Health Sex and sexual health STIs The A to C of Hepatitis What’s the difference between hepatitis A, B and C? How can they affect you? And how can you treat them? HEPATITIS A Hepatitis A is found in faeces. It can be acquired through contaminated food or water or through sex acts such as rimming. Fucking or fingering a guy can also transmit hepatitis A, as it’s easy to transfer it from your fingers to your mouth. The best way to prevent hepatitis A is by getting vaccinated. The vaccine is available at most GUM clinics or you can ask your GP. The vaccine is a course of two injections taken six months apart. Symptoms can appear two to six weeks after infection. These can include headache, fever, loss of appetite, nausea, vomiting, lethargy, and muscle and joint pains. Later your eyeballs and skin may become jaundiced (go yellow). Your urine can turn dark brown and your faeces can turn pale. Your liver (just below your ribs on the right side of your body) may become tender. Not everyone will have such severe symptoms. A sexual health clinic can test you. The only treatment for hepatitis A is plenty of rest, a low-protein and high-carbohydrate diet, and avoiding fatty foods and alcohol. The illness clears up by itself within one to three months, causing no lasting damage. Once you have had it, you will be immune to catching it in the future. In more severe cases, you may require a hospital stay, which is why it’s important to get diagnosed and receive professional medical advice. HEPATITIS B Hepatitis B virus is found in blood, cum, urine, spit and faeces, as well as other body fluids of a person who’s infected. It can be spread by sharing needles, sharing snorting straws, unprotected sex, or by getting blood or other infected body fluids in the mouth, eyes or on broken skin. Using condoms can help prevent many cases but the best way to prevent infection is by getting vaccinated. The vaccine is available from GUM clinics. The vaccine is a short course of injections taken at set intervals (usually weeks to months between injections depending on what clinic you attend or what is convenient for you). The number of injections you need will depend on your response to the vaccine but expect about three. You may not show any symptoms if you have it, but if you do they can include fatigue, nausea, vomiting, pain in the liver area, dark urine or light coloured bowel movements, and fever. Many adults develop jaundice, which turns their skin and the whites of their eyes a yellowish colour. To help stop the infection your GP can start you on the vaccine which work against the virus until the vaccine starts to take effect. These are advised within 48 hours after possible exposure but can be given up to a week afterwards. Treatment depends how long you’ve had it: Short-term (acute) hepatitis B doesn’t normally need treatment but you can get help to relieve the symptoms. You’ll be referred to a liver specialist and advised to get plenty of rest. Most people recover completely in a couple of months but you will need regular blood tests. Long-term (chronic) hepatitis B is treated with medication. This won’t necessarily cure the infection and you may need lifelong treatment. There are two types of treatment: if your liver is working well the first treatment offered is Peginterferon alfa-2a, which stimulates the immune system to control the virus. It’s given by injection once a week for 48 weeks. If your liver isn’t working well or interferon treatment hasn’t worked then most people will be treated with an antiviral medication that interferes with the virus’ ability to reproduce. HEPATITIS C Hepatitis C is present primarily in blood and can also be present in cum. Fucking and fisting can be ways it is transmitted. Traditionally injecting drug use was the most common way to catch hepatitis C but it is now known that unprotected sex, particularly high risk sex, and chemsex is associated with hep C infection. You can reduce the risk of getting it by: using a new condom when you fuck or get fucked, using a new sterile syringe and needle for injecting steroids or recreational drugs. Making sure the man fisting you is wearing an unused latex glove or if you don’t have any latex gloves, make sure the man fisting you doesn’t have cuts or sores on his hands and has washed his hands thoroughly if he has just fisted someone else. You should use a new condom on your dildo if it’s been used on someone else, and use your own drug snorting straw, banknote or bullet. It produces many of the same symptoms as hepatitis A and B, although most people do not notice any symptoms when they are first infected. A sexual health clinic can test you for it. Short-term infections may be monitored with blood tests to see how well your body fights off the virus. For a long-term chronic infection treatment will be recommended. If you’ve been infected for 6 months or more you’ll be given tablets to fight the virus, test how well your liver is working, and be advised to make lifestyle changes like limiting any alcohol intake to prevent more damage. It’s treated by using a type of medicine called direct acting antivirals. They are highly effective in more than 90% of people, with treatment lasting between 8-12 weeks. At the end of your treatment, you will have a blood test to see if the virus has been cleared, and a second blood test 12 or 24 weeks after treatment has stopped. If both tests show no sign of the virus, this means treatment has been successful however it doesn’t protect you from another hepatitis C infection. You can still catch it again. Acute hepatitis C from sex is more common among HIV-positive men but if you feel you have been at risk it is free and easy to do the test in a GUM clinic. Treatment is more effective early on so if you’ve been at risk, getting tested regularly is recommended.