Hep A

[guru]

I always thought it was caused by a virus but a friend has it and the doc was talking about number of parasites in the blood test. Can it be caused by parasites and is it the usual water/ food mode of transmission?

[lopburi3]

It is a virus and the faecal-oral route is normal but beyond that would have to depend on Google. FYI the cost of Hep A vaccine shot in mid-high level Bangkok hospital today was 1,760 baht. As both A and B are preventable believe most sources recommend.

[guru]

Thanks lopburi that's good to know. I did a wiki on hepatitis and it lists infectious causes as being either virus, bacteria, parasites, fungi or Protozoa and non infectious causes such as alcohol. My search for knowledge has left me even more confused.

[AyG]

Hepatitis simply means a swelling or inflamation of the liver. This can be caused by many things.

Hepatitis A is a specific form of hepatitis, caused by a virus - the Hepatitis A virus.

The doctor almost certainly was not referring to hepatitis A when talking about parasites, but to hepatitis in general.

[Sheryl]

As above. If specifically Hepatitis A then the cause is viral, but there are other causes of hepatitis as well. Sounds like your friend has inflammation of the liver and they are in the process of determining the cause.

[Parvis]

I had Hepatitis vaccination - and booster shots - BEFORE coming to Thailand

Question: Does that give lifetime protection?????????

Edited August 26, 2012 by Parvis

[lopburi3]

There was no Hep A vaccine before I came to Thailand and believe the jury is out on how long they protect as too soon to know but Wiki has this:

Protection is proven to last at least 10 years and is estimated to last 21 to 27 years if the full course is administered

[cheeryble]

I believe Hep A is no big concern.....like getting a bug which goes away.... but Hep B and C certainly are a concern.

Hep B can be transmitted by sex. It can be dealt with by most people who become antibody positive but stay OK and of course are immune to future infection.

However a modest but significant number of people....including my wife......get it chronically and it may surface after many years to cause anything up to liver cancer, necessitating 6 monthly ultrasounds etc.

If you are free but antibody negative a series of shots over 6months can immunise you, as I have been.

As for Hep C a lot of injecting drug users get it, and I believe it's the worst of the lot.

[AyG]

I believe Hep A is no big concern.....like getting a bug which goes away....

Not really true. An admittedly small proportion of those infected remain so after six months. Having had a friend who was totally debilitated for three months by the virus, I know it's no trivial matter. However, the big concern is the risk of liver failure for those over 50 infected, which runs at about 17 per 1,000 cases. Really, everyone should be vaccinated against Hep A (and against Hep B if sexually active).

[cheeryble]

Thankyou AyG

I was indeed underestimating Hep A, though the figures are confusing, me finding:

"The prognosis is excellent and recovery is complete. Mortality rates for large epidemics are less than 1 per 1,000. (Note: The mortality rate among people over age 50 who contract hepatitis A is higher: about 1.8 percent.) Rarely does Hepatitis A cause liver failure, and it does not lead to development of cirrhosis of the liver or chronic hepatitis."

Also it seems a high proportion of children in developing countries get resistance whereas Westerners don't, and it becomes a bigger problem for the Westerner travelling then getting it later in life.

Also significant is that Hep A seems to be most dangerous when overlaid on top of B and C.

I presume my gf, with B, got checked for A antibodies but I shall check and if not will want to know why not.

Anyway, thanks

[katana]

I knew someone who had Hep A. Knocked them out for two weeks. Apparently after you get it, you have lifelong immunity, so no further Hep A shots needed.

Edited August 26, 2012 by katana

[lopburi3]

Suspect anyone who has gone through the previous, rather nasty, preventive measures of frequent Gamma Globulin shots for Hep A will welcome having a vaccine available. As said above it can be a major kick in the ass for both the GG and having Hep A. Those I have worked with have taken weeks to months to recover. Those stats of it being minor is for those exposed all there lives - for those from cleaner areas getting later in life it can be a really bad experience.

[guru]

Well he has hav which is the hep a virus but also parasites are down from 3000 to 200. Maybe his hepatitis is due to 2 different factors?? Anyway he can't drink alcohol for months.

[guru]

Personally I had the twinrix hep a / hep b vaccination in 1998.

I had another hep a and it's 6 month booster in 2008. For whatever reason my uk doc didn't give me hep b vaccine again although I asked for it.

she said im good for 20 years with that hep a vaccine.

What about the hep b from 1998. Ive read that both the hep a / hep b give at least 20years and probably life time immunity???

[lopburi3]

Well he has hav which is the hep a virus but also parasites are down from 3000 to 200. Maybe his hepatitis is due to 2 different factors?? Anyway he can't drink alcohol for months

. Are you sure this is not Platelets Count in blood test?

[guru]

It may have been platelets and he misheard parasites. He had already had a shock at hearing hav and thinking the doc had said something else. Anyway the doc was happy that whatever p word it was it was down to 200.

[Sheryl]

It is neither parasites nor platlets if it went from 3,000 to 200 and this was a good sign.

May be SGPT, a liver enzyme.

[Sheryl]

Personally I had the twinrix hep a / hep b vaccination in 1998.

I had another hep a and it's 6 month booster in 2008. For whatever reason my uk doc didn't give me hep b vaccine again although I asked for it.

she said im good for 20 years with that hep a vaccine.

What about the hep b from 1998. Ive read that both the hep a / hep b give at least 20years and probably life time immunity???

Hep B: it varies with individual but after 15 years after immunization the antibody levels detectable in the blood start to decline. It is not yet known how this correlates to protection from the disease so there are not yet any specific recommendations for boosters in place. It is possible to test the hep A and B antibody levels in the blood to determine the degree of protection of a specific individual. Personally, for anyone who is sexually active with locals in Thailand, I would recommend a repeat series if blood test does not show adequate protection. If you are in a monogamous relationship with someone whom you are sure is not a Hep B carrier then can probably skip this.

Hep A: You are good for at least 20-25 years http://www.cdc.gov/hepatitis/hav/havfaq.htm

[AyG]

If you are in a monogamous relationship with someone whom you are sure is not a Hep B carrier then can probably skip this.

If you are in a monogamous relationship and always have safe sex, possibly so. However, if you have unprotected sex with your partner, whether you believe the relationship to be monogamous or not, then get tested/vaccinated, and keep your fingers crossed that your "monogamous" partner doesn't pick up HIV (or any one of a host of other sexually transmitted diseases).

[msg362]

As above. If specifically Hepatitis A then the cause is viral, but there are other causes of hepatitis as well. Sounds like your friend has inflammation of the liver and they are in the process of determining the cause.

Agree, can you clarify, my ancient microbiology says Hep A does not have a vaccine but Hep B does

OOPs I think my memory is going! it's Hep C no vaccine and a probable cause of liver cancer. Can someone correct me?

Edited August 28, 2012 by msg362

[msg362]

I believe Hep A is no big concern.....like getting a bug which goes away.... but Hep B and C certainly are a concern.

Hep B can be transmitted by sex. It can be dealt with by most people who become antibody positive but stay OK and of course are immune to future infection.

However a modest but significant number of people....including my wife......get it chronically and it may surface after many years to cause anything up to liver cancer, necessitating 6 monthly ultrasounds etc.

If you are free but antibody negative a series of shots over 6months can immunise you, as I have been.

As for Hep C a lot of injecting drug users get it, and I believe it's the worst of the lot.

Hep B can be transmitted in a number of ways: blood to blood and so on, not just sex so please don't label it as such. Drug use is a common reason as was untested blood transfusions a while age

[Sheryl]

As above. If specifically Hepatitis A then the cause is viral, but there are other causes of hepatitis as well. Sounds like your friend has inflammation of the liver and they are in the process of determining the cause.

Agree, can you clarify, my ancient microbiology says Hep A does not have a vaccine but Hep B does

OOPs I think my memory is going! it's Hep C no vaccine and a probable cause of liver cancer. Can someone correct me?

there are vaccines for both A and B (including a single combined vaccine for both), none yet for C.

[lopburi3]

Yes but age could be a factor in his thinking as B had vaccine a few years before A became available so if his " ancient microbiology" was during my working days it would have been as remembered.

[BuckarooBanzai]

Having had the vaccination shots 20 years ago I requested that a blood test I was having checked for my immunity. Blood test came back no problem as antibodies still strong. Just a suggestion for the next time you get a blood test.