How do you know if you're at risk for hepatitis?
Well, do you have anal or oral sex? How about rimming? Have you ever shared a needle for an injection of drugs, steroids, or other substances? Are you into body-piercing or skin art?
If you answered yes to any of those questions, you definitely need to know the facts about hepatitis. For example, according to the Immunization Action Coalition Hepatitis B is 100 times more infectious than HIV and it can lead to chronic illness and even death. The good news is that there are vaccines and practices that can protect you from some types of hepatitis, provided you take control and act now.
Different types of hepatitis are caused by different types of viruses: the most commonly known and occurring are hepatitis A, B and C, plus the much less common D and E. All forms of hepatitis are potentially serious because all of these viruses attack the liver, one of the body's most crucial organs. Also, you can be infected with hepatitis without showing a single symptom, infecting others while you remain indefinitely asymptomatic.
This week we'll look at one of the most common forms of the disease, hepatitis A, and how to protect yourself and your partners. We'll do the same next column with hepatitis B and C.
According to the Centers for Disease Control and Prevention (CDC), hepatitis A is "spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A." Translated into real terms, this means that any fun you have with your partners' bottom can put you at risk for catching hepatitis A if your partner is infected. Remember, the incubation period for hepatitis A is about 28 days, so you won't necessarily see any signs that your partner is infected. Just like HIV, you can't assume a partner is infected or not just from their outward appearance.
The hepatitis A virus can also be transmitted by sharing needles with someone who is infected, or the use of tattooing or piercing equipment that has not been properly cleaned.
If you get sick with hepatitis A, you will likely develop one or more of the following symptoms: fever, fatigue, loss of appetite, nausea, dark urine or jaundice (yellowing of the skin or the whites of the eyes). The illness will generally last from two to six months but it does not usually cause the chronic liver problems associated with other strains of hepatitis.
Nonetheless, if you suspect you or a partner has hepatitis, it is time to abstain from sexual contact, focus on extremely fastidious hygiene, and see a doctor. If you delay, you risk spreading this nasty virus through the community.
So how can you protect yourself from this form of hepatitis? Luckily, there is a hepatitis A vaccine available which provides about 20 years worth of protection. The CDC strongly suggests that all gay men receive the vaccine whether sexually active or not. Obtaining the vaccine is a smart idea, since in addition to being spread sexually, it is possible to contract hepatitis A by consuming food or water that has been contaminated by feces. The CDC also recommends that anyone traveling to a country with high rates of hepatitis A receive the vaccine, so if you're planning any trips, be sure to talk with your doctor.
But why bother with the vaccine if hepatitis A is a relatively short-lived illness? Because, says Dr. Philippe Chiliade, Medical Director of Whitman-Walker Clinic, one to two percent of hepatitis A cases become serious enough to be life-threatening. Importantly, people with HIV/AIDS can and should also get this vaccine.
If you haven't been vaccinated and think you may have been recently exposed to hepatitis A, you can be treated with immune globulin, which may protect you from getting ill if you get the shot within two weeks of the exposure. So if you suspect you've been exposed, see your doctor as soon as possible.
Short of the protection of the vaccine, barrier methods and careful hygiene before and after sex should help prevent transmission -- and those precautions should be taken in any event to prevent transmission of other sexually transmitted diseases.
Whitman-Walker offers the hepatitis A vaccine free of charge if you meet certain income criteria -- otherwise, you pay for it on a sliding scale. Normally, protection is afforded through a regime of two vaccines (but, as will be discussed next week, the hepatitis A and B vaccines can be combined into just three total shots). While those who have had hepatitis A in the past would now be immune to the virus, Chiliade says it is more cost effective to vaccinate everyone in the community rather than screen for hepatitis A with a blood test and then vaccinate selectively.
Also, vaccination against or immunity to hepatitis A won't do anything to protect your from any of the other strains of the disease.
So consider it your civic duty and get to your doctor or the clinic for your shots. Next column, we'll take a closer look at treatment and prevention of hepatitis B and C.