FAQ

FAQ section on the liver and hepatitis B, C and D

Here you can find frequently asked questions and answers about liver health, hepatitis B, hepatitis C und hepatitis D.
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Hepatitis and the liver

What is the function of the liver?

The liver is an important metabolic organ. The liver stores nutrients, produces proteins, contributes to digestion and breaks down substances that the body can no longer use or are toxic.

What is hepatitis?

Hepatitis is inflammation of the liver (hepar = liver, -itis = inflammation). In extreme cases, this can cause the organ to lose its ability to function.

What causes hepatitis?

Liver inflammation or hepatitis can have many causes. This includes pathogens such as various hepatitis viruses, alcohol abuse, poisoning, autoimmune diseases, fatty liver and injuries.

What is fibrosis?

Fibrosis is scarring of the liver. It occurs when dead liver cells are replaced by connective tissue.

What is cirrhosis?

Liver cirrhosis is a very advanced stage of liver scarring (fibrosis). It can lead to serious complications such as dropsy (Ascites), esophageal varicose veins and internal bleeding, brain disorders and liver failure. It also increases the risk of liver cancer.

Hepatitis C

What is hepatitis C?

Hepatitis C is inflammation of the liver caused by an infection with the hepatitis C virus. It can be acute and then heal spontaneously. However, it becomes chronic in up to 85 percent of those infected.1

How is the hepatitis C virus transmitted?

Hepatitis C transmission occurs through blood-to-blood contact. Here, you can see cases in which contagion can occur.

How can you protect yourself from infection with the hepatitis C virus?

By avoiding blood-to-blood contact. Under Prevention and Preemption you will find important measures to protect yourself from hepatitis C.

What are the consequences of hepatitis C disease?

In the case of acute Hepatitis C, the infection heals without further measures and then usually has no consequences. Chronic hepatitis C can lead to long-term risk of liver cirrhosis and liver cancer.1

How do I know if I have hepatitis C? What are the symptoms?

There are no clear symptoms. Signs of hepatitis C include: Tiredness and a lack of energy, upper abdominal pain, itching, joint pain and increased liver values.1 However, the disease can also progress without symptoms.

Can I get a vaccination for hepatitis C?

No, there is currently no vaccination for hepatitis C.

What tests can be carried out to detect hepatitis C?

There are several ways to detect the hepatitis C viral infection. Antibody tests for the virus show that the immune system has encountered the pathogen. So-called ‘rapid tests’ are also an option. If the test works and the result is positive, confirmation by detecting viral genetic material, of so-called HCV RNA (hepatitis C virus ribonucleic acid), is required. This second form of evidence is decisive for the diagnosis.1

How often should I get tested for hepatitis C?

That cannot be answered in general terms. Anyone who believes that they may have been infected with hepatitis C as part of a one-off incident can get tested just once. However, anyone who repeatedly or continuously involves themselves in situations that are risky should be tested more frequently, perhaps even on a regular basis. For example, people who inject drugs are recommended to get tested annually.2

Where can I get tested for hepatitis C?

Hepatitis C testing options are provided by doctor’s surgeries, health authorities, AIDS facilities on occasion, or by drug and addiction support groups.

How can you treat hepatitis C?

Treatment almost always leads to hepatitis C being cured, improves a person’s state of health, protects their liver from further damage or even enables previous liver damage to recover. The following is also important: Successful treatment ensures that you can no longer infect other people with the virus.

Why should I have hepatitis C treated?

Treatment almost always leads to hepatitis C being cured, improves a person’s state of health, protects their liver from further damage or even enables previous liver damage to recover. The following is also important: Successful treatment ensures that you can no longer infect other people with the virus.

Who bears the costs of the treatment?

The costs for hepatitis C medication is covered by health insurance companies.2

Can I get hepatitis C for a second time following successful treatment?

Yes, reinfection is a possibility.

Hepatitis B

What is hepatitis B?

Hepatitis B is an inflammation of the liver caused by infection with the hepatitis B virus. It can be acute and then heal spontaneously. In some cases, however, it can have a chronic course.3,5

How do you get hepatitis B?

You get hepatitis B by becoming infected with the hepatitis B virus.

How is the hepatitis B virus transmitted?

Transmission is primarily via blood. Here you can find examples of hepatitis B transmission routes.

How can you protect yourself from infection with the hepatitis B virus?

The most important measure to prevent viral infection with hepatitis B is to get the vaccination. There are also various practices and measures to protect yourself from the infection.

What are the consequences of hepatitis B?

In adults, hepatitis B usually heals without consequences. If the disease becomes chronic, it can develop into liver cirrhosis or liver cancer over the long term, especially if hepatitis B is not treated.4

How do I know if I have hepatitis B? What are the symptoms?

Infection with hepatitis B viruses is often inconspicuous. However, if you have the following symptoms, you should consider hepatitis B a possibility:4

  • Fatigue and lack of energy
  • Discomfort in the upper right side of the abdomen
  • Loss of appetite
  • Tendency to bruise
  • Itchy skin
  • Yellowing of the skin and eyes
  • Dark colored urine
  • Stool discoloration
  • Elevated liver values

Can I get a hepatitis B vaccination?

Yes, there is a highly effective and well-tolerated vaccination for hepatitis B.6

What tests can be carried out to detect hepatitis B?

To detect hepatitis B, a person’s blood is tested for various components of the hepatitis B virus and respective antibodies.

Who should get tested for hepatitis B?

Testing for hepatitis B is particularly advisable for:

  • Drug users who use injection equipment or tubes together with others
  • Life and sexual partners of infected people
  • People with frequently changing sexual partners
  • People from countries with high rates of hepatitis B
  • People who are employed in the medical field and have contact with blood
  • Pregnant women (standard examination from the 32nd week of pregnancy)7
  • Newborns whose mothers are infected

Where can I get tested for hepatitis B?

Hepatitis B testing options are provided by doctor’s surgeries and health authorities.

How can you treat hepatitis B?

Acute hepatitis B usually does not need to be treated, chronic hepatitis does not always always need to be treated either. Various factors, such as the concentration of viral genetic material (HBV DNA for short), determine whether treatment is necessary.4  There are two different drug therapy options.

Hepatitis D

What is Hepatitis D?4

Hepatitis D is liver inflammation caused by infection with the hepatitis D virus, which always means you also have the hepatitis B virus.

How do you get hepatitis D?

You can get hepatitis D if you become infected with the hepatitis D virus. In order to multiply, however, this virus is dependent on the hepatitis B virus.

What is a simultaneous infection with the hepatitis D virus?

A simultaneous infection is when a patient becomes infected with the hepatitis viruses B and D at the same time.

What is hepatitis D virus superinfection?

A superinfection is when a patient is already chronically ill with hepatitis B and then also becomes infected with the hepatitis D virus.

How is the hepatitis D virus transmitted?

Like hepatitis B, hepatitis D is also transmitted via virus-contaminated blood and other bodily fluids.

How can you protect yourself from infection with the hepatitis D virus?

The most important measure is getting a vaccination for hepatitis B, since hepatitis D viruses can only multiply in the presence of hepatitis B viruses. Otherwise, it is important to prevent contact with virus-contaminated blood, semen, vaginal secretions and other bodily fluids by taking the following measures.

What are the consequences of hepatitis D disease?

In the case of a simultaneous infection, severe acute courses and a transition to chronic hepatitis D disease are rare. The situation is different in the case of a superinfection. This can lead to a severe chronic course.

How do I know if I have hepatitis D? What are the symptoms?

The symptoms of hepatitis D are usually non-specific and comparable to those of other virus-related liver inflammations.

Can I get vaccinated against hepatitis D?

There is no vaccination specifically for hepatitis D. However, vaccination against hepatitis B also protects against infection with hepatitis D viruses.

What tests can be done to detect hepatitis D?

There are two test methods for hepatitis D detection, both of which are carried out using a blood sample. First you look for antibodies against the hepatitis D virus. If the test is positive, the genetic material of the virus, the so-called HDV RNA, is tested for diagnosis confirmation.

Who should get tested for hepatitis D?

All patients with hepatitis B should also be tested for hepatitis D.5

Where can I get tested for hepatitis D?

Testing for hepatitis D can be done in doctor’s offices and by public health departments.

Is hepatitis D treatable?

Hepatitis D can be treated with medication. The aim is to stop the virus from multiplying and thus protect the liver from damage.8 Talking to the treating doctor can help to find the best possible treatment and improve the prognosis.

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References

  1. https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HepatitisC.html (last accessed: September 2021).
  2. https://www.leberhilfe.org/lebererkrankungen/hepatitis-c-hcv/ (last accessed: October 2021).
  3. https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HepatitisB.html (last accessed: October 2021).
  4. https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-d (last accessed: October 2021).
  5. Cornberg M et al. S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) zur Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virusinfektion. Z Gastroenterol 2021; 59: 691–776; abrufbar über: https://www.awmf.org/uploads/tx_szleitlinien/021-011l_S3_Prophylaxe-Diagnostik-Therapie-der-Hepatitis-B-Virusinfektion_2021-07.pdf
  6. RKI. Epid Bull 29/2021.
  7. https://www.frauenaerzte-im-netz.de/schwangerschaft-geburt/schwangerenvorsorge/mutterpass/ (last accessed: October 2021).
  8. Urban S et al. 2021; 70(9): 1782-1794.