. The injured liver may be unable to perform functions such as toxin removal, processing of nutrients, removal of old red blood cells, or production of bile to aid in fat digestion.
Viral hepatitis is caused by the hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), hepatitis E virus (HEV), and hepatitis G virus (HGV). However, the only vaccines available are for hepatitis A and B.
Some people with viral hepatitis may have no symptoms. Others have a severe form that leads to death in a few days. Many are somewhere in between. Initially, fatigue, muscle and joint aches, upper respiratory tract symptoms (nasal discharge or sore throat), and loss of appetite occur. Nausea and vomiting are frequent. A slight fever generally is present. Pain is usually present in the upper right part of the abdomen. Five to 10 days later, jaundice (yellowing of the skin and whites of the eyes) may be present. Hepatitis can last just a short time, with symptoms going away after two to three weeks, or it can become a chronic, lifelong disease.
Hepatitis A: Also known as infectious hepatitis, hepatitis A does not become a long-term illness. Transmission occurs via a fecal-oral route due to such things as contaminated food or water or improper hand washing. The virus is in the stool of infected persons and if swallowed by another person may cause disease. This is more likely in crowded or unsanitary conditions. Close contact with infected people is also a mode of transmission. Death seldom occurs from hepatitis A. Especially in children, hepatitis A tends to show no symptoms. Symptoms are often more severe in adults.
Hepatitis B and D: Also known as serum hepatitis, this form can be found in blood, saliva, semen, and vaginal secretions. The virus is transmitted via blood transfusions, sexual contact, or contaminated needles. It is common in homosexual men and IV drug users. Infected mothers can also pass it on to their babies at the time of delivery. Some people with this form of hepatitis will develop chronic hepatitis. These people have a 25-40% greater risk of developing cirrhosis and liver cancer. Hepatitis D can only occur when there is also infection with Hepatitis B. Hepatitis D is uncommon in the United States, except in those requiring multiple transfusions or in IV drug users.
Medically Reviewed by a Doctor on 8/13/2014
Mai Kim Lai, MD
Douglas C Finefrock, DO
Gregory L Walker, MD, FACEP, Ped EM
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