Definition and Overview

Hepatitis B is a common infectious disease caused by Hepatitis B virus. This attacks the liver, causing inflammation and producing the usual symptoms of the disease. Infection with Hepatitis B may be chronic or acute. Chronic infection leads to liver cirrhosis and fulminant liver failure.

According to the World Health Organization, more than 200 million people are affected with the condition worldwide. In some areas in the world, namely Africa and Asia, infection rates have been documented to be as high as 10% of the population. This condition typically develops in patients who were infected at a younger age. Approximately 90% of patients who acquire the infection during infancy and 30-50% of patients who acquire the infection before the age of five develop chronic Hepatitis B later in life. More than 780,000 patients die from the symptoms and complications of Hepatitis B infection every year.

Cause of Condition

Hepatitis B is primarily caused by Hepatitis B virus, which is also known as HBV. This virus can survive for seven days outside the body, and at this time, it can still infect vulnerable patients. Transmission of this virus is blood-borne, meaning it is transferred from one person to another via exposure to blood or other bodily fluids that are infected. The common routes of transmission include blood transfusion with infected blood products, needle stick injuries or reusing of contaminated syringes seen typically among drug users, sexual contact with an infected individual, and transmission from mother to child (vertical transmission). If no intervention is done, an infected mother has a 20% risk of transmitting the virus to her baby during childbirth. Preventive strategies are being implemented around the world to prevent the transmission of this virus. These include screening of blood products during donation, safe injection strategies, proper disposal of used needles, and the use of barrier protection (condoms) during sex.

Key Symptoms

Many people who are acutely infected with Hepatitis B do not develop any symptoms. In some patients, infection may be limited; this means that the individual is able to fight off the virus within a few months. If you are not able to fight off the infection after six months, you will become a chronic carrier. At this time, you may still not have any symptoms, but you can transmit the virus.

Some patients do develop symptoms during the acute phase of infection. The most prominent symptom is jaundice, where the skin and the white portion of the eyes become yellowish in color. Jaundice can also manifest as darkening of the urine to a brownish color. Other symptoms are not very specific and include fever, abdominal pain, vomiting, loss of appetite, muscle pains and unexplained weakness or fatigue.

Patients with chronic Hepatitis B can eventually develop liver cirrhosis, resulting in irreversible damage and scarring of the parenchyma of the liver and liver failure. Patients with cirrhosis can also present with jaundice, fluid in the abdomen (ascites) resulting in abdominal enlargement and even changes in sensorium. Some patients may also eventually develop liver cancer.

Who to See and Types of Treatments Available

Individuals who develop symptoms of HBV infection should consult a health care professional immediately. Medical professionals who specialize in the treatment of this condition include hepatologists (who treat liver diseases), gastroenterologists (who treat digestive diseases), and doctors who specialize in the treatment of infectious diseases.

Since many people who are infected do not develop symptoms, it is also recommended that high-risk groups, including drug users, patients with renal failure, on long-term hemodialysis, and health care workers, also seek consult.

Infection with Hepatitis B is diagnosed by a blood test known as the Hepatitis panel. With this test, your doctor will be able to determine whether you are infected with the virus, whether you have developed antibodies against it, and whether you are contagious. If you are indeed diagnosed to have Hepatitis B, your physician will conduct several other laboratory examinations to determine your albumin levels and bleeding parameters. Liver function test and liver biopsy are also ordered to determine any damage that the virus has already caused. .

If you have Hepatitis B, it is important to keep your liver as healthy as possible. Patients are advised to avoid intake of alcohol. You should also check what medications or supplements you are taking, as some drugs, such as acetaminophen, could have negative effects on your liver. If you are a carrier, you should schedule regular appointments with your physician so that your liver and viral levels can be monitored.

Acute infection with Hepatitis B is usually self-limiting and goes away after a couple of weeks. You should eat a healthy and nutritious diet and get a lot of bed rest in order to speed up your recovery. The liver returns to its normal state several months after the acute infection. Chronic Hepatitis B, on the other hand, is treated with oral antiviral medications, such as tenofovir. These drugs can reduce your viral load, slow down the progression of the disease, and improve survival. Injections of interferon may also be done. Interferon is a medication that can help boost a person's immune system. This helps minimize the inflammation in the liver, but can cause a number of side effects. Patients at later stages of the disease, specifically those who have already developed cirrhosis, may eventually need liver transplant as treatment.

The most important aspect in the management of Hepatitis B is prevention. A Hepatitis B vaccine is readily available and should be routinely given to all babies. Additional 2 to 3 more doses are given as the infant grows and should be completed before one year of age. More than 95% of patients who receive the complete vaccine series develop protective antibodies against HBV. Children who have not been vaccinated at birth and health care workers should also receive booster shots or catch-up doses. If you have had contact with infected blood or fluids, you can get vaccinated with a Hepatitis immune globulin or HBIG within 24 hours to prevent infection

References:

  • Hepatitis C Association. https://www.hepcassoc.org./
  • Advocacy and Support Organizations for Hepatitis. http://www.va.gov.web-resources/advocacy.asp
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