Hepatitis B

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 5, 2016
StartDiseasesHepatitis B

Hepatitis B is an infection caused by the hepatitis B virus. One can either have acute hepatitis B, which gets better after a short amount of time, or chronic hepatitis B, which is a long-term infection.

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Definition & Facts

Hepatitis B is a type of hepatitis or inflammation of the liver that is caused by a viral infection. Hepatitis B can lead to scarring of the liver, liver failure, and cancer, and if left untreated, can be fatal.

The number of occurrences of this disease has decreased in recent years. Rates have drastically dropped in the last 30 years from 200,000 cases per year to 18,000. People who are between the ages of 20 and 49 are the most common demographic to get the disease.

A very small percentage of people over the age of 5 who have this disease end up with a chronic infection. Most infants who contract the virus, however, do end up with chronic hepatitis B. Currently, there are up to 1.4 million people who suffer from chronic hepatitis B infection in the United States.

Symptoms & Causes

One to four months after contracting the virus, mild or severe signs and symptoms can occur. Some of these symptoms may include fever, joint pain, stomach pain, dark urine, loss of appetite, weakness and fatigue, nausea and vomiting, and jaundice. Sometimes those with hepatitis B infection exhibit no symptoms but can still transmit the disease to others.

Causes

Hepatitis B infection is caused by a virus that is transmitted through blood, bodily fluids, and semen. This can be transmitted through sexual contact if blood, semen, saliva, or vaginal secretions are exchanged.

It can also be transmitted through the sharing needles while using intravenous drugs. Sharing any IV drug tools can put someone at risk due to the chance of having the virus present on a needle and infecting another person. Pregnant women can pass the virus onto their children during childbirth. Fortunately, newborns are able to be vaccinated to avoid being infected.

Diagnosis & Tests

To determine the presence of hepatitis B, blood tests are performed. A blood test will be able to determine if the virus is present by testing for both hepatitis B antigens which are proteins that exist on the surface of the virus as well as antibodies that the body produces to fight the hepatitis B virus. A physical examination is also necessary.

A liver biopsy may also be performed to determine if there is liver damage and what the extent of it is. During a biopsy, a doctor inserts a small needle through the skin and into the liver to remove a tissue sample to be sent to a laboratory for analysis.

Doctors may also test some healthy people for the hepatitis B infection, due to the ability of the virus to damage the liver prior to causing signs and symptoms. People should be screened for hepatitis B if they live with someone who is infected, have had sexual relations with an infected person, have unexplained abnormal results from a liver enzyme, have hepatitis C or HIV, are originally from or have family from areas that have high rates of hepatitis B, such as Asia, Africa, the Pacific Islands, and Eastern Europe.

People should also be screened if they inject illegal drugs, have spent time in prison, have received a kidney dialysis, or take immunosuppressive drugs such as medications used to prevent the body from rejecting an organ transplant. Pregnant women should also be tested.

Treatment & Therapy

Call a doctor immediately if you know you have been exposed to the virus. It is important to receive the hepatitis B vaccine shortly after exposure if one has not already been vaccinated. This may stop the development of the virus in the body. That being said, it is important to be vaccinated anyway.

Acute hepatitis B may not need treatment and may go away on its own. Fighting off this infection may require nothing more than rest and fluids. However, treatment for a chronic infection is more intense. Treatments must be done to reduce the risk of liver disease in patients with chronic hepatitis B. These treatments will also prevent the transmission of the infection to other people. Some of these treatments include antiviral drugs such as lamivudine, adefovir, telbivudine and entecavir. These drugs can help to fight the virus as well as slow down its ability to damage the liver.

Another treatment is interferon alfa-2b. This is a synthetic version of a substance that is produced by the body in order to fight infection. It is mainly used for young people with the disease who would prefer a short term treatment or if they are interested in having a baby. This drug is given by injection. This comes with some side effects including depression, chest tightness, and difficulty breathing.

A liver transplant is a third option for the treatment of chronic hepatitis B. If the liver has been damaged severely, a liver transplant is an option. To complete a liver transplant, a surgeon removes the damaged liver, replacing it with a healthy liver. The majority of transplanted livers come from liver donors who have passed away. However, some liver donations come from donors who are living, yet donate a portion of their liver.

Prevention & Prophylaxis

The hepatitis B vaccine is given over 6 months in a series of three or four injections and is a primary preventive tool. Especially if traveling to a place where Hepatitis B is common, it is important to ensure that vaccines are complete. Hepatitis B can not be contracted from the vaccine.

An important way to prevent hepatitis B from spreading is to practice safe sex. It is vital for sexual partners to discuss their respective health statuses. Using a new, unopened latex or polyurethane condom each time there is a sexual encounter can help prevent the risk of contracting hepatitis B but does not eliminate the risk altogether.

Avoiding IV drugs and not sharing needles are also imperative. Additionally, taking caution in body piercing and tattooing by only using reputable shops to perform these actions is an important preventive measure. Asking questions at piercing and tattoo parlors about the cleaning routine of the equipment is a key precautionary measure.