Chat:The A, B, Cs & D, E, Gs of Hepatitis

liver411

Town Hall Hosted Chat - August 7th, 2001





Hosted by Steve Bonning PA-C, Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD. (Platinum Room)



MODERATOR:  Welcome thomas52. We will start the chat at 8 PM Eastern time.

MODERATOR:  The topic tonight is the discussion of the 6 different types of hepatitis: A, B, C, D, E, and G. You are welcome to submit your general questions about these types of hepatitis.

MODERATOR:  Welcome flowergirl. Welcome calfinda. The chat will start in about 15 minutes. MODERATOR:  Welcome moonlioness.

MODERATOR:  The topic is "The A, B, C’s & D, E, G’s of Hepatitis".

MODERATOR:  Welcome to you also VBosworth.

MODERATOR:  You are welcome to send your general questions about the 6 types of hepatitis that we will be discussing tonight. Just type in the text box at the bottom of your screen and click on Send to Moderator.

MODERATOR:  For those who are new to our moderated chats, I will explain how the works before we begin.

MODERATOR:  Hello OLD TIFF, welcome. Welcome jselkirk.

MODERATOR:  Welcome everyone to another chat in the hepatitis Neighborhood. Before we begin I will explain how our moderated chats work.



MODERATOR:  Questions first go to screeners for review of topic and possible slight editing. They are then sent to the Moderator. I hold questions in queue for posting one at a time for the host speaker to answer. If you do not see your question posted, it may be because it was not on the chat topic, had already been asked and answered, was a duplicate, or there was not enough time to post all questions submitted. We will answer as many questions as possible during our hour together. The Moderator will decide which questions are selected to go to the speaker and the order in which they are sent to the speaker to be answered. Usually questions that are on TOPIC are first, and not always in the order in which they were submitted by members. Please do NOT ask the guest speaker to DIAGNOSE or PRESCRIBE for you, or interpret your specific lab results. Please try and limit your questions to ones that do NOT require the speaker to have detailed knowledge of your medical history. Please do not type in your detailed medical history in the question, be as brief as possible. Please make your questions readable, clear and concise. If your question does not get answered, feel free to post it on the ASK-the-NURSE Message Board. Also, be sure to check the Library Articles and the TRANSCRIPT ARCHIVES for the text of past chats, which may hold answers to your questions.



MODERATOR:  Now that you know how the chat works, we're ready to begin.

MODERATOR:  It is with pleasure that I welcome our special guest host tonight, Steve Bonning, PA-C. Steve is a certified Physician assistant with great knowledge and experience in hepatitis and it's treatment.

MODERATOR:  You are welcome to send general questions about the 6 types of hepatitis, A, B, C, D, E, and G for Steve to answer.

MODERATOR:  He has logged on to the chat and we will begin momentarily.



MODERATOR:  Our first question tonight is from thomas52.



thomas52:  Can a person have cirrhosis before contracting Hepatitis C?



Steve Bonning PA-C:  Certainly viral hepatitis is not the only way to get cirrhosis.  Alcohol abuse is the best example of getting cirrhosis without viral hepatitis. There's also autoimmune hepatitis and biliary disease among other diseases causing cirrhosis.



MODERATOR:  Welcome to everyone just joining us. Steve has just answered the first question.



peterc:  Why was "F" left out when the types (names) were given?



Steve Bonning PA-C:  Good question!  I don't know for sure, but I think that, after hepatitis "E" was confirmed, another virus was discovered and thought to be a hepatitis virus, and tentatively named "F", but later found out not to be a true hepatitis virus. Since "F" had already been used, when the next true hepatitis virus was confirmed, it was named "G."



VBosworth:  When you have HCV can you ever get rid of it or does it just go into remission, and if you do relapse how do you know?



Steve Bonning PA-C:  We now can use the word 'cure' with hepatitis C; if you go on treatment and reach no detectable levels of virus,  and 6 months after finishing therapy there is still no detectable virus, then you have a 98-99% chance of never seeing the virus return. Most people who relapse do so in the first 3 months after finishing therapy.  We find either detectable levels of virus or rising liver enzymes. That's why I would check for virus at 3 months and at 6 months after therapy, then 1 year later.



liv4ever26003:  Do you know exactly when the Hepatitis C virus was actually discovered?



Steve Bonning PA-C:  No, but it's been around a long time.  Some researchers have gone back to saved blood from World War II and Korean War veterans and found HCV. So it's not new, just our ability to recognize it is.



MODERATOR:  Welcome to all just joining us. You can only see the last few lines of text. The topic is "The A, B, C’s & D, E, G’s of Hepatitis." There will be a full transcript posted in Town hall in 3-5 working days.



sissyaj:  Are Hep A, B, and C all viral and how are they contracted?



Steve Bonning PA-C:  Yes, Hepatitis A, B, C, D, E and G are all viruses.  Hep A and E are contracted through oral-fecal spread; Hepatitis C, D, and B are primarily spread through blood, such as IV drug use, needle sticks, etc., however Hep B has a strong sexual transmission rate.  Hep E is not often seen in the U.S. and is primarily spread through fecally contaminated water.  Not a lot is known about Hep G, but preliminary studies show that it may be much like Hep C.  Hepatitis D can only exist in the presence of Hepatitis B. That is, you can't have Hep D without having Hep B.



helenm:  Can Hep C manifest with jaundice and swollen liver?



Steve Bonning PA-C:  It can, but that's seen in acute Hepatitis C as opposed to chronic hep C.  Only about 25% of patients will have any symptoms at all, and those symptoms are usually vague, flu-like symptoms.  Jaundice and swollen liver is not often seen in Hepatitis C.  It's more often very silent until extensive liver damage is done.



MODERATOR:  Welcome to all just joining us. You can only see the last few lines of text. The topic is "The A, B, C’s & D, E, G’s of Hepatitis." There will be a full transcript posted in Town hall in 3-5 working days. Don't forget to check out your welcome page.



moonlioness:  How soon after getting HCV does it show up in a test?



Steve Bonning PA-C:  Just to clarify a point about hepatitis...there's acute and chronic hepatitis... about 85% of people who get acute hepatitis C will go on to develop chronic hepatitis C...by definition, if the virus is present 6 months after the acute episode, then chronic disease is present.  In practical terms, you would test positive for hepatitis C antibody (HCV AB) in about 12 weeks after exposure;  if the HCV RNA by PCR test is done, virus can be detectable within a week or two of developing the disease.



Steve Bonning PA-C:  Sorry, you would test positive for the HCV antibody (HCV AB) in about 12 weeks after exposure and the PCR test could detect presence of virus in just a week or so. But remember, most people have no obvious symptoms of acute hepatitis C infection so there's no good way to know that you’ve had acute Hep C.  The decision to test patients has to be based on the presence of RISK FACTORS. ..blood transfusions before 1992,  any IV or nasal drug use,  sexually-transmitted diseases or multiple sex partners, multiple tattoos or body piercings, hemodialysis, or unexplained elevations in your liver enzyme tests (ALT, AST).  As well, having a close household contact with Hep C is a risk factor.



MODERATOR:  Welcome to all just joining us. Yo