1. Hepatitis – What is it?

Hepatitis simply means inflammation of the liver.

Hepatitis can be caused through a number of viruses, excessive use of drugs and/ or alcohol, or through an auto-immune response (where the body literally attacks itself).

The following pages will focus on three viral types of hepatitis: hepatitis A, hepatitis B and hepatitis C.

2. Hepatitis A

Hepatitis A (hep A) can be a severe illness from which you can take up to 3 months to recover. Symptoms may include: fevers, sweats, fatigue, loss of appetite, vomiting, diarrhoea, dark urine and pale faeces (shit), yellowing of the skin and eyes (jaundice).

How is hep A transmitted? Hep A is present in faeces (shit) and bowel secretions. It is transmitted by:

contact with surfaces, utensils, food and water, contaminated by shit then not washing your hands
rimming (oral-anal sex)
anal penetration with the fingers or penis and then contact with the mouth
Seafood found in waterways contaminated by sewerage can also be a source of infection.
How can I prevent hep A infection? You can get a vaccine for hep A which should protect you from the virus for up to 10 years. A course of two injections over twelve months is usually required for complete protection against hep A. There is a charge for hep A vaccinations - check with your GP for details. If you're sexually active, or if you already have chronic hepatitis B or C infection, then it's a really good idea to get vaccinated. Some other useful tips to help prevent you getting hep A include washing your hands thoroughly with soap and water:

after using the toilet
after having sex
before and after injecting
after touching shit or anything associated with it (eg. a used condom)
before preparing food or drink

3. Hepatitis B

Hepatitis B (hep B) may develop into a chronic (long term) disease. Acute (short term) hep B may show no symptoms, or it can cause severe symptoms including: fatigue, fever, vomiting, weakness, jaundice. Hospitalisation may be necessary in some cases. Most people recover and will resolve the infection, however up to 10% go on to develop a chronic infection.

Chronic (long term) hep B is a much more serious type of illness. You may not know you have been infected for a long time, however serious conditions such as cirrhosis (scarring of liver tissue) or liver cancer have been known to occur in about 20% of people with chronic hep B. People who are infected with the chronic form of the virus have the disease for life and may pass it on at anytime.

How is hep B transmitted? Hep B is found in just about all body fluids, but it is most commonly transmitted through infected blood, cum and vaginal fluids. This means hep B can be transmitted through:

unsafe fucking (not using condoms for anal/ vaginal sex)
sharing injecting equipment, toothbrushes, razor blades or sex toys
oral sex including rimming
skin piercing
piss and shit
How can I prevent hep B infection? You can get hep B vaccinations which will provide protection from the virus for up to 5 years. A course of three injections over six months is required for complete protection against hep B. Other things you can do to keep yourself safe:

If you inject drugs, make sure you use new, sterile syringes and equipment each time (don’t share)
practise safe sex
avoid sharing personal hygiene items such as razors, toothbrushes, tweezers and nail clippers
use reputable body piercing and tattooing services that practice universal infection control
Combined hep A and hep B vaccinations are available, however, you must be sure to complete the course to provide protection. Speak to your health professional about your choices.

4. Hepatitis C

We know that about 80% of people with hep C in Australia have acquired it through injecting drug use (past or current). People with hep C may experience no symptoms and may not be aware that they have the virus until tested. Some manage to clear the virus within 2 to 6 months of first being infected, but will carry the antibodies in their system for some time.

Like hep B, there is a chronic form of hep C which about 75 to 80% of those infected will develop. Hep C is believed to cause more serious conditions like cirrhosis or liver cancer in up to 5% of people who are infected. In others, the virus may cause symptoms such as chronic lethargy and tiredness, nausea, and pain in their upper right side.

How is hep C transmitted? Hep C is a "blood borne" virus which means it can be transmitted when infected blood comes into direct contact with your bloodstream. Hep C is rarely transmitted sexually, unless infected blood is present during the sexual act. This is most likely to occur with unprotected anal sex, or if a female partner is menstruating (and is hep C positive). There is an increased risk of sexual transmission if there is a co-infection with genital herpes (particularly in the active phase when there are likely to be open blisters). Hep C is contracted through:

sharing injecting equipment (needles, syringes, spoons, swabs, water and tourniquets)
un-sterile tattoo or skin piercing procedures
any other activity where blood to blood contact can take place
It is also a risk to share personal hygiene items such as razors, toothbrushes, and nail clippers because they can potentially pierce the skin which, if shared, may transmit infected blood.
Hep C cannot be caught by: kissing, sharing cups, using toilets, day to day social contact or coming into contact with blood free body fluids.

How can I prevent hep C infection/ reinfection? There is no vaccine for hep C. As hep C is very infectious, the smallest amount of blood may be enough to pass on the virus. To avoid the transmission of hep C:

do not share injecting equipment, including tourniquets, swabs, filters, water and spoons
always use new, sterile syringes and equipment every time you inject.
wash hands before and after injecting
use reputable body piercing and tattooing services that practice universal infection control
practise safe sex when there is any doubt about bleeding during sex
avoid sharing personal hygiene items