Hepatitis

Hepatitis means "inflammation of the liver", and viral hepatitis is caused by a group of viruses (germs) that mostly affect the human liver.

The sexually transmitted ABC

The ABC of Viral Hepatitis

Hepatitis means ‘inflammation of the liver’, and viral hepatitis is caused by a group of viruses (germs) that mostly affect the human liver
Men who have sex with men are at a higher risk for viral hepatitis
The main types of hepatitis are A, B and C
Each virus is different and can be prevented in different ways

Hepatitis A

What is it?

A virus that lives in the gut of humans and can be excreted in faeces (shit)
Even a tiny amount of faeces can spread infection. This may cause outbreaks of Hep A when an infected chef does not wash their hands after going to the toilet
Men who have sex with men are at risk of Hep A if they engage in rimming (oral to anal contact)

How do I know if I have it?

Symptoms occur a few weeks after exposure
Adults who get infected with Hep A may develop severe symptoms
The classic symptom is jaundice (yellow eyes and skin, sometimes with dark urine and pale faeces)
Fever, nausea and right-sided abdominal pain may occur
A blood test can tell if you have been exposed to Hep A in childhood and if you are at risk of the disease

How do I get treatment?

Hep A usually clears up on its own after a month or two and has no specific treatment – drink lots of fluids, eat a special diet and rest
How do I prevent it?
If you’ve already had Hep A you cannot get it again
Get tested to see if you are at risk of the disease
Get vaccinated – the vaccine is safe and extremely effective in preventing Hep A, even if you are exposed again
If you have not been vaccinated, avoid any activities that might expose you to faeces, such as rimming, or not washing your hands after touching your partner’s anus

Hepatisis B

What is it?

Hep B is a sexually transmitted infection (STI), caused by a virus that lives in blood and possibly other fluids such as semen, urine and saliva, that can be transmitted during unsafe sex
Can also be spread through sharing injection drug equipment or even through sharing straws or banknotes when snorting recreational drugs
The virus can cause an acute infection lasting a short period, or may cause a lifelong infection leading to liver complications such as cirrhosis (liver scarring) or cancer
The virus is quite hardy and can survive for long periods outside the body in blood and other body fluids

How will I know if I have it?

Symptoms occur between 1 and 6 months after exposure
Sometimes the infection causes no symptoms at all – you would only know if you have had it by doing a blood test
In other cases jaundice (yellow eyes and skin, sometimes with dark urine and pale faeces) may occur
Fever, nausea and right sided abdominal pain may also occur
About 10% of people who get Hep B become chronic (long-term) carriers of the virus
Chronic infection may lead to cirrhosis which requires ongoing medical treatment|

How do I get treatment?

Get screened for Hep B at your clinic
Hep B is potentially curable although achieving a full cure is not easy
Treatment may consist of injections of interferon or of tablets (the same tablets used to treat another common virus – HIV)
Hep B requires long-term management and monitoring to prevent later complications such as cirrhosis and cancer from occurring

If you have hepatitis B you can transmit the illness to your sexual partners if there is any transfer of even tiny amounts of blood, semen, saliva or urine.
Always use a condom if you are Hep B positive and ensure that your regular sex partner is vaccinated!

How do I prevent it?

Get tested to see if you have already been exposed to this virus
Get vaccinated – the Hep B vaccine is safe and extremely effective in preventing infection
If you are unsure if you have been vaccinated, your doctor can do a blood test to see if you need a booster
Using condoms for anal sex may prevent transmission of Hep B but this is not 100% effective – your best option is to get vaccinated!

Hepatitis C

What is it?

A virus that lives in the blood and causes liver damage, spread mainly through sharing drug-taking equipment such as syringes and needles, and non-injection drug equipment such as straws and banknotes used to snort drugs
Hep C is spread during sex among men having sex with men – it can be transmitted via unprotected anal sex, sharing of sex toys or engaging in other extreme sex acts such as fisting
Hep C is still relatively uncommon in South Africa but infection rates may be increasing
Hep C may cause a chronic (long-term) infection which is not curable
There is no effective vaccine against Hep C

How do I know I have it?

Often this infection causes no symptoms and goes unnoticed – you will only know if you have been exposed if you have a blood test
If symptoms occur they are very similar to hep B (see above)
Have a blood test if you are unsure of being exposed