Prevention:

Prevention of Hepatitis A

Vaccination. Hepatitis A is preventable by vaccination. Two vaccines (Havrix, Vaqta) are available, both very safe and effective. They are given in 2 shots, 6 months apart. A combination Hep A - Hep B vaccine (Twinrix) that contains both Havrix and Engerix-B (a hepatitis B vaccine) is also available for people age 18 years and older. It is given as 3 shots over a 6-month period.

The U.S. Centers for Disease Control and Prevention (CDC) recommend hepatitis A vaccination for:

• Children at age 1 year (12 - 23 months)
• Travelers to countries where hepatitis A is prevalent; they should receive the hepatitis A vaccine at least 2 weeks prior to departure.
• Men who have sex with other men
• Users of illegal drugs, especially those who inject drugs
• People with chronic liver diseases, such as hepatitis B or C

Others who may benefit include:

• People who have chronic liver disease
• People who receive clotting factor concentrate to treat hemophilia or other clotting disorders
• Military personnel
• Employees of child day-care centers
• People who care for institutionalized patients

Prevention After Exposure to Hepatitis A. Unvaccinated people who have recently been exposed to hepatitis A may be able to prevent hepatitis A by receiving injection with immune globulin (IG) or the hepatitis A vaccine. These shots must be given within 2 weeks after exposure to be effective. In the past, immune globulin was the standard postexposure prophylaxis (preventive treatment after exposure) for hepatitis A. However, recent studies have indicated that the hepatitis A vaccine provides as good protection as immune globulin. The CDC� ' s Advisory Committee on Immunization Practices now recommends the vaccine for postexposure prophylaxis for healthy individuals between the ages of 1 - 40 years. Others should be given immune globulin if warranted.

Lifestyle Measures for Hepatitis A Prevention. Frequent handwashing after using the bathroom or changing diapers is important for preventing transmission of hepatitis A. International travelers to developing countries should use bottled or boiled water for brushing teeth and drinking, and avoid ice cubes. It is best to eat only well-cooked heated food and to peel raw fruits and vegetables.

Prevention of Hepatitis B

Vaccination. Hepatitis B is preventable by vaccination. There are several inactivated virus vaccines, including Recombivax HB and Engerix-B. A combination vaccine (Twinrix) that contains Engerix-B and Havrix, a hepatitis A vaccine, is also available. The hepatitis B vaccine is usually given as a series of 3 - 4 shots over a 6-month period.

The CDC recommends hepatitis B vaccination for:

• All children should receive their first dose of hepatitis B vaccine at birth and complete their vaccination series by 6 - 18 months. Children younger than age 19 who were not vaccinated should receive “catch-up” doses.
• People who live in a household with or who have sexual relations with a person with chronic hepatitis B
• People with multiple sex partners
• People who have a sexually transmitted disease
• Men who have sex with men
• People who share drug-injection needles and equipment
• Healthcare workers at risk for exposure to blood
• People with end-stage renal disease who are on dialysis (hemodialysis or peritoneal dialysis)
• People with chronic liver disease
• People infected with HIV
• Residents and staff of institutions for the developmentally disabled
• Travelers to regions that have moderate-to-high rates of hepatitis B infection

Prevention After Exposure to Hepatitis B. The hepatitis B vaccine or a hepatitis B immune globulin (HBIG) shot may help prevent hepatitis B infection if given within 24 hours of exposure.

Lifestyle Measures for Hepatitis B Prevention. The following are some precautions for preventing the transmission of hepatitis B (and hepatitis C):

• Use a condom and practice safe sex.
• Avoid sharing personal items such as razors or toothbrushes.
• Do not share drug needles or other drug paraphernalia (such as straws for snorting drugs).
• Clean blood spills with a solution containing 1 part household bleach to 10 parts water.

Hepatitis B (and hepatitis C) viruses cannot be spread by casual contact such as holding hands, sharing eating utensils or drinking glasses, breast-feeding, kissing, hugging, coughing or sneezing.

Prevention of Hepatitis C

There is no vaccine for hepatitis C prevention. Lifestyle precautions are similar to those for hepatitis B. People who are infected with the hepatitis C virus should avoid drinking alcohol as this can accelerate the liver damage associated with hepatitis C. People who are infected with hepatitis C should also receive vaccinations for hepatitis A and B.