The 3 Primary Types Of
Hepatitis Infections - Warnings
Due For Carriers
By Lauran Neergaard
AP Medical Writer
(AP) - There are three main types of hepatitis, a group of viruses that inflame the liver:
Hepatitis A is a relatively mild form of the virus. It spreads primarily through food contaminated by poor sanitation, such as raw shellfish culled from tainted water or food handlers who contaminate salad bars. It can cause food poisoning symptoms, although most patients require no medical care; hepatitis A clears out of the body quickly. It is most common in developing countries, and a vaccine is recommended for world travelers.
Hepatitis B is more severe, sometimes fatal. It can cause both acute attacks of jaundice and chronic liver infection. It does not spread through food, but primarily through blood and through sex with infected people. The U.S. blood supply is tested against hepatitis B so cases from transfusions today are rare. People injecting illegal drugs commonly spread hepatitis B by sharing needles; health care workers are at risk from needle sticks, and patients undergoing kidney dialysis may be at risk if equipment isn't properly sterilized. A vaccination recently became available, and it is given routinely to children, but adults who have not been vaccinated remain at risk.
Hepatitis C also is very severe and causes long-term liver infection that damages over time. It afflicts an estimated 3.9 million people, is the leading reason for liver transplants and kills up to 10,000 Americans a year. Most patients today are 30 to 49, and doctors fear deaths could triple in coming years as they reach the age where complications from chronic liver disease typically occur. Because it seldom causes early symptoms, many patients don't know they're infected. Sharing needles to inject drugs is the biggest risk, but thousands of Americans were infected from transfusions before the blood supply was tested adequately in 1992.
There is no vaccine or cure. About 15 percent of patients overcome the virus without treatment. Others can try injections of interferon A, starting when liver tests indicate the virus is active. If standard treatment fails, patients can try a new therapy approved last summer, a combination of the shots and ribavirin pills for six months.

By Lauran Neergaard AP Medical Writer
(AP) -- Thousands of people will soon open their mailboxes to find warnings that they may have caught the dangerous liver virus hepatitis C from blood transfusions before 1992. It's the first step in a long-awaited government attack on the epidemic.
Hepatitis C afflicts an estimated 3.9 million Americans, many of whom don't know they're infected because the virus can lurk silently in their bodies.
But now that doctors finally have treatments to offer -- a handful of drugs -- the government is launching a major campaign to get people tested. First on the list are tens of thousands who received transfusions before purity tests of the blood supply began in 1992.
Those people shouldn't panic, stressed Dr. Louis Katz of the the Mississippi Valley Regional Blood Center, who advised the government on the campaign.
"The message is: Ask your doctor," he said. Many people will just be carriers of the disease, but for those with active hepatitis C, "we now have something to offer."
A few hospitals, including some in Wisconsin and Minnesota, already have begun tracking down at-risk transfusion recipients. But most were awaiting guidelines from the Centers for Disease Control and Prevention, issued Thursday, so doctors would have the best advice for worried patients.
"Whether you feel sick or not, you should have a blood test for hepatitis C," says an information sheet the American Association of Blood Banks developed to mail to at-risk patients.
Once the hospitals have traced everybody they can, the CDC said Thursday it will launch an advertising campaign next year to urge even more people to be tested.
Hepatitis C, which kills up to 10,000 Americans each year, is the most common blood-borne infection in the United States and the leading reason for liver transplants.
Some people overcome the virus without medical help. But 85 percent develop a chronic, simmering infection that they can spread to others. Most of them will suffer at least some liver damage, especially if they also drink alcohol, and 15 percent will develop severe damage.
Sharing intravenous drug needles is the chief source of hepatitis C, causing 60 percent of cases. The CDC recommended testing for:
--Anyone who ever injected drugs -- even once as a teenager 20 years ago.
--Hemophiliacs who used clotting factors before 1987, when they became better purified.
--Recipients of organ transplants or blood transfusions before 1992.
An estimated 300,000 Americans were infected from transfusions before 1992, the year that accurate testing of blood donors began.
Today, the risk from transfusions is very small. But only now are doctors tracking down past transfusion recipients to reveal the risk -- because it was only in the last year that they figured out how best to treat hepatitis C.
"These people need to be told," said Rep. Christopher Shays, R-Conn., who led a House subcommittee investigation that concluded government notification should have started earlier. "The federal response has been sluggish at best and mute at worst."
Responded CDC hepatitis chief Miriam Alter: "It's only recently that we have advice to give individuals that might help them protect their liver from further harm."
Under the massive notification program, every U.S. blood bank must identify possibly tainted blood donated before 1992, and begin sending hospitals those records by March. Then hospitals have a year to go through their own records and track down patients who received the blood.
Many may have died of other causes in the ensuing years, or moved away so doctors can't find them. The CDC expects 62,000 people to respond to the program, 37,000 of whom statistics predict will be infected.
"It's a really huge job," said Laurie Becker, the nurse in charge of notification at the Southeast Wisconsin Blood Center. "It's taken me hours and hours and hours" to identify 319 units of possibly tainted blood sent to 31 hospitals.
Getting a head start, she notified the hospitals a year ago, yet so far they have traced just 45 percent of the blood, a number Becker called disappointing. Eleven people have come in for free hepatitis testing; five were infected and sent to doctors for treatment.