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Hepatitis A, B and C

Description

Hepatitis A, B and C are inflammations of the liver caused by different viruses.

Symptoms

People with hepatitis A, B and C do not always have symptoms.

When people have symptoms, they appear at different times depending on the type of hepatitis:

  • Hepatitis A: 15 to 50 days (28 days on average) after infection
  • Hepatitis B: 1 to 6 months (2 to 3 months on average) after infection
  • Hepatitis C: 2 weeks to 6 months (6 to 9 weeks on average) after infection

Symptoms of hepatitis include the following:

  • Fatigue
  • Loss of appetite, nausea or vomiting
  • Stomach pain
  • Fever
  • Diarrhea
  • Yellow discolouration in the skin and eyes (jaundice)
  • Pale stools and dark urine

When to consult

Consult a health-care professional or call Info-Santé 811 if you have symptoms or if you have taken part in 'at risk' behaviours, such as:

  • Having unprotected sex
  • Sharing paraphernalia used to prepare, inject or inhale drugs
  • Getting tattooed or pierced with non-sterile equipment

Treatment

Hepatitis A

In most cases, a hepatitis A infection heals itself within 2 months. The body gets rid of the virus and produces antibodies that protect against all new infections by the hepatitis A virus. There are no “chronic carriers”. The person is generally protected for life.

Hepatitis B

In most cases, the infection heals itself within 6 months. The body gets rid of the virus and produces antibodies that protect against all new infections by the hepatitis B virus. The person is generally protected for life.

Sometimes the body is unable to get rid of the virus and does not produce antibodies to protect against hepatitis B. In such a case, the infection is not cured and the person can spread hepatitis B even if he or she has no symptoms. Such a person is a “chronic carrier” of hepatitis B.

Treatments are available to limit complications associated with chronic hepatitis B and to cure certain chronic carriers of the virus.

Hepatitis C

In some people, the infection heals without treatment within 6 months. The body gets rid of the virus and produces antibodies against hepatitis C. However, the antibodies do not protect the person against a new infection of hepatitis C.

In most cases, the body is unable to get rid of the virus. The infection does not heal and the person can spread hepatitis C even without having symptoms. Such a person is a “chronic carrier” of hepatitis C.

Treatments are available to limit complications associated with chronic hepatitis C and cure the infection. However, even if a person is healed, he or she is not protected against a new infection of hepatitis C.

Inform partners

People with hepatitis should notify their sex and drug partners as quickly as possible. This way, their partners:

  • Can be tested, evaluated, receive appropriate treatment and avoid complications
  • Can avoid spreading infections to other people

Complications

In chronic carriers of hepatitis B and C, possible complications include:

  • Cirrhosis (liver disease)
  • Liver cancer

Transmission

An infected person can spread hepatitis A, B, or C even if he or she does not have symptoms.

Hepatitis A

The hepatitis A virus is found in the stools of an infected person. Stools can be in food, water or on various surfaces. They are not always visible.

Hepatitis A is spread through:

  • Consumption of contaminated water or food
  • Contact with contaminated objects
  • Contact of the mouth with the anus
  • Sharing of sex toys
  • Preparation or use of drugs in unsanitary conditions

Hepatitis B

The hepatitis B virus is spread through sex or blood.

Sexual transmission can occur:

  • during vaginal sex (penetration of the vagina with the penis);
  • during anal sex (penetration of the anus with the penis). The risk increases during anal sex that can create lesions or injury, such as when the fingers or the fist are inserted in the anus;
  • when sharing sex toys;
  • in the presence of blood.

Sexual transmission can occur in the absence of orgasm or ejaculation.

Transmission through blood can occur during:

  • Sharing of paraphernalia used to prepare, inject or inhale drugs
  • Tattooing or piercing with non-sterile equipment
  • Contact between a liquid contaminated by blood with
    • Damaged skin surface (bites, stings, cuts and sores for example)
    • Mucous membranes such as linings of the mouth or female and male genitals
  • Blood transfusions where safety measures are not applied (they are applied in Canada)

An infected mother can also pass on hepatitis B to her baby during pregnancy or childbirth. For further information, read the Sexually Transmitted and Blood-borne Infections (STBBIs) and Pregnancy page.

Hepatitis C

The hepatitis C virus is spread through sex or blood.

Sexual transmission can occur:

  • during vaginal sex (penetration of the vagina with the penis);
  • during anal sex (penetration of the anus with the penis); the risk increases during anal sex that can create lesions or injury, such as when the fingers or the fist are inserted in the anus
  • when sharing sex toys;
  • in the presence of blood.

Transmission through blood can occur during:

  • Sharing of paraphernalia used to prepare, inject or inhale drugs
  • Tattooing or piercing with non-sterile equipment
  • Contact between a liquid contaminated by blood with
    • Damaged skin surface (bites, stings, cuts and sores for example)
    • Mucous membranes such as linings of the mouth or female and male genitals
  • Blood transfusions where safety measures are not applied (they are applied in Canada)

An infected mother can also pass on hepatitis C to her baby during childbirth.

Protection and prevention

Vaccination

Vaccination is the best means of protection against hepatitis A and B.

There is a vaccine to protect against hepatitis A and another for hepatitis B. A combined vaccine that protects against both hepatitis A and hepatitis B is also available. There is no vaccine to protect against hepatitis C.

The Québec Immunization Program provides for the administration of a combination vaccine against hepatitis B at the ages of 2 and 4 months and one vaccine against hepatitis A and B at the age of 18 months. The vaccination program in the fourth year of primary school against hepatitis A will continue until the children born before June 1, 2019 have reached the fourth year of primary school.

Vaccination against hepatitis A and hepatitis B is also offered free of charge to people who are more at risk of getting these infections.

Since free vaccination was introduced in Québec, the number of cases of acute hepatitis B has decreased by almost 98%.

To receive more information about vaccines, you can:

Preparation and use of drugs

Washing hands and using sterile water to prepare and use drugs lower the risk of catching hepatitis A. The use of new paraphernalia for the preparation, injection and inhalation of drugs lowers the risk of catching hepatitis B and C through blood.

Never share drug paraphernalia. To know the location of distribution points for drug injecting material, call Info-Santé 811.

Tattoos and piercings

Tattoo artists and piercers must use new, disposable or sterilized material. Such precaution lowers the risk of spreading hepatitis B and C. This includes razors, needles, blades, bottles and inks, as well as everything that comes into contact with the skin or blood. With regard to ear piercing, the earlobe should be disinfected before piercing and the piercing gun must be disinfected with 70% alcohol between each client. Tattoo artists and piercers must also wash their hands and wear gloves.

Sexual protection

For the best protection against hepatitis A, B and C, use a condom:

  • During all contact between genital organs
  • During the entire course of oral, vaginal or anal sex
  • With each sexual encounter

The use of a sheet of latex to cover the vulva or anus during oral sex lowers the risk of spreading hepatitis viruses. It helps prevent direct contact between the mouth and the genitals. A sheet of latex can be made by unrolling a condom, cutting off both ends and then cutting it lengthwise.

The use of a latex glove lowers the risk of spreading hepatitis C during fingering or fisting of the anus. The glove must be changed after each partner.

Sex toys should not be shared. People who share sex toys can lower the risk of spreading hepatitis by covering them with a condom. They must change condoms after each partner.

In case of contact with an infected person’s blood, sperm or vaginal secretions

Consult a health-care professional or call Info-Santé 811 immediately if:

  • You have come into contact with the blood, sperm or vaginal secretions of a person who could be infected with the hepatitis B virus. You may have to receive preventive treatment that protects you from catching hepatitis B. This treatment is called “post-exposure prophylaxis”. It must be administered as soon as possible after contact

Consult a health-care professional if:

  • You have come into contact with the blood of someone who could be infected with the hepatitis C virus. You can get tested and receive appropriate care, as needed

Testing

Hepatitis A is usually detected when there are symptoms. If you have symptoms, consult a health-care professional.

A blood test can detect if you have hepatitis B or C.

A person must get tested if he or she has taken part in 'at risk' behaviours, such as:

  • Having unprotected sex
  • Sharing paraphernalia used to prepare, inject or inhale drugs
  • Getting tattooed or pierced with non-sterile equipment

This way, he or she can prevent complications and avoid spreading hepatitis B or C to other people.

To get tested for hepatitis B or C, consult a health-care professional or call Info-Santé 811.

Last update: June 22, 2023

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