The hepatitis alphabet

Someone just asked me why hepatitis C holds the “C” designation. The name contains the third letter of the alphabet because it’s the third type of hepatitis that was named. Before the 1990s, no one was sure it was a distinct disease, so it was called non-A and non-B hepatitis. Since then researchers have been moving up through the alphabet with diseases that inflame the liver:

  • Hepatitis A: This is transmitted through food or water that is contaminated with feces. It’s common in children and is usually a very mild disease.
  • Hepatitis B: Like hepatitis C, it is transmitted through blood. It can also be spread through sex with an infected partner.[i] Only 5 percent of cases become chronic.
  • Hepatitis C: Hep C is passed along through blood-to-blood contact. About 80% if infected people develop the serious, chronic form of the illness. 25% of those develop cirrhosis. Each year, 1 – 4% of people with cirrhosis get liver cancer.[ii]
  • Hepatitis D: This is a co-infection that occurs with Hepatitis B. It causes severe liver disease.
  • Hepatitis E: A common disease in India, hepatitis E is transmitted through feces-contaminated food and water. It worsens any type of liver disease.
  • Hepatitis F: This very rare virus was found in 1994 in patients in Western Europe and India who had undergone blood transfusions. The virus was injected into rhesus monkeys and caused hepatitis.[iii]
  • Hepatitis G: This is transmitted through blood but doesn’t do much harm to the liver.[iv]

For references, please see the Readings page.


Hepatitis C carried on a cart

A woman who underwent uterine surgery in New Jersey hospital acquired hepatitis C through an anesthesiologist’s medicine cart, the Journal of the American Medical Association reported this month. Unlike the syringes and vials used in surgery, the carts were not sterilized. Right before the woman’s operation, another patient, who had already been diagnosed with hep C, was anesthetized by the same person, using the same cart. Five weeks later the second patient was diagnosed. Both patients were found to have the same genotype.

The anesthesiologist gave propofol, a short-acting hypnotic, to both patients. It may have come into contact with the cart’s contaminated surface, investigators from the New Jersey Department of Health concluded.

The infection, which occurred in 2010,  sparked a Centres for Disease Control and Prevention warning that health-care personnel should be continually trained in  infection control. In the United States and Canada, transmission through medical practices is rare, but in the developing world, it’s still a big problem. The World Heath Organization is working on ways to solve it.

Valentines and Hepatitis Testing

With Valentine’s Day approaching, I’ve been thinking about the man I love and how I’m happy that in our 32-year relationship, he stayed free of HCV. I didn’t know I had it until last spring, and once I did he got tested. So did my daughters. Everyone was free and clear—except me.

Now I’m probably free and clear. I’ll get my final viral count in March, and the virus has been non-detectable since August. But even though my family didn’t contract hepatitis C, I’m wondering about the decade before I met my husband. Did I infect anyone? I wasn’t celibate.heart

In one of the earliest studies of transmission between heterosexual partners, researchers at the Red Cross Blood Bank in Amsterdam, Netherlands, found absolutely no transmission from persons with HCV to their sexual partners. They tested 50 heterosexual couples who had a median relationship duration of 13 years.*

In another study, published in 2004 in The American Journal of Gastroenterology, not one of 776 persons with HCV who remained monogamous for 10 years, transmitted the virus to their heterosexual partner. The couples did not use condoms, which would reduce transmission. They didn’t engage in anal sex or sex during the woman’s period, which might increase transmission. Three of the partners contracted HCV, but the gene sequence of their virus was different from their partner’s. That means they must have contracted their virus from some other source.

Still, some sex is risky, and studies show that sex with multiple partners is riskier. On Valentine’s Day that’s a lot to think about. It would be hard to locate a person you hooked up with for a week, some 35 years ago, and according to the studies, it’s extremely unlikely the virus would have spread. But urging your partner to be tested, no matter what, will get rid of that teeny-tiny doubt. If your partner is a Baby Boomer, he or she should be tested in any event. After my husband got his results, he smiled and life went on as usual.

* The studies referred to on this page are listed in the Readings page.