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Hepatitis

Hepatitis is inflammation of the liver and can be caused by a viral infection. The three most common viral forms are Hepatitis A, Hepatitis B and Hepatitis C and it is possible to pass on the Hepatitis A, B and C virus during sex.

What is Hepatitis A

Hepatitis A is caused by the Hepatitis A virus and is found in the faeces of someone with Hepatitis A infection. The virus is most commonly spread through contaminated water or food, usually through poor hand washing. It can also be spread through some sexual practices, such as oral-anal sex (rimming), digital-anal sex and sharing sex toys.

How can Hepatitis A affect me?

Hepatitis A can be unpleasant, but it's not usually serious and most people make a full recovery within a couple of months. Symptoms usually develop around four weeks after becoming infected, although not everyone will experience them.

Symptoms can include fever, feeling tired and generally unwell, joint and muscle pains, loss of appetite, stomach pain, jaundice, itchy skin, dark urine and pale faeces.

Some people may not have any symptoms and may not recognise they have become infected.

With Hepatitis A there are usually no long term problems, however it can occasionally last for many months and, in rare cases, it can be life-threatening if it causes the liver to stop working properly (liver failure).

Should I be tested for Hepatitis A?

You would only be tested for Hepatitis A if you were unwell with symptoms of Hepatitis. It is not possible to have chronic infection with Hepatitis A so there is no need for a test if you are well.

What is Hepatitis B

Hepatitis B is an infection of the liver caused by the Hepatitis B virus which is found in the blood and body fluids of someone with Hepatitis B infection. Hepatitis B infection is more common in certain countries.

Hepatitis B is 100 times more infectious than HIV. It can be spread by:

How can Hepatitis B affect me?

Many people have mild or no symptoms and don’t recognise that they have become infected. Symptoms can include fever, feeling tired and generally unwell, joint and muscle pains, loss of appetite, stomach pain, jaundice, itchy skin, dark urine and pale faeces. In rare cases, it can be life-threatening if it causes the liver to stop working properly (liver failure).

The vast majority of people infected with Hepatitis B in adulthood are able to fight off the virus and fully recover within one to three months. Most will then be immune to the infection for life.

People who also have Hepatitis C or HIV are at greater risk of chronic infection and becoming carriers.

Those with chronic infection may have no symptoms for years but the liver is slowly being damaged. Although treatment can help, there's a risk that people with chronic Hepatitis B could eventually develop serious problems such as scarring of the liver (cirrhosis) or liver cancer.

If you have chronic infection you can pass the virus on to others.

Should I be tested for Hepatitis B?

Because it is possible to have chronic infection with Hepatitis B without having any symptoms testing is recommended if you have ever been at risk. Testing is done by a blood test.

Groups considered to be at risk are:

What is Hepatitis C?

Hepatitis C is caused by the Hepatitis C virus and is found in the blood of someone with Hepatitis C infection. It is spread by blood to blood contact. The Hepatitis C virus is highly infectious; this means you can get the virus even if you have been in contact with a very small amount of it. It can be passed on through open cuts, wounds or scratches but cannot be passed on through unbroken skin. In the UK the virus is often passed on by the sharing of drug injecting. Hepatitis C is rarely passed on during sex between a man and a woman. Although the infection has spread sexually among gay men the increased incidence of Hepatitis C in men who have sex with men is thought to be confined men who experience sex associated with trauma or injury, men using recreation drugs (including taking recreational drugs during sex, known as ‘ChemSex’, men who are HIV positive or have a history of an infection called lymphogranuloma venereum). There are an estimated 39,000 people currently living in Scotland with a chronic (long term) Hepatitis C infection and more than half of these people are undiagnosed.

How can Hepatitis C affect me?

Many people have no symptoms at all and may never know they have the virus. About one in five people infected with Hepatitis C will clear the virus, in its acute form, within two to six months. Around four in five people who are infected with Hepatitis C will develop a chronic infection.

Chronic Hepatitis C can be very different for each individual; many find some of their symptoms come and go and some may find they have the symptoms of tiredness, weight loss, loss of appetite or feeling sick, discomfort in the liver area, inability to tolerate alcohol, joint and muscle ache, itchy skin, jaundice and flu like symptoms including fever chills and night sweats.

Should I be tested for Hepatitis C?

Because it is possible to have chronic infection with Hepatitis C without having any symptoms testing is recommended men who are HIV positive and in HIV negative men where there is an additional risk factor (e.g. multiple or anonymous partners, sex associated with trauma or, injury, history of recreational drug use or rectal lymphogranuloma venereum infection).

Hepatitis C testing is also recommended for

Hepatitis C is a curable condition and some people merit regular testing.

How can I protect myself against Hepatitis A, B and C?

As Hepatitis A, B and C are can be passed on during sex using a condom for oral, vaginal and anal sex and a dam when licking/sucking the genitals or anus will reduce your chances of becoming infected. It will also reduce your chances of other sexually transmitted infections. Condoms and dams are available free of charge from all sexual health services and many other places – just ask your local sexual health clinic. Sexual Health D&G offer a » condoms by post service.

If you are a man having sex with other men and having rough or extreme sex and / or using drugs, see our advice about reducing your risk.

Vaccination

The good news is that there are vaccines that can give most people at risk protection against the Hepatitis A and Hepatitis B viruses. There is no vaccine for Hepatitis C but testing is crucial to identify those who are chronically infected. Up to one in five of those chronically infected may develop serious liver disease and a small proportion of these go on to develop liver cancer. Hepatitis C treatment is becoming increasingly effective with nine out of ten patients being cured of their infection.

Is the vaccine safe?

Hepatitis A and B vaccines have been available for many years and have a very good safety record. Like many other vaccinations there can be mild soreness and redness around the site of the injection. Much less common are flu-like symptoms. Serious side effects including allergic reactions are very unusual. At Sexual health Services depending on your individual circumstances you may be offered a combined vaccination for Hepatitis A & B or a vaccine only for Hepatitis B.