Overview

Hepatitis B is a liver disease caused by the hepatitis B virus. Most hepatitis B infections clear up within 1-2 months without treatment. When the infection lasts more than six months, it can develop into chronic hepatitis B, which can lead to chronic inflammation of the liver, cirrhosis, liver cancer, liver failure or death

Title
Hepatitis B

Types

- Acute hepatitis B : is associated with acute viral hepatitis, an illness that begins with general ill-health, loss of appetite, nausea, vomiting, body aches, mild fever, and dark urine, and then progresses to development of jaundice

Chronic hepatitis B: Chronic infection with hepatitis B virus either may be asymptomatic or may be associated with a chronic inflammation of the liver (chronic hepatitis), leading to cirrhosis over a period of several years. It dramatically increases the incidence of the cancer of the liver.

Symptoms

Symptoms usually appear within 25 to 180 days following exposure to the virus. The most common symptoms are:

- Yellowing skin and eyes (jaundice)

- Fatigue that lasts for weeks or even months

- Abdominal pain in the area of the liver (upper right side)

- Loss of appetite

- Nausea

- Vomiting

- Joint pain

- Low-grade fever

- Dark urine and light-colored stool

- Widespread itching  Rash

Causes

Hepatitis B is caused by the hepatitis B virus. This virus is spread through contact with body fluids of an infected person, such as blood, semen, vaginal fluids, and saliva. A woman infected with hepatitis can pass the virus on to her baby during childbirth.

Diagnosis

Is based on symptoms and medical history, and physical exam. Hepatitis B is diagnosed with blood tests, which are also used to monitor its effects on the liver. For chronic cases, a liver biopsy may be needed. A biopsy is the removal of a sample of liver tissue for testing.

Treatment

The symptoms of hepatitis B can be treated with medication. Patients with uncomplicated cases can expect to recover completely.

Medications include:

Interferon alfa-2b (Intron A) injection

Lamivudine (Epivir-HBV) oral medication

Chronic hepatitis B patients should avoid anything that can further injure the liver. These include:

Alcohol

Certain medications, dietary supplements, and herbs (Discuss these substances with your doctor before taking them.)

Chronic hepatitis B patients should prevent the spread of their infection by:

Telling their doctors, dentists, and sexual partner(s) that they have hepatitis B

Never donating blood, organs, or tissue

Discussing hepatitis B status with health professionals  during pregnancy or before becoming pregnant is important  to ensure the baby receives treatment

Prevention

Hepatitis B can be prevented through vaccination, which consists of three injections over a six-month period. Protection is not complete without all three injections. Anyone at increased risk for hepatitis B should be vaccinated.

In addition, to prevent the transmission of hepatitis B :

  • Use condoms or abstain from sex
  • Limit number of sexual partners.
  • Never share needles or syringes.
  • Do not share personal items that might have blood on them, such as:
    • Razors
    • Toothbrushes
    • Manicuring tools
    • Pierced earrings
  • For health care or public safety worker:
    • Get vaccinated against hepatitis B.
    • Always follow routine barrier precautions and safely handle needles and other sharp instruments.
  • Wear gloves when touching or cleaning up body fluids on personal items, such as:
    • Bandages
    • Band-aids
    • Tampons
    • Linens
  • Cover open cuts or wounds.
  • Use only sterilized needles for drug injections, blood testing, ear piercing, and tattooing.
  • For pregnant women, have a blood test for hepatitis B.
  • Infants born to mothers with hepatitis B should be treated within 12 hours after birth.
Complications

People with hepatitis B can sometimes develop serious liver problems. These mostly affect people with an untreated long-term (chronic) infection.

- Cirrhosis

Scarring of the liver (cirrhosis) affects around 1 in 5 people with chronic hepatitis B, often many years after they first got the infection.

- Liver cancer

People with cirrhosis caused by hepatitis B have around a 1 in 20 chance of developing liver cancer every year.

- Fulminant hepatitis B In less than 1 in 100 cases, short-term (acute) hepatitis B can lead to a serious problem called fulminant hepatitis B. This is where the immune system attacks the liver and causes extensive damage to it.

Risks

Coming in contact with the blood or other body fluids of someone infected with hepatitis B increases the risk for infection. The following situations may increase the risk of getting hepatitis B:

- Having sex with someone infected with hepatitis B or who is a carrier of hepatitis B

- Injecting illicit drugs, especially with shared needles

- Having more than one sexual partner

- Being a man who has sex with men

- Living in the same house with someone who is infected with hepatitis B

- Having a job that involves contact with body fluids, such as first aid or emergency workers, funeral directors, medical personnel, dentists.

- Having a sexually transmitted disease at the time you come in contact with hepatitis B

- Traveling to areas where hepatitis B is common

- Receiving a non-safe blood transfusion

- Receiving multiple transfusions of blood or blood products, as hemophiliacs do (risk is greatly reduced with modern blood screening techniques)

- Working or being a patient in a hospital or long-term care facility

- Working or being incarcerated in a prison

- Being bitten so that the skin is broken by someone whose saliva contains the virus .

 

Recovery

Hepatitis B in adults will usually pass within one to three months. Most patient that recover from Hepatitis B, develop antibodies that protect them from the virus. However, some people, especially those infected during early childhood, remain infected for life because they never clear the virus from their bodies. Once a treatment is started, there is need for regular blood tests to see how well the treatment is working and to detect side effects or drug resistance. Monitoring will continue after finishing treatment to determine if the infection has come back. Treatment should not be stopped without discussing this with the doctor because, in some cases, the virus can come back quickly, causing severe liver injury.

Living with

- Avoid having unprotected sex – including anal and oral sex, unless the partner has been vaccinated against hepatitis B

- Avoid sharing needles used to inject drugs with other people

- Take precautions to avoid the spread of infection – such as not sharing toothbrushes or razors with other people; close contacts such as family members may need to be vaccinated

- Eat a generally healthy, balanced diet – there's no special diet for people with hepatitis B

- Avoid drinking alcohol – this can increase your risk of developing serious liver problems

- Speak to a health professional if there is a plan of having a baby

- People with hepatitis B can usually have a healthy pregnancy, but it's a good idea to discuss plans with a health professional first as there is need of extra care

There's a risk of pregnant women with hepatitis B passing the infection on to their child around the time of the birth, but this risk can be reduced by ensuring the baby is vaccinated shortly after they're born.

Self-help
Home treatment can help relieve symptoms and prevent the spread of hepatitis B virus (HBV).
  • Reduce activity to match your energy. Slow down when you are tired.
  • When feeling tired at work or school, try to reduce the workload.
  • Avoid strenuous exercise.
  • When feeling better, slowly go back to your regular activities.
  • Eat right: for most people, nausea and loss of appetite become worse as the day goes on. Try eating a substantial (but not heavy) meal in the morning and lighter meals later in the day.
  • Avoid dehydration: it is important to keep your body well-hydrated when you have hepatitis B, especially if you have been vomiting.