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Hepatitis A, B, C, D and E summary

Hepatitis A

Ways hepatitis A is spread Course & outcome of infection Vaccine or PEP

Faecal-oral

faeces containing the virus are transferred to another person’s mouth.

Most infections in Australia are associated with:

  • contaminated food, drink and eating utensils
  • hands contaminated via contact with nappies, toys or towels soiled with faeces from an infected person
  • oral/anal sexual contact
  • sewage-contaminated water or shellfish
  • travel to countries where hepatitis A is endemic (always present)
  • injecting and non-injecting drug use

Acute infection

Symptoms occur in less than 10% of young children and 40 to 70% of adults who become infected.

Chronic infection

Does not occur in hepatitis A infection

Yes

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Hepatitis B

Ways hepatitis B is spread Course & outcome of infection Vaccine or PEP

Blood-to-blood and sexual contact

Most infections in Australia are associated with:

  • immigration from a high prevalence country (where hepatitis B is more common)
  • sharing injecting equipment
  • unprotected sex
  • mother-to-baby transmission at or around the time of birth
  • child-to-child contact through open sores and wounds
  • tattooing or body piercing
  • household contact – sharing razors and toothbrushes
  • receiving blood or blood products before screening from 1971

 

Acute infection

Symptoms occur in up to 50% of adults in the period 2 to 3 months after infection.

Chronic infection

Develops in:

  • 5 to 10% of people infected as adults
  • 30 to 50% of children infected under 4 years of age
  • 90% of infants infected in the perinatal period
Yes

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Hepatitis C

Ways hepatitis C is spread Course & outcome of infection Vaccine or PEP

Blood-to-blood contact

Most infections in Australia are associated with:

  • immigration from a high prevalence country (a country where hepatitis Cis more common)
  • sharing injecting equipment
  • receiving blood or blood products before screening from 1990
  • tattooing, body piercing or acupuncture
  • being a prisoner.

Acute infection

15 to 25% of people will develop symptoms which are usually mild and may include jaundice.

Chronic infection

50 to 80% of people remain chronically infected.

25% of this group will develop scarring of the liver (cirrhosis) and some will develop liver cancer

No

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Hepatitis D

Ways hepatitis D is spread Course & outcome of infection Vaccine or PEP

Blood-to-blood contact

Most infections in Australia are associated with:

  • immigration from a high prevalence country (a country where hepatitis B and D are more common)
  • sharing injecting equipment

Acute infection

In co-infection, acute hepatitis B and D occur simultaneously. Super infection occurs in people already infected with hepatitis B.

Chronic infection

More likely after super infection

Yes with hepatitis B vaccine

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Hepatitis E

Ways hepatitis E is spread Course & outcome of infection Vaccine or PEP

Faecal-oral

Faeces containing the virus are transferred to another person’s mouth.

Most infections in Australia are associated with travel to countries where hepatitis E is endemic (always present).

Less commonly, infection can be passed from a pregnant woman to her fetus, or through infected blood transfusion.

Acute infection

Symptoms are rare in young children. Disease is usually self-limiting with recovery but can be serious, particularly in pregnant women.

Chronic infection

Does not occur in hepatitis E infection

No

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Definitions

Post exposure prophylaxis (PEP)

Antibiotics, vaccination or immunoglobulin (a solution containing human antibodies that is made from blood products) may be offered to contacts after exposure to some infectious diseases. A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person. This may prevent the development of the infection during the incubation period, make the infection less severe if it does develop, or reduce the risk of the infection being passed on to other people.

Acute infection

the early weeks or months after infection has occurred. Symptoms may include abdominal discomfort, nausea, fever, fatigue, sometimes followed by jaundice (yellow skin and eyes)

Chronic infection

There may be no symptoms but the person remains infected. Chronic infection may lead to cirrhosis, liver failure or liver cancer in some people

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