May is Hepatitis Awareness Month and May 19th is Hepatitis Testing Day

By Sarah de Ruiter, BSN, RN, MA, Immunization Nurse Educator, Michigan Department of Health and Human Services, Division of Immunization

Centers for Disease Control and Prevention (CDC) and MDHHS would like to bring awareness to viral hepatitis. Hepatitis is a disease that affects the liver. A person may have a flu-like illness or experience a quick onset of symptoms. Symptoms may include fever, headache, malaise, anorexia, nausea, vomiting, diarrhea, abdominal pain, or dark urine. However, people do not often show any symptoms and without a blood test they may never know they are infected with hepatitis. Millions of Americans are living with chronic hepatitis and may not know it but can still infect others. Knowing the facts will help protect others.

Hepatitis A Virus

Hepatitis A virus (HAV) is an acute illness often with a discrete onset of symptoms.

HAV infection is widely underreported and is estimated that approximately 25,000 people are infected annually. HAV is transmitted through fecal-oral route. This can happen through:

  • Close person-to-person contact with infected person
  • Sexual contact with infected person
  • Ingestion of contaminated food/water

At increased risk for HAV:

  • International travelers
  • Men who have sex with men
  • People who use injection or non-injection drugs
  • People with occupational risk of exposure
  • Close personal contact with an international adoptee
  • Experiencing homelessness

At increased risk for severe HAV:

  • People with chronic liver disease
  • People with HIV

Hand washing and hepatitis A vaccination are key in preventing infection.

For more information, go to: or

Hepatitis B Virus

Hepatitis B Virus (HBV) is an acute or chronic illness. Over 860,000 people are living with HBV in the U.S. and over 1,600 people die every year due to the complications of having HBV. HBV is most commonly transmitted sexually or at birth from mother-to-child. HBV is transmitted through percutaneous (punctures of the skin) and through mucosal contact with infectious blood or body fluids. This can happen through:

  • Having sex with an infected partner
  • Injection-drug use or by sharing needles, syringes, or drug-preparation equipment
  • Birth to an infected person
  • Contact with blood or contaminated body fluids of an infected person
  • Exposures to needle sticks or sharp instruments
  • Sharing razors, toothbrushes, nail clippers, glucose monitoring equipment (anything that contains contaminated blood or body fluids)

The best way to prevent the spread of HBV is to be fully vaccinated with hepatitis B (hepB) vaccine. All babies need hepB vaccine within 24 hours of birth to have a safety net of protection. Babies born to an HBV infected person need hepB vaccine and hepB immune globulin (HBIG) within 12 hours of life, a complete hepB vaccine series and post-vaccination serologic testing.

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The hepB vaccine is recommended for:

  • All infants
  • Unvaccinated children under 19 years of age
  • Adults 19 through 59 years of age
  • Adults 60 years and older with risk factors for HBV

The following may also receive hepB vaccination:

  • Adults 60 years and older without known risk factors for HBV

For more information, go to the MMWR, Universal Hepatitis B Vaccination in Adults Aged 19-59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices – United States, 2022:

Hepatitis C Virus

Hepatitis C virus (HCV) is an acute or chronic illness. Over 3.5 million people are chronically infected in the U.S. HCV is most commonly transmitted through blood exposures. This can happen through:

  • Sharing drug injection or preparation equipment
  • Birth to an infected person
  • Health care exposures
  • Sex with an infected person (not common, more common among men who have sex with men)
  • Unregulated tattoos/body piercings
  • Sharing personal items (razors, toothbrushes, nail clippers, glucose monitors)
  • Blood transfusions and organ transplants

The best way to prevent the spread of HCV is avoid sharing or reusing needles, syringes, or any other drug preparation equipment. Do not share personal items and do not get tattoos or body piercings from an unlicensed facility. Current treatments can cure most people of HCV in 8 – 12 weeks.

MDHHS launched the We Treat Hep C Initiative in April 2021 to increase access to HCV treatment for Michigan Medicaid and Healthy Michigan Plan beneficiaries. Below are the changes:

Prior authorization removed for MAVYRET® Sobriety and prescriber criteria removed.
Any prescriber with prescriptive authority can treat HCV. MDHHS has implemented complimentary HCV consultation programs to help providers feel more confident treating patients with HCV.

For more information, go to:, or