Understanding the strains of hepatitis

May 29, 2014 by Cedric Ricks, University of Cincinnati
Electron micrographs of hepatitis C virus purified from cell culture. Scale bar is 50 nanometers. Credit: Center for the Study of Hepatitis C, The Rockefeller University.

Hepatitis C is a very sneaky creature that coats itself in an envelope which changes every time the body tries to mount an immune response, says Kenneth Sherman, MD, PhD, a UC Health physician and professor in University of Cincinnati (UC) College of Medicine.

"It's very similar to HIV in that regard," says Sherman, director of the internal medicine department's division of digestive diseases.

There is no vaccine for C, which is receiving renewed attention as the public learns more about a heroin epidemic that is affecting not just the Tristate but the nation. Hepatitis C is spread largely through injection drugs and shared needles and is following the heroin epidemic.

May is also Hepatitis Awareness Month, according to the Centers for Disease Control and Prevention. In the United States, it's estimated that 3 million to 5 million people are infected with hepatitis C, which attacks and inflames the liver, says Sherman.

"In the '60s and '70s, a lot of people played around with injection drugs," says Sherman. "It only takes once with a shared needle to become infected. Others were exposed to contaminated blood or had exposures from other sources. That is why the Centers for Disease Control and Prevention now recommend that all baby boomers, those born between 1945 and 1965, be tested at least once for hepatitis C by their care provider."

"We are now seeing a new epidemic of hepatitis C," says Sherman. "The epidemic is among the 15- to 30-year-olds in this generation. We are already seeing that in the Cincinnati area and throughout the region."

Hepatitis C can now be treated in 12 weeks, while previous treatments just three or four years ago were four times as long, says Sherman. The cost of treatment remains controversial with the Food and Drug Administration (FDA) approving a new drug, Sofosbuvir, which costs $84,000 for a 12-week treatment, says Sherman.

But the price might be considered a bargain if it is compared with the cost of a liver transplant if Hepatitis C goes unchecked and ravages the liver, says Sherman. The cost of managing end stage liver , combined with the cost of a liver transplant may approach $500,000 per person per transplant and as much as $35,000 annually afterward for maintenance medications.

Hepatitis C may get the most publicity, but the disease is only one among the family of hepatitis viruses.

"There are different types of with names ranging from A through E. Other viruses remain to be discovered," says Sherman.

Hepatitis A is a virus that is acquired through food and water contamination with fecal waste. It causes acute hepatitis and does not go on to the chronic (long term) disease state, says Sherman.

"You don't maintain an active virus for more than a period of six months," he explained.

Hepatitis B is a virus that is spread through sexual exposure and injection drug use and from mothers to infants and it is common in immigrant populations, says Sherman.

"In the Cincinnati area we see high rates of hepatitis B in immigrant Asian populations," says Sherman. "It does persist in many patients leading to a chronic disease state and creates long-term infection which is associated with liver injury, cirrhosis and development of liver cancer."

Hepatitis A and B are both vaccine preventable, says Sherman.

Hepatitis D is a strange virus that only co-exists with hepatitis B, says Sherman. "It utilizes hepatitis B to be able to replicate itself. When you get both together the severity of the disease is much worse. Luckily, hepatitis D is considered relatively rare in the United States."

Hepatitis E is in some ways the new player on the block, says Sherman.

"It is something that we are actively studying at the University of Cincinnati," says Sherman. "It has historically been a disease of resource limited countries with poor sanitation systems which is spread like Hepatitis A through contaminated water and food."

"In recent years, we have come to understand that it is very common in the U.S. and is probably being spread through exposure to pigs and pig products, meaning eating poorly cooked sausage and goetta," says Sherman. "It can cause and in addition, it can cause a among those with HIV or in people who have had an organ transplant or are taking cancer chemotherapy."

With chronic hepatitis E, there have been some recent case reports suggesting that treatments used in the hepatitis C treatment regimen may be successful, says Sherman. There are two vaccines that have been studied—one in China and one in Nepal —but neither have been approved for use by the FDA.

Explore further: Hepatitis C remains major problem for HIV patients despite antiretroviral therapy

Related Stories

Hepatitis C remains major problem for HIV patients despite antiretroviral therapy

March 17, 2014
A new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania has found that the risk of hepatitis C-associated serious liver disease persists in HIV patients otherwise benefitting from ...

Deaths from viral hepatitis surpasses HIV/AIDS as preventable cause of deaths in Australia

April 17, 2014
The analysis was conducted by Dr Benjamin Cowie and Ms Jennifer MacLachlan from the University of Melbourne and Melbourne Health, and was presented at The International Liver Congress in London earlier this month.

Pancreatic, liver disease shift up on risk list

May 23, 2014
Money changes everything. To date, lung, breast, prostate and colorectal cancers have accounted for the largest number of cancer deaths. In response, these cancers currently receive the most research funding from the National ...

Hepatitis C screening for baby boomers

April 29, 2013
If you were born during 1945-1965, talk to your doctor about getting tested for hepatitis C. The word "hepatitis" means swelling of the liver. Hepatitis is most often caused by a virus. In the United States, the most common ...

FDA advisers unanimously back J&J hepatitis C drug

October 24, 2013
An experimental hepatitis C drug from Johnson & Johnson has won unanimous support from government experts who say the medication should be approved to treat patients infected with the liver-destroying virus.

New test IDs genotype of hepatitis C

June 20, 2013
(HealthDay)—A new test to help doctors identify the genotype of a person's hepatitis C infection has been approved by the U.S. Food and Drug Administration.

Recommended for you

New study offers insights on genetic indicators of COPD risk

January 16, 2018
Researchers have discovered that genetic variations in the anatomy of the lungs could serve as indicators to help identify people who have low, but stable, lung function early in life, and those who are particularly at risk ...

Previous influenza virus exposures enhance susceptibility in another influenza pandemic

January 16, 2018
While past exposure to influenza A viruses often builds immunity to similar, and sometimes different, strains of the virus, Canadian researchers are calling for more attention to exceptions to that rule.

Don't hold your nose and close your mouth when you sneeze, doctors warn

January 15, 2018
Pinching your nose while clamping your mouth shut to contain a forceful sneeze isn't a good idea, warn doctors in the journal BMJ Case Reports.

New antifungal provides hope in fight against superbugs

January 12, 2018
Microscopic yeast have been wreaking havoc in hospitals around the world—creeping into catheters, ventilator tubes, and IV lines—and causing deadly invasive infection. One culprit species, Candida auris, is resistant ...

Dengue takes low and slow approach to replication

January 11, 2018
A new study reveals how dengue virus manages to reproduce itself in an infected person without triggering the body's normal defenses. Duke researchers report that dengue pulls off this hoax by co-opting a specialized structure ...

Different strains of same bacteria trigger widely varying immune responses

January 11, 2018
Genetic differences between different strains of the same pathogenic bacterial species appear to result in widely varying immune system responses, according to new research published in PLOS Pathogens.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.