TABLE 1: Chronic hepatitis B and C high risk groups and factors

Injection drug use Intranasal cocaine use Persons with transfusion before 1990 Hemophilia with transfusion before 1987 Men who have sex with men Infants of infected mothers Chronic hemodialysis History of incarceration Tattoos Acupuncture Vietnam era veterans Needle sticks (risk 3-10%) Household contacts (blood exposure?) Multiple sexual partners

Chronic hepatitis secondary to hepatitis B and hepatitis C viruses are a significant public health issue over 1 million and 4 million infected Americans respectively. Both conditions cause progressive liver disease that can lead to cirrhosis and liver failure and both increase the risk of developing liver cancer. Both viruses share mode of transmission with transmission via parenteral routes (i.e. intravenous drug use, infected needle stick exposure, tattoos, infected blood products received before 1990, etc). For hepatitis B there is also a high risk of sexual transmission and transmission from infected mothers to children during childbirth, a similar risk for hepatitis C exist but it is not a major route of infection. Acute hepatitis with the usual symptoms of fatigue, general malaise, jaundice and abdominal pain can be seen with both viruses but it is more common with hepatitis B. Hepatitis C is in most instances asymptomatic and is detected on routine testing when liver enzymes are noted to be elevated. There are available treatment options for both viruses and therefore the emphasis has been on early detection. Screening of high risk groups (see table 1) is the key for early detection and treatment. If you think you have a risk factor, inform your physician so the proper testing can be order. For more information go to our patient information links.