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Viral Hepatitis Fact Sheet
Fact sheet on viral hepatitis.
Background
The word "hepatitis" means inflammation of the liver. This can be caused by a number of things,
such as chemicals, alcohol, drugs and infection by viruses. The viral hepatitides are a group
comprising of several different viral hepatitis infections, which may have similar clinical
presentations but which differ in their epidemiology, etiology, immunology, and pathology. The
symptoms of acute viral hepatitis include fever, headache, lethargy, nausea, dark urine, pale stools
and jaundice. The most commonly encountered viral hepatitidies are type A, type B and type C.
Hepatitis A
Commonly referred to as infectious hepatitis, hepatitis A is caused by an enterovirus. Infection,
particularly in children, may be asymptomatic, or symptoms may be mild, thus the incidence of
hepatitis A is difficult to determine.
Hepatitis A symptoms, when present, may include abdominal discomfort, loss of appetite, nausea,
low-grade fever and tiredness, sometimes followed by jaundice, dark urine and pale faeces. The
infectious period is from two weeks before jaundice occurs, then during the first week of jaundice.
There is no specific treatment for hepatitis A. Most patients are told to rest for one to four weeks
after diagnosis is made, and to avoid intimate contact with other people.
Transmission
Transmission of infection is by the faecal-oral route, usually by ingesting water or food that has been
contaminated with faecal matter containing the virus. Recent significant outbreaks in Australia have
been associated with contaminated foods such as oysters.
Prevention
Control of the spread of the infection includes:
Good hygiene, including adequate hand washing and cleaning procedures,
Excluding employees from work or children from care centres, for seven days after the onset of
jaundice or illness, and
Vaccination of groups at risk.
Details of Hepatitis A vaccine and vaccination recommendations are available in the Immunisation
Handbook 8th edition, 2003.
Surveillance and reporting
Hepatitis A is a notifiable disease. Notifications are reported to State and Territory health
departments, and then collated nationally in the National Notifiable Diseases Surveillance System
(NNDSS). NNDSS data are published in Communicable Diseases Intelligence (CDI) and can be
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Hepatitis B
Hepatitis B virus (HBV) belongs to the hepadnavirus family. Most people infected with the virus do
not develop clinically recognised illness. It is estimated that less than 10 per cent of children and
30-50 per cent of adults who experience an acute hepatitis B infection will have jaundice. Of those
that develop clinical disease, the severity varies considerably, some cases detectable only by liver
function tests and others developing into liver failure. Some individuals, who are carriers of the virus
for many years, have a very high risk of developing chronic hepatitis and hepatocellular carcinoma
later in life. HBV may cause as many as 80 per cent of all cases of hepatocellular carcinoma
worldwide.
Transmission
Transmission occurs by exposure to infective body fluids. After inoculation with the virus, there is an
incubation period usually between 45 and 180 days. In infected individuals, hepatitis surface antigen
(HBsAg) has been found in most body secretions. Transmission usually occurs from inoculation or
mucosal contact with blood or sexual secretions from a person with active infection (HBsAg positive).
Known modes of infection include blood transfusion, sharing of needles and syringes, sexual contact
and mother to baby during birth. Unlike HIV, HBV is stable in the environment (eg. on surfaces) for
several days, posing the risk of indirect inoculation.
About 2-4 per cent of those infected as adults and most infants, who are infected, will remain so for
many years, becoming virus carriers and a potential source of infection to others. All people who are
HBsAg positive are potentially infectious. Chronically infected patients who are HBcAg positive may
also be infectious.
Prevention
Control of the spread of infection includes:
Avoiding sharing of injecting equipment such as needles and syringes;
Precautions when handling blood-contaminated items;
Good hand washing, cleaning and disinfecting practices;
Covering open sores, cuts and abrasions;
Prevention of aggressive behaviour such as biting and scratching; and.
Vaccation of groups at risk.
There is currently no cure for hepatitis B. A safe and effective vaccine is available (see page NHMRC
Immunisation Handbook, 8th Edition) and vaccination has recently been added to the NHMRC
Standard Vaccination Schedule.
Surveillance and reporting
Hepatitis B is a notifiable disease. Notifications are reported to State and Territory health
departments, and then collated nationally in the National Notifiable Diseases Surveillance System
(NNDSS). NNDSS data are published in Communicable Diseases Intelligence (CDI) and can be
accessed on the department's website. Carrier rates are likely to be about 0.1 to 0.2 per cent
amongst Caucasians in Australia. Higher carriage rates often occur in Mediterranean and Asian
population groups, and can be as high as 10 per cent in some Aboriginal communities.
Resources
Australian Immunisation Handbook 8th edition.
Recommendations on Hepatitis B Immunisation, NHMRC 1996.
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Hepatitis C
Hepatitis C (HCV) is caused by an enveloped RNA virus which belongs to the family Flaviviridae.
While the virus is frequently asymptomatic, infection may results in chronic carriage of the virus in
at least 50 per cent of cases. About 20 per cent of these patients develop cirrhosis of the liver within
approximately 20 years and 5-10 per cent of these will develop liver cancer within 5-10 years.
Symptoms of hepatitis C may include abdominal discomfort, loss of appetite, nausea, fever,
tiredness, joint pain, dark urine, and jaundice.
Transmission
Hepatitis C is essentially a bloodborne disease, and the current data suggest that it is spread mainly
through the sharing of needles and syringes by injecting drug users. It accounted for up to 90 per
cent of all transfusion-related cases of non-A, non-B hepatitis before the screening of blood
donations. Mother-to-child transmission may also occur. In Australia, injecting drug use is currently
the most frequent route of transmission. The incubation period ranges from two to six months,
commonly 6-9 weeks. Hepatitis C is infectious from one or more weeks before the onset of
symptoms to indefinitely in most infected persons.
Prevention
Control of the spread of the infection includes:
Avoiding sharing of injecting equipment such as needles and syringes;
Precautions when handling blood-contaminated items;
Good hand washing, cleaning and disinfecting practices;
Covering open sores, cuts and abrasions;
Prevention of aggressive behaviour such as biting and scratching
Recent evidence indicates over 50 per cent of people who are infected and who undergo treatment
will be cured with available therapies. People who successfully complete treatment no longer
experience hepatitis C related symptoms or progression of severe liver disease.
There is currently no vaccine for hepatitis C.
Surveillance and reporting
Hepatitis C is a notifiable disease. Notifications are reported to State and Territory health
departments, and then collated nationally in the National Notifiable Diseases Surveillance System
(NNDSS). NNDSS data are published in Communicable Diseases Intelligence (CDI) and can be
accessed on the department's website.
For further information about the Hepatitis C Virus (HCV) please refer to the National Hepatitis C
Resource Manual. It covers essential information on the hepatitis C virus, other hepatides, reducing
transmission, testing, health maintenance, care and support, treatments, preventing discrimination,
education and training, and a summary of jurisdictional responses to hepatitis C.
Page last modified: 15 April, 2005
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