Hepatitis

Hepatitis

Prevention Is Your
Best Defense

Country-western singer Naomi Judd was near tears. She and her daughter Wynonna had just finished their signature song "Love Can Build a Bridge" at Murphy Center in Murfreesboro, Tennessee, in front of 10,000 screaming fans. But as the two stood on the stage holding hands and waving to the audience during the concert's final moments on that December night in 1991, mother and daughter were clearly reluctant to leave.

Tonight, Naomi Judd, 45, was not just leaving the stage until her next performance. She was leaving it for the last time--forced into retirement by hepatitis C, a virus that attacked her liver, sapped her strength and ended her career.

There are five different forms of the hepatitis virus that have been identified, says Francisco Averhoff, M.D., an epidemiologist with the Centers for Disease Control and Prevention (CDC) in Atlanta, and they attack men and women in about equal numbers.

Hepatitis A, which is transmitted most commonly by food and water, affects an estimated 100,000 to 200,000 people every year in the United States. It's occasionally passed along when infected restaurant employees forget to wash their hands after going to the bathroom. It accounts for 30 percent of all cases of hepatitis in the United States.

Hepatitis B, which can be transmitted through sexual intercourse, affects 200,000 to 300,000 people in the United States every year, says Dr. Averhoff. It is also spread by sharing razors, needles and toothbrushes with carriers and is passed from infected mothers to their newborn infants. It is responsible for half of all reported hepatitis cases in this country every year.

Hepatitis C may also be transmitted through sexual intercourse and shared needles, but the cause is unknown in 40 percent of cases. It affects approximately 150,000 people in the United States and is a particular problem among health-care professionals: A moment's carelessness when disposing of a syringe can cause a needle-stick injury that transmits the virus.

Most--But Not All--Recover

The other two hepatitis viruses, D and E, are rare, says Dr. Averhoff. Hepatitis D is transmitted primarily among drug users already infected by the hepatitis B virus, and hepatitis E occurs mostly in India.

People often recover completely from hepatitis within a few weeks or months, says Dr. Averhoff. The flulike symptoms--malaise, muscle aches, mild fever, abdominal pain and nausea--disappear, although the infection may flare up once in a while until the virus is gone forever. And in some cases, particularly with hepatitis B or C, people who are infected will have such mild symptoms that they won't even realize they've been infected, even though they are still carrying the virus and are able to infect other people.

People with hepatitis B or C may go on to develop chronic disease, says Dr. Averhoff. Approximately 5 percent of those with hepatitis B and 50 percent of those with hepatitis C--like Naomi Judd--will develop a chronic liver disease that can lead to cirrhosis of the liver, a condition in which the liver becomes scarred. It can eventually lead to liver failure and the need for a liver transplant.

"Hepatitis B and C are probably the most serious forms of hepatitis because they can go on to cause chronic disease," says Dr. Averhoff. "Hepatitis B kills 5,000 people a year and hepatitis C about 10,000. With either form, many people don't even know they have it until they're diagnosed with cirrhosis."

Since there are no reliable cures for hepatitis, the best way to handle the virus is to prevent it, experts agree. Here's how.

Wash your hands. Washing your hands, and teaching your children to wash theirs, will go a long way toward preventing hepatitis A, says Dr. Averhoff.

Practice safe sex. "Any woman who is sexually active with multiple partners is at risk for hepatitis B," says Miriam Alter, Ph.D., chief of the epidemiology section at the CDC's hepatitis branch. "So if you're sexually active, practice safe sex." Use condoms every time you have intercourse.

Get a shot. A vaccine is available for hepatitis B. If you are sexually active with more than one partner or are a health-care worker, doctors caution, you should talk to your doctor about getting the vaccine.

Protect your liver. "If you get chronic hepatitis, don't drink and don't take drugs--not even over-the-counter drugs--without consulting a doctor," says Dr. Alter. Both can significantly damage a liver that's already been hurt by hepatitis.