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All forms of hepatitis infect the liver, causing nausea, sickness and jaundice. Jaundice is due to a build-up of bile, normally eliminated by a healthy liver, and is characterised by yellowness of both the skin and the whites of the eyes. Dark urine and pale stools accompany jaundice.
Hepatitis A virus is spread via traces of the faeces of an infected person to the mouth, usually via inadequately washed hands. Once recovered, people are not infectious to others. A preventative vaccination is available.
Hepatitis B or C viruses are spread by bodily fluid exchange, usually via needles or unprotected sex. Once recovered, some persons become virus 'carriers' (where the virus never completely leaves the body). Some carriers are very infectious (if bodily fluids are exchanged), others less so. About fifty per cent of carriers develop liver disease. A vaccination is available for Hepatitis B, but not Hepatitis C. Vaccination is recommended for persons working with high risk people. Booster vaccinations are required every few years.
Hepatitis C infection is widespread where drug use involves needles, and is usually only found with routine blood testing for Hepatitis C antibodies. Such drug users should be tested for Hepatitis C. However, not all those with antibodies are actually infected, and further testing is usual. Follow-up of sufferers is important, as a large percentage who do still carry the virus in the liver will develop the liver disease cirrhosis in ten to twenty years time. No vaccine is yet available. For the Hepatitis C phone advice line, see Table 5.