www.yumasun.com
MITCH M. FREEMAN, M.D.
Jun 20, 2005
The liver is a vital organ located in the upper right-hand side of the abdomen. It performs many functions in the body, including processing the body’s nutrients, manufacturing bile to help digest fats, regulating blood clotting and breaking down potentially toxic substances into harmless ones that the body either can use or excrete.
Hepatitis is an inflammation of the liver that can be caused by viruses, chemicals, drugs, alcohol, inherited diseases or the patient’s own immune system. The most common cause of hepatitis is an infection with a virus.

There are four primary types of hepatitis: A, B, C, D and E. Hepatitis D and E are rare in the United States, so this article will focus on the first three.
Hepatitis A (HAV) is the most common form of viral hepatitis, and is the virus that has recently made local headlines. Unlike hepatitis B and C, which spread through contact with infected blood or body fluids, HAV is contracted when the feces (stool) of an infected person reaches food or water that is ingested by a susceptible person.
The symptoms of all forms of hepatitis are the same, but vary from person to person and may vary over time. Many people have few or mild symptoms that may be mistaken for the flu.
These may include fatigue, nausea, loss of appetite, fever and abdominal pain. Others may experience a yellow skin tone (jaundice), itching, dark colored urine and light colored stools. A physical examination may reveal a liver that is tender and enlarged.
Hepatitis A typically resolves on its own, so there is not a standard treatment for the virus. However, if a person has been exposed to the virus, an injection of HAV immune globulin (antibodies) given within 14 days of exposure may prevent the development of illness or lessen the severity of symptoms.
During the time the virus is active, following a healthy diet, drinking plenty of fluids and obtaining adequate rest can make a person feel better.
Arizona’s proximity to Mexico provides a higher rate of HAV virus incidence. Any travel outside the United States increases the risk of exposure to HAV.
Children are the most frequently infected and become a source of infection in others. Teaching children proper hand washing techniques is very beneficial in reducing the risk of spreading infection.
The hepatitis A vaccine is recommended for anyone at risk of exposure to HAV, including day care workers, homosexual men and people who travel internationally. People with hepatitis B or C or other types of liver disease should receive the HAV vaccine to prevent further complications of liver disease.
The vaccine is given in two doses and is thought to provide protection against hepatitis A for at least 20 years. Check with your primary care physician to see if you are a suitable candidate for the vaccine.
Most patients with hepatitis A recover fully within a couple of weeks. As many as one-third of the U.S. population becomes infected with HAV at some point in their life. Globally, it is estimated that 1.5 million people are infected with hepatitis A at some point.
Many people have had hepatitis A and do not even realize they have been exposed to the virus. Most of those people were exposed in their childhood and most kids do not show signs or symptoms when infected with hepatitis A.
Hepatitis A infection usually results in full recovery with no liver damage and will not affect the person in the future in any way.
Hepatitis B can be spread by exposure to blood, infected needles, through sexual relations and from mother to baby.
Most people will get better without any intervention, but a very small percent of patients become “carriers” — chronically infected and able to continue to infect others.
Newborns are especially vulnerable to chronic infection, with up to 90 percent of those exposed becoming carriers. Most chronic hepatitis B infections are now seen in people born in parts of the world (particularly southern and eastern Asia, southern Europe and Africa) where infection among newborns still remains common.
Chronic hepatitis usually causes no symptoms or may be noticeable as only a loss of energy and tiredness. In some people, chronic hepatitis can gradually damage the liver and, after many years, cause liver failure. The chronic form typically lasts for many years and only rarely goes away without treatment.
Chronic hepatitis may simmer for 20 years or more before causing significant symptoms related to progressive liver damage, such as cirrhosis (scarring and loss of function), liver cancer or death.
Hepatitis C is spread in much the same way as hepatitis B. However, compared to hepatitis B, it is more likely to be spread by exposure to blood or infected needles. This includes IV drug use and needle sharing, sexual relations or transfer of blood from mother to baby.
It is the form of hepatitis that is of most concern to individual health. It is less common than hepatitis B as a cause of acute hepatitis, but is the most common cause of chronic hepatitis. According to the CDC, from 55 percent to 85 percent of those exposed to the virus develop chronic hepatitis.
Statistically, Yuma County has the highest hepatitis C patient rate in the state of Arizona. A majority of current hepatitis C patients were infected in other states and moved to Yuma due to access to health care and mental health services.
Dr. Mitch M. Freeman, who is board certified in family practice, has a private practice in Yuma and can be reached at 314-1695. Dr. Freeman also serves as a member of the Medical Staff of Yuma Regional Medical Center.
PROPER HAND WASHING TECHNIQUES
—-WET YOUR HANDS WITH WARM WATER. ADD SOAP AND RUB YOUR HANDS TO MAKE A SOAPY LATHER
—-WASH THE FRONT AND BACK OF YOUR HANDS, BETWEEN YOUR FINGERS AND UNDER YOUR NAILS. COUNT TO 20, OR SING “HAPPY BIRTHDAY.” THIS TAKES ABOUT 20 SECONDS)
—-RINSE WELL.
—-DRY HANDS WITH A CLEAN PAPER TOWEL.
—-TURN OFF FAUCET WITH A PAPER TOWEL, IF POSSIBLE.