ABCs of Hepatitis
This video was created for general education on hepatitis A, B, and C in substance use disorder (SUD) programs.
EACH MOC (MAN ON CAMERA) REPRESENTS A DEMOGRAPHIC OF THE VETERAN POPULATION.
MOC SEGMENTS ARE SHOT TO MERGE OR "MORPH" INTO EACH OTHER
VO (Voice Over)
MOC #1: There are a lot of things that can mess up your body. You know...drugs...alcohol. Maybe somebody else wants you to stop gettin' messed up. Maybe you want to change that. Stop gettin' messed up.
MOC #2: So now you're thinkin' about it. That's good. You're ready to get back in control...get straight...get healthy And maybe you're wondering about how your alcohol or drug use might have affected your health.
MOC #3: Let's talk about that. People who have problems with drugs and alcohol are at higher risk for a disease called hepatitis. Hepatitis is an infection that can mess up your liver, and make any damage that drugs and alcohol might have done to it a lot worse.
GRAPHIC: ANATOMICAL ILLUSTRATION OF FULL BODY WITH ORGANS OUTLINED. PUSH IN TO GRAPHIC AND MORPH TO MORE DETAILED ILLUSTRATION OF LIVER RELATIVE TO LUNGS, HEART, STOMACH AND INTESTINES WITH BULLETS:
- Stores nutrients
- Makes and regulates body substances
- Breaks down alcohol and drugs
- Gets rid of waste
- Fights infection, helps stop bleeding
VO: Your liver is a pretty important organ...bigger than your heart or stomach...right behind the lower ribs on the right side of your body. It does a lot of things to keep you healthy.
It stores the vitamins, sugars, fats and other good nutrients from the food you eat. It makes some of the substances your body needs, and makes sure your body gets the right amount of other substances it needs. It breaks down harmful substances like alcohol or poisonous chemicals.
It gets rid of waste products in your blood. It fights infection, and helps stop bleeding.
MOC SEGMENTS CONTINUE
MOC #2: Your liver is kind of like a gate keeper for your whole body. It lets the good guys in and gets the bad guys out. When it's healthy, it works like it's supposed to. But if your liver gets sick, it can't do a very good job. It's kind of like when a garbage disposal stops working and all that stuff backs up into the sink. Trouble is, a lot of the time you don't even know you got hepatitis. And that can kill you.
MOC #1: When your liver stops working, you're stuck with a lot of junk that should be going down the drain and it can't get out. You got a real mess to clean up. Worse, if you don't know you have it, you can give hepatitis to someone else and make them real sick too.
MOC #3: If you ignore it, hepatitis can be the worst kind of killer. The one that some people don't find out about until it's too late. So maybe you need to find out more about it. You have to have a blood test to find out if you've been exposed to hepatitis. Then you need to know that no matter what the test shows, your situation doesn't have to stay the way it is. If you have hepatitis, there are treatments that can keep it from getting worse, possibly even cure it. There are ways that you can keep from spreading it. And if you don't have hepatitis, there are things you can do to keep from getting it.
GRAPHIC: ANATOMICAL ILLUSTRATION OF FULL BODY WITH ORGANS OUTLINED WITH TEXT:
- hepatitis A virus (HAV)
- hepatitis B virus (HBV)
- hepatitis C virus (HCV)
- "inflammation of the liver" appears next to the liver
VO: The most common forms of hepatitis in this country are hepatitis A, B and C. The main differences are how you get each virus, how long you have it, and what each virus can do to your liver. The word hepatitis means swelling or inflammation of the liver after it's been attacked by a virus. A, B or C refers to the kind of hepatitis virus that's making your liver sick.
GRAPHIC: PHOTO OF RAINDROPS HITTING A PUDDLE... MORPHS INTO PHOTO OF HANDS DOING FOOD PREP WORK... MORPHS INTO PHOTO OF JAUNDICED MAN...MORPHS INTO ANATOMICAL ILLUSTRATION
TEXT: Hepatitis A virus (HAV)
- Spreads through food or water contaminated with human waste
- May produce flu-like symptoms or jaundice
- May further damage diseased liver
VO: Hepatitis A virus, called HAV, is usually spread through food or water that's been contaminated by human waste, like can happen after a flood or hurricane, or when people who have hepatitis A don't wash their hands before preparing food.
If you get HAV infection, you might feel like you have the flu. Your skin or the whites of your eyes can look a little yellow. This is called jaundice. Most people who get HAV infection get well again in about six months. A lot of people who get hepatitis A don't feel or look bad at all. But if you already have liver disease, hepatitis A can do a lot more damage to your liver.
GRAPHIC: OVER SOFT FOCUS PHOTO OF COUPLE ...MORPHS INTO PHOTO OF DRUG WORKS (SYRINGES, FOIL, WHITE POWDER)... MORPHS INTO PHOTO OF TATTOOED AND PIERCED MALE TORSO... MORPHS INTO SOFT FOCUS PHOTO OF COUPLE, AMBIGUOUS POSE, COULD BE DRUGS OR SEX
TEXT: Hepatitis B virus (HBV)
- Spreads through contact with infected blood, sexual fluids or spit
VO: Hepatitis B virus, called HBV, is spread in different ways.
You get it by coming in contact with blood, sexual fluids or spit.
That means you can get it if you're sharing needles, cookers, filters, or water for shooting up, or if you snort cocaine or meth. If you have unprotected sex with someone who has hepatitis B. If you get a tattoo with a contaminated needle, or if you accidentally get stuck with a contaminated needle, or if your blood is exposed in any way to blood that carries the hepatitis B virus.
GRAPHIC: PHOTO OF A MAN HOLDING HIS HEAD IN A TOWEL ... MORPHS INTO PHOTO OF OLDER MAN HOLDING HIS HEAD... MORPHS INTO PHOTO OF YOUNGER MAN WITH PAINED EXPRESSION HOLDING HIS HEAD ... MORPHS INTO PHOTO OF A WOMAN WITH PAINED EXPRESSION HOLDING HER HEAD
TEXT: Hepatitis B may cause
- no symptoms or flu-like symptoms
- feeling tired
- lack of appetite
- diarrhea or vomiting
- yellowish skin or eyes (jaundice)
VO: You can have it and not even know it, or you might feel bad, kind of like the flu again, only worse, with pains in your muscles, stomach or joints.
You could feel tired, and not feel like eating. You can have diarrhea or vomiting. You might get yellowish skin or eyes.
GRAPHIC CHANGES TO LIVER MAN
VO: Like hepatitis A, hepatitis B can go away on its own, or it can turn into chronic hepatitis B. That means a disease you have for the rest of your life.
PICTURE CHANGES TO DISEASED LIVER
TEXT: If untreated, chronic hepatitis B could cause cirrhosis, or scarring on your liver. It can also lead to liver cancer.
VO: If chronic hepatitis B isn't treated, you could develop cirrhosis, a condition where scar tissue blocks up your liver and keeps it from working right.
Chronic hepatitis B can also lead to liver cancer.
GRAPHIC: BLOOD CELL IMAGE...MORPHS INTO PHOTO OF DRUG WORKS...MORPHS INTO PHOTO OF TATTOOED TORSO ...MORPS INTO PHOTO OF HEALTH CARE WORKER IN SCRUBS WITH BLOODY LATEX GLOVES
TEXT: Hepatitis C virus (HCV) spreads through contact with infected blood by
- sharing drug works
- contaminated needle
- unprotected sex with someone with hepatitis C (not often)
- blood transfusion before 1992
VO: Hepatitis C, or HCV, is spread by direct exposure to blood, like can happen if you share drug works, or snort cocaine or meth. You can get it through body piercing or getting a tattoo with a contaminated needle.
If you're a health care worker, you can get the hepatitis C virus if you accidentally get stuck with a contaminated needle.
Hepatitis C can be spread by unprotected sex with someone who has hepatitis C, but this does not happen often.
You might be exposed if you get hemodialysis, or if you had a blood transfusion before 1992.
GRAPHIC: TEN MALE AND FEMALE SHADOW FIGURES IN BLACK...8 OF 10 FIGURES TURN YELLOW
TEXT: Hepatitis C turns into chronic hepatitis C in up to 8 out of 10 people
GRAPHIC: 4 OF 8 YELLOW SHADOW FIGURES TURN GREEN
TEXT: 4 may progress to cirrhosis
GRAPHIC: 1 GREEN FIGURE TURNS RED
TEXT: 1 may experience liver failure or get liver cancer
VO: The symptoms are often mild, and sometimes treatment can eliminate the virus from your body.
The danger with hepatitis C is that up to eight out of ten people who are exposed to it develop chronic hepatitis C. They have it for the rest of their lives unless they get treatment. Many people with hepatitis C remain healthy, especially if they have good health habits. On the other hand, out of the eight people with chronic hepatitis C, up to four may progress to cirrhosis. About one of those four experiences liver failure or get liver cancer. In fact, HCV is the leading reason that people need liver transplants in the United States.
TEXT: Hepatitis C is the main reason people need liver transplants in the United States
MOC # 2: The bottom line is, you don't want to get any form of hepatitis. If you have one kind, you don't want to get another kind, because together they'll make you sicker. And you don't want to give hepatitis to anybody else. So how can you keep from getting sick in the first place?
GRAPHIC: SOFT FOCUS PHOTO OF HANDS DRAWING UP A SYRINGE
TEXT: Hepatitis A & B vaccination
- Inactive hepatitis virus is injected into your body
- Your body recognizes the inactive virus as disease cells, and produces living cells, or antibodies, to fight them
- Getting vaccinated will not make you sick.
VO: The best way to prevent hepatitis A and B is to get vaccinated. There is no vaccination for hepatitis C. To vaccinate you against A or B, your doctor injects inactive hepatitis virus into your body.
Your body reacts to the inactive virus cells by producing antibodies, or living cells that your body makes to fight certain diseases.
VO: It's important to know that you can't get hepatitis A or B from the vaccination, so you don't have to be afraid of it making you sick. Testing can tell you if you need a vaccination.
MOC #3: It couldn't be much simpler. Depending on what vaccine you need, you may get two or three shots. The hardest part is remembering to get the last shot six months later.
TEXT: Remember to return to your clinic six months later for your last shot.
SILENT PAUSE FOR EMPHASIS
MOC #2: Now it may sound like a bad idea to be putting the virus into your body when the whole reason for a vaccination is to keep you from getting hepatitis. So remember, these inactive virus cells are actually dead. That's why they can't make you sick. The vaccinations just keep you from getting hepatitis A or B.
VO: The VA recommends that all veterans with any of these risk factors be vaccinated for hepatitis A and B. If you're using needles to inject drugs. If you have multiple sex partners, unprotected sex, or a history of sexually transmitted diseases, including HIV or AIDS. If you're a man who has sex with men.
VIDEO: GRAPHIC OF A TARGET
TEXT: Risk Factors for Hepatitis A & B:
- Injecting drugs
- Multiple sex partners, unprotected sex, or history of STDs
- Sex with other men
- Liver disease
- Tattoos or body piercings
- Hepatitis B in household
- Work with blood or body fluids
- Time in prison
- Personal contact with prisoners or former prisoners
- Travel to underdeveloped countries
- If you already have any form of liver disease from alcohol or hepatitis C.
- If you have tattoos or body piercings.
- If someone you live with has hepatitis B.
- If you work with blood or body fluids.
- If you've spent time in prison.
- If you have personal contact with prisoners or former prisoners.
- If you plan to travel to underdeveloped countries.
MOC # 1: And remember, if you protect yourself against getting hepatitis A or B, then you can't give it to anybody else. But now you're thinking, what about hepatitis C?
TEXT: There is no vaccine for hepatitis C.
VO: The vaccines don't keep you from getting hepatitis C, and they are not a cure for any kind of hepatitis.
CHANGE TEXT: You can keep from getting hepatitis C by avoiding contact with other people's blood.
VO: The best way to keep from getting hepatitis C is to avoid coming into contact with other people's blood. Here are some of the most obvious ways.
Don't share personal items that might have blood on them, like razors and toothbrushes.
GRAPHIC: CLOSE-UP OF A MAN SHAVING WITH RAZOR CROSSED OUT ... PHOTO OF SYRINGES AND CAN CROSSED OUT...PHOTO OF JEANS POCKET WITH CONDOM STICKING OUT... PHOTO OF PERSON IN SCRUBS WITH BLOODY LATEX GLOVES AND A SURGICAL INSTRUMENT IN THEIR HAND...PHOTO OF PHYSICIAN ... PHOTO OF PATIENT WITH PHYSICIAN
TEXT CHANGE: Don't share personal items.
TEXT CHANGE: Don't inject drugs.
VO: Don't inject drugs. If you can't stop, use a new needle every time, and don't share your needle or works with anyone else. You can buy new needles at a pharmacy without a prescription.
TEXT CHANGE: Use a new condom (rubber) every time you have sex.
TEXT CHANGE: Report needle sticks or other injuries.
TEXT CHANGE: Ask your doctor about other risk factors for hepatitis C.
VO: Use a new condom, or rubber, every time you have sex. The virus usually can't get through the latex barrier. The risk of transmitting hepatitis C sexually is actually pretty low. If you're a health care worker, handle needles and other sharp objects carefully, and report any needle stick or other injury to your supervisor.
Your doctor can tell you about more specific risk factors for hepatitis C and how to avoid them. What you do about them can be a life-saving decision, because up to 80% of patients develop chronic hepatitis C after their first exposure to the virus.
MOC #2: So now you're wondering, what if you find out that you already have hepatitis C? Does that mean you're going to be sick for the rest of your life, and that hepatitis C is eventually going to kill you? The simple answer is no. Here's why.
GRAPHIC: PHOTO OF VIAL OF BLOOD... PHOTO OF PHYSICIAN...PHOTO OF PHYSICIAN AND PATIENT ...PHOTO OF SCIENTIST WITH MICROSCOPE ... PHOTO OF SCIENTIST WITH VIALS...PHOTO OF PATIENT WITH PHYSICIAN... PHOTO OF HANDS WITH GLOVES DRAWING UP A SYRINGE
VO: If the test shows that you have the hepatitis C virus, the most important thing to know is that there are treatments for it. The first thing to do is be evaluated by your doctor, even if you don't feel sick. You can have the virus in your body for a long time without even knowing it.
A complete evaluation helps your doctor determine the best treatment for you at the time your hepatitis C is diagnosed. In some people, the virus can be totally eliminated.
But even if that's not the case, you can live a long time with hepatitis C if you learn how to protect your liver from further damage. Scientists are doing lots of research to better understand how to treat people with hepatitis C. There is hope for better treatments in the future that will cure even more people. You need to be connected with a treatment program so you can protect your liver and take advantage of new treatments when they are available.
Getting vaccinated for hepatitis A and B is one thing you can do, because if you have hepatitis C, you have a much greater risk for complications if you pick up another virus.
GRAPHIC: PHOTO OF BEER GLASSES MORPHS TO CROSSED OUT BEER GLASSES
VO: Another important step is to stop drinking any alcohol.
VIDEO: MOC SEGMENT
MOC #2: OK, now that's easier said than done, right? It's tough to stop doing things you're used to, even if they're causing problems in your life. But if you have hepatitis C, you have to deal with it. Quitting drinking is one of the ways that can help your body live with hepatitis C. People are going to be telling you that a lot.
If you're drinking enough to think that you should try to stop, or if someone else thinks you are, then you're probably drinking enough to damage your liver. Too much alcohol makes your liver get inflamed. After a while, the inflamed part develops scar tissue, just like when you cut yourself.
MOC #3: If you've been drinking a lot for a long time, eventually the scar tissue can block up parts of your liver so it can't do a good job of getting rid of your body's waste. That's called cirrhosis. Remember the clogged garbage disposal? Everything backs up to where it's not supposed to be, and you're going to get sick. Hepatitis C makes your liver get inflamed and can cause scarring and cirrhosis too.
MOC #1: So it's like, if you've got an open sore that's inflamed and raw, you try to keep from hurting it again, right? Well, if your liver is inflamed, drinking alcohol is going to hurt it more. You wouldn't deliberately aggravate an open sore. Why would you do that to your liver? That's an extreme example, but you get the point. If you have hepatitis C, drinking is going to make it worse. You have to stop or at least cut way down. Less is better, but no alcohol is best. But you must be thinking about quitting or you wouldn't be here. And deciding to stop is the first step.
GRAPHIC: CHANGING PHOTOS OF ALCOHOL USE: SOFT FOCUS PHOTO OF STORE SHELF WITH LIQUOR BOTTLES, PHOTO OF MAN WITH A DRINK AT A BAR, PHOTO OF MARTINI GLASS, PHOTO OF MAN WITH A GLASS IN HIS HAND HOLDING HIS HEAD
VO: A drug or alcohol problem can make many health challenges harder to manage. The opposite is also true. A health challenge can make it more difficult to overcome a drug or alcohol problem. Excessive drinking or hepatitis can do significant damage to your liver. If they occur together, the damage can be much worse, with serious consequences to your health and your recovery. That's why it's important to be tested for hepatitis.
LIVER CELL GRAPHIC WITH TEXT:
Hepatitis C Prevention:
- CHANGE TEXT: Avoid other people's blood
- CHANGE TEXT: Cut down or quit alcohol and drugs, Don't share needles, cookers, filters, or water for shooting up
CHANGE TEXT: If you test positive for hepatitis C:
- CHANGE TEXT: Get a medical evaluation and get into a treatment program,
- CHANGE TEXT: Get vaccinated against hepatitis A and B,
- CHANGE TEXT: Ask your doctor for information.
AUDIO: If your test is negative, there are things you can do to avoid getting hepatitis. You've heard about many of them. You should avoid contact with other people's blood. You can cut down or quit drinking and drugging, and don't share works.
If your test is positive for the virus, you can be evaluated and get into a treatment program right away and learn to manage the disease. If the test indicates it, you should also be vaccinated against hepatitis A and B.
And you can always ask your doctor for information.
MOC # 1: The purpose of this clinic is to help you recover from your drug or alcohol problem. The medical professionals here can help you put together what you need to support your efforts. You won't be going through recovery by yourself.
MOC #2: Other people who know you're trying to stop drinking or using drugs can help too. Let them know if you're having a hard time. Talk about it with someone who wants you to succeed as much as you do. They can help you over the rough spots.
MOC #3: Protecting yourself from hepatitis will also help your recovery. Keeping your liver healthy improves the health of your whole body. Work with your doctor to decide the next step that's best for you.