Hepatitis is inflammation of the liver. There are many causes of hepatitis (including certain chemicals and alcohol abuse), but infection with a virus is the main cause. The common types of viral hepatitis are hepatitis A, B and C (discovered in the late 1980s). There are other types of viral hepatitis (D and E), but little is known about them, yet.

  • Symptoms

    • flu-like symptoms, including loss of appetite and fatigue
    • dark orange urine
    • pale-coloured stools (shit)
    • dark yellow colour to the skin and eyes (jaundice)
    • pain in the right upper side of the abdomen (where the liver is located)

    Some people show only mild symptoms or none at all, so you may not realize you are infected.

    With hepatitis A, symptoms may begin from two to six weeks after exposure; with hepatitis B, from two to six months; and with other kinds of hepatitis, from two weeks to six months.

  • How you get it

    Hepatitis A can be transmitted by different kinds of sexual contact (especially oral-anal) and by contaminated water or food. This is because it is found in a person’s stool, and is passed on to others via the hands if the person does not wash carefully after bowel movements. Once symptoms have cleared up, you are no longer infectious for hepatitis A, and you will become immune. Re-infection with hepatitis A is very rare.

    Hepatitis B is found generally in the blood, semen, and in smaller amounts, in saliva. Like the AIDS virus, you can get hepatitis B if someone else’s infected blood or semen gets into your blood-stream. For this reason, unsafe anal sex and needle-sharing are very risky. You can also contract hepatitis B during oral sex, if you get semen in your mouth. Transmission by saliva is very rare, and can only happen if an infected person bites you and saliva gets into your bloodstream. Blood tests will tell when you are no longer infectious.

    Hepatitis C is found in the blood, and is transmitted by sharing needles. Before 1990 when a test for hepatitis C became available, it was also passed on by blood transfusions. Sexual transmission may occur, but has not yet been documented.

  • Complications

    There usually are no serious complications with hepatitis A. Once you are infected, your body produces antibodies which protect you against re-infection (i.e. you become immune).

    With hepatitis B, most people recover within six months, and become immune to it. However, about 10 per cent of people develop chronic hepatitis, and become carriers (i.e. they continue to be infectious). Some carriers become immune, while others may get recurrent bouts of hepatitis B or develop liver damage that can eventually lead to cirrhosis, cancer and death. With hepatitis C, it is not yet clear what percentage of patients recover from their infection and what percentage remain carriers.

  • Testing

    Your doctor can diagnose hepatitis A, B and C by testing your blood. Blood tests are also used to assess the degree of damage to the liver (called liver function tests). You should take these tests routinely, until your liver is functioning normally.

  • Treatment

    There is no treatment for hepatitis. Your body’s own defense mechanisms can eliminate the infection, in most cases. You should avoid alcohol and certain drugs that can cause liver damage until you have recovered. Also avoid fatty and hard-to-digest foods, and get lots of rest. You must continue to have medical check-ups until you have recovered completely.

  • Prevention

    There are now vaccines available to prevent both hepatitis A and B. They are given in two and three injections respectively, over a six-month period. The hepatitis B vaccine is free in Ontario. The hepatitis A vaccine must be purchased. Both are highly recommended for people who have numerous sexual partners or who share needles. People from countries where hepatitis is very common may already be immune.

    Practicing safer sex may also prevent you from getting hepatitis B and C. With hepatitis A, you must take more careful precautions. If you are infected, you should wash your hands after bowel movements and before handling food. The virus can be passed by oral-anal sex, or on fingers or soiled condoms, so care must be taken here.

    With hepatitis A and B, partners in the past two weeks should get injections of immune globulin or hepatitis B immune globulin (HBIG) respectively, which give short-term immunity. Partners of hepatitis B carriers should be vaccinated with the hepatitis B vaccine as well.

  • How you can prevent getting or passing on STIs (including HIV)

    Using condoms during anal and vaginal sex will stop most types of STI. Use latex condoms and water-soluble lube, and squeeze out air from the tip of the condom. There are also non-latex alternatives available, but if you use lambskin, cover it with a latex condom. Pulling out before you “ome might guard against infection if the condom breaks during intercourse.

    If the condom breaks, urinating immediately after sex and washing your penis with soap and water may help prevent urethral infections, although this method is not very reliable.

    During oral sex, don’t get semen, blood or vaginal fluid in your mouth, since there is a risk (low) of picking up HIV and hepatitis B this way. Using a condom prevents spreading HIV and other STIs from oral sex.

    It is also advisable not to perform oral sex within two hours of flossing or brushing your teeth, since these activities could cause cuts in the gums, providing entry points for HIV.

    Similarly, you should be careful after recent dental surgery, or if you have problems with bleeding gums or other sores in your mouth. If you’re worried because someone has performed oral sex on you, washing and urinating may help, as noted above.

    Performing oral sex may also expose you to hepatitis A and parasites. The virus can be present anywhere in the anal area or on fingers which have touched the anus of an infected person.

    Rimming is risky for the person doing the rimming, since it may expose them to parasites and hepatitis A. You and your partners should wash the anal area thoroughly, before engaging in any oral contact near the anus. Douching is not a good idea, since it can damage the anal canal and drive infections further in.

    Sex toys can pass on parasites, hepatitis A, HIV and a number of other STIs. Cover sex toys with condoms, or wash them carefully with bleach and rinse well before and after using. Keep in mind that the lining of the anus is easily damaged by fists, dildos and other sex toys, so precautions should be taken.

    Routine testing is very important for people who have casual sex. You can pick up a number of STIs without having symptoms, so testing may be your only way of knowing whether or not you’re infected. If you have casual sex, get a syphilis blood test at least once a year, depending on how many different partners you have had, and whether or not you had unprotected sex. You may also need urethral, anal and throat swabs for gonorrhea and chlamydia, depending on what sexual activities you engage in.

    Get an HIV blood test, to find out if you’ve been infected with HIV. Don’t assume you’re negative because you feel well, or because you haven’t had unsafe sex for a long time. Also, don’t assume that your sexual partners are HIV negative. Keep in mind that there is now a lot you can do to stay well, if you test positive. Don’t wait until it’s too late.

    Consider getting vaccinated for hepatitis A and B, if you are at risk (i.e. multiple sexual partners, or sharing needles).

    Inform your sexual partner(s) if you have an STI. Speak to a nurse or counsellor first to decide whom you need to inform.