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Over two billion people, the WHO announced recently, have been infected with one of five hepatitis viruses. While the overwhelming majority of people who have been infected with hepatitis survive, hepatitis causes at least a million deaths every year.

Hepatitis A Through E Found In Nearly Every Nation

The danger of hepatitis is that carriers of the virus do not know they can infect others, and disability and death can come suddenly with little warning after years or even decades of silent infection.

The ABC's of Viral Hepatitis

While hepatitis was once considered to be a single condition with a wide range of symptoms, modern medicine identifies five strains of hepatitis viruses that cause the majority of infections. Scientists only identified the virus that causes the most common form of hepatitis, hepatitis A, in 1973.

Hepatitis A is both the most common and the mildest form of viral hepatitis. People infected with this strain of hepatitis begin to spread the virus 14 to 21 days after exposure, before they develop the characteristic jaundice, yellowing of the eyes and skin. The damage to the liver in hepatitis A is caused by the immune system's attack on the virus, rather than the virus itself.

This strain of hepatitis is spread by fecal-oral contact. In the developing world, it most commonly strikes infants and toddlers under the age of 2 who acquire the virus from their mothers. In the industrialized world, it most commonly strikes children aged 5 to 17 who are exposed to virus when infected children do not wash their hands after using the toilet. After six weeks to two months, people who have hepatitis A cease to be infectious.

Hepatitis B, on the other hand, is a life-long infection. First seen under the electron microscope in 1970, hepatitis B is passed from person to person through blood-to-blood or sexual contact.

Nearly 350 million people worldwide carry hepatitis B infection. As long as the immune system does not attack the virus, there are no symptoms. In any given year, however, there is about a 2% chance the immune system will try to get rid of the virus by attacking the liver. The infection can lead to cirrhosis of the liver or liver cancer. Treatments for hepatitis B are interferon, which works in about 1/3 of the people given it, or liver transplant.

Hepatitis C was once known as non-A, non-B hepatitis, until the virus was identified in the 1980's. Before the late 1980's, the only way to diagnosis this form of hepatitis was by testing for enzymes that  indicate liver damage. Many other conditions cause elevation of these liver enzymes, but doctors tended to label any elevation of liver enzymes as non-A, non-B hepatitis. Since the condition was thought to be associated with homosexuality in men and intravenous drug abuse in women, doctors commonly dismissed their patients as "not worthy" of medical attention on the presumption they must be hiding illicit lifestyles.

Doctors now know that most cases of hepatitis C occur in people who received contaminated blood products in medical procedures. In Egypt, 22% of the population acquired hepatitis infections through contaminated drugs intended to treat parasites. Like hepatitis B, hepatitis C can remain dormant in the liver for many years until the immune system activates a process that can lead to cirrhosis or liver cancer. Over 170,000,000 people in the world carry the hepatitis C virus.
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