Preventing sharps injuries

Hepatitis B is an infectious illness caused by the Hepatitis B virus (HBV) which infects the liver of humans and causes an inflammation called hepatitis. Hepatitis B is one of the most common infectious diseases in the world and is passed from one person to the other through body fluids.

Hepatitis B infections are either acute or chronic. Acute infections can last between a few weeks and a few months and it is possible to recover from acute hepatitis B on your own. The infected person can remain healthy without any symptoms while the virus clears from the body, with some people not even knowing they have been infected. However, until the virus is completely gone from the body, it is able to be passed on to others.

Chronic hepatitis B is much more serious. This strain of the disease will be with a person throughout their life and there is a chance they will go on to develop permanent scarring of the liver - called cirrhosis - and may eventually develop liver cancer.

Common symptoms

• Flu-like symptoms - tiredness, aches and pains, headaches and fever
• Loss of appetite
• Weight loss
• Nausea or vomiting
• Diarrhoea
• Jaundice

Treatment
For chronic hepatitis B infection there are 2 different types of treatment interferon and anti-viral drugs. Interferon is a protein that is naturally produced by your body in response to a viral infection. It works by preventing the virus multiplying inside your cells. Injections of Interferon will prevent further damage to your liver. There can be side effects to taking this treatment, including flu like symptoms, especially in the early stages. These side effects can be severe, so they are not suitable for long-term treatment. Antiviral drugs can also help to stop the virus from multiplying in your body.

Hepatitis C is a dangerous infection of the liver caused by the hepatitis C virus. It can cause inflammation and fibrosis of the liver tissue. Those with significant liver damager (cirrhosis) will go on to develop liver failure or worse complications, including liver cancer or life-threatening oesophageal varices and gastric varices.

Many people do not realise they have been infected with the virus until the liver is significantly damaged as there are no symptoms. Flu-like symptoms can occur but could easily be mistaken for another illness. An estimated 180 million people worldwide are infected with hepatitis C with an estimated 215,000 people infected in England and Wales.

You can become infected with hepatitis C if you come into contact with the blood or, less commonly, body fluids of an infected person. The hepatitis C virus mutates very easily, which makes it hard to create a vaccine and the virus has different genetic variants.

Symptoms
In most cases, the initial infection doesn't cause any symptoms. When it does, they tend to be vague and non-specific. Possible symptoms of Hepatitis C infection include:

• Fatigue
• Weight loss
• Loss of appetite
• Joint pains
• Nausea
• Flu-like symptoms
• Anxiety
• Difficulty concentrating
• Alcohol intolerance and pain in the liver area

The most common symptom experienced is fatigue, which may be mild but is sometimes extreme. Unlike Hepatitis A and B, Hepatitis C doesn't usually cause people to develop jaundice. About 20-30% of people clear the virus from their bodies but for about 75% of infected people it lasts for more than 6 months, known as chronic hepatitis C. In these cases, the immune system has been unable to clear the virus and will remain in the body long term unless medical treatment is given. Most of these people have a mild form of the disease with intermittent symptoms of fatigue or no symptoms at all. Around 1 in 5 people with chronic Hepatitis C develops cirrhosis of the liver within 20 years.

Treatment
People with chronic Hepatitis C infection should be seen by a hospital liver specialist who may recommend antiviral drug treatments either as single drug therapy or as combination therapy. Blood tests are required to identify which strain of Hepatitis C infection is present and how well the liver is functioning, and a liver biopsy to establish whether cirrhosis is occurring.

Treatment is usually a combination of two drugs; Interferon to prevent the virus multiplying inside your cells and Ribavirin stops the Hepatitis C virus from spreading inside the body. These drugs offer the best chance to clear the virus from the body and are often used together as dual or combination therapy which has been shown to be effective in 55% of cases. However, there are side effects to these drugs that some people find difficult to tolerate.

Human Immunodeficiency Virus is a lentivirus that causes AIDS, a condition in humans where a weakened immune system allows life-threatening infections and cancers to swarm the body. Through the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk, HIV is able to be passed along to another person. Within these bodily fluids, HIV will be present as both free virus particles and a virus within infected immune cells. The 1st stage of HIV is known as primary HIV infection. Many people develop symptoms but might not recognise them. The symptoms of HIV usually occur 2 to 6 weeks after infected with HIV.

Symptoms of primary HIV infection:

• A blotchy rash
• Fever
• Joint pain
• Muscle pain
• Sore throat
• Swollen glands
• Tiredness

These symptoms are often very mild, so it is easily mistaken for a cold or glandular fever, however, it is unusual to get these symptoms in conjunction with a rash. After the primary symptoms have dissipated, HIV will often not cause any further symptoms for many years. This is known as asymptomatic HIV infection. However, during this time, the virus will still be reproducing and is continuing to damage your immune system.

Treatment
If you are diagnosed with HIV, you will be referred to an HIV clinic and be offered counselling. You will need to undergo regular blood tests as part of your treatment to measure your CD4 count (this is the number of CD4 cells in your blood) and your viral load (this is the amount of HIV in your blood).

There is no cure or vaccine for HIV. However, combination therapy slows the progression of the virus and can prolong life. A combination of medicines is needed because of the adaptive nature of the virus, as it can become resistant to the medication.