Hepatitis B : Sign & Symptoms, Transmission, Risk factors, Diagnosis, Complication, Treatment and Prevention

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis of liver (permanent scarring of the liver). Most people infected with hepatitis B as adults recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic hepatitis B infection. A vaccine can prevent hepatitis B infection but there’s no cure if you have it. If you’re infected, taking certain precautions can help prevent spreading HBV to others.

In 2016, the World Health Assembly passed the Global Health Sector Strategy on Viral Hepatitis, which included specific targets for eliminating Hepatitis B virus and Hepatitis C virus by 2030. Therefore, to estimate hepatitis B surface antigen prevalence, prophylaxis, diagnosed and treatment in the general population and also specially in children aged 5 years at that time, researchers combined traditional meta-analysis, national expert interviews, and modeling to determine these quantifications. They found the global prevalence of hepatitis B surface antigen in 2016 was 3.9% (291,992,000 infections), which is higher than previous studies because it excluded studies performed in blood donors and other non-representative populations. Of these infections, around 29 million (10%) were diagnosed, and only 4.8 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Among children aged 5 years, there were approximately 1.8 million infections with a prevalence of 1.4%.

Sign & Symptoms of Hepatitis B infection :

Signs and symptoms of hepatitis B, ranging from mild to severe, usually appear about one to four months after infection.

Hepatitis B infection may be either short-lived (acute) or long lasting (chronic).

  • Acute hepatitis B infection lasts less than six months. Patient immune system likely can clear acute hepatitis B from his/her body, and the patient should recover completely within a few months. Most people who acquire hepatitis B as adults have an acute infection, but it can lead to chronic infection.
  • Chronic hepatitis B infection lasts six months or longer. When the patient immune system can’t fight off the acute infection, hepatitis B infection may last a lifetime, possibly leading to serious illnesses such as cirrhosis and liver cancer.

The younger people are when get hepatitis B – particularly newborns or children younger than 5 years of age; the higher chances to infection becoming chronic. Chronic infection may go undetected for decades until a person becomes seriously ill from liver disease.

Signs and symptoms of hepatitis B may include:

  • Abdominal pain
  • Dark urine
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea and vomiting
  • Weakness and fatigue
  • Yellowing of your skin and the whites of your eyes (jaundice)

Time of Doctor Consulting :

  • If the person know he or she have been exposed to hepatitis B; consult with doctor immediately. A preventive treatment may reduce risk of infection if he/she receive the treatment within 24 hours of exposure to the virus.
  • If patient have signs or symptoms of hepatitis B, consult immediately with doctor.

Mode of Transmission of HBV:

Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from person to person through the contaminated blood, semen or other body fluids.

Common ways HBV is transmitted include:

  • Sexual contact : Person may become infected if the person have unprotected sex with an infected partner whose blood, saliva, semen or vaginal secretions enter in the body.
  • Sharing of needles : HBV is easily transmitted through needles and syringes contaminated with infected blood. Sharing intravenous (IV) drug paraphernalia puts you at high risk of hepatitis B.
  • Accidental needle sticks : Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.
  • Mother to child : Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated to avoid getting infected in almost all cases. If the person is pregnant or want to become pregnant; always talk to doctor about being tested for hepatitis B.

    Modes of transmission of hepatitis B

Risk factors of HBV infection :

Hepatitis B spreads through contact with contaminated blood, semen or other body fluids from an infected person. Risk of hepatitis B infection increases if the person:

  • Have unprotected sex with multiple sex partners or with someone who’s infected with HBV
  • Share needles during intravenous (IV) drug use
  • Are a man who has sex with other men
  • Live with someone who has a chronic HBV infection
  • Are an infant born to an infected mother
  • Have a job that exposes the person to contaminated human blood.
  • Travel to regions with high infection rates of HBV, such as Africa, Central and Southeast Asia, and Eastern Europe

Diagnosis of Hepatitis B infection : 

If the doctor suspects that the person have hepatitis B infection then he or she will examine and likely order for HBsAg blood test. Blood tests can determine if patient have the virus in his or her circulation system and whether it’s acute or chronic. Doctor might also want to remove a small sample of your liver for testing (liver biopsy) to determine whether patient have liver damage. During this test, doctor inserts a thin needle through patient’s skin and into the liver and removes a tissue sample for laboratory analysis.

Doctor sometimes test certain healthy people for hepatitis B infection because the virus can damage the liver before causing signs and symptoms. Talk to doctor about screening for hepatitis B infection if the person:

  • Live with someone who has hepatitis B infection.
  • Have had sex with someone who has hepatitis B infection.
  • Person have a liver enzyme test with unexplained abnormal results.
  • Have HIV or hepatitis C infected.
  • Are an immigrant from, have parents from or have adopted children from places where hepatitis B is common, including Asia, the Pacific Islands, Africa and Eastern Europe
  • Inject illegal drugs.
  • People are an inmate.
  • Are a man who has sex with men.
  • Receive kidney dialysis.
  • Take medications that suppress the immune system, such as anti-rejection medications used after an organ transplant
  • Are pregnant.

Complications of Hepatitis B infection :

Having a chronic HBV infection can lead to serious complications, such as:

  • Scarring of the liver (cirrhosis) : The inflammation associated with a hepatitis B infection can lead to extensive liver scarring (cirrhosis), which may impair the liver’s ability to function.
  • Liver cancer : People with chronic hepatitis B infection have an increased risk of liver cancer.
  • Liver failure : Acute liver failure is a condition in which the vital functions of the liver shut down. When that occurs, a liver transplant is necessary to sustain life.
  • Other conditions : People with chronic hepatitis B may have kidney disease, inflammation of blood vessels or anemia.

Treatment of Hepatitis B infection :

If the person know he/she have been exposed to the hepatitis B virus; consult with physician immediately. If the person haven’t been vaccinated or aren’t sure whether he or she have been vaccinated or whether responded to the vaccination, receiving an injection of hepatitis B immune globulin within 12 hours of coming in contact with the virus may help protect the person from developing hepatitis B infection. Person should be vaccinated at the same time.

Treatment for acute hepatitis B infection :

If the doctor determine hepatitis B infection is acute; patient may not need treatment. Instead, doctor might recommend rest and adequate nutrition and fluids while body fights the infection.

Treatment for chronic hepatitis B infection :

If the patient have been diagnosed with chronic hepatitis B infection then the patient may have treatment to reduce the risk of liver disease and prevent from passing the infection to others. Some common treatments include:

  • Antiviral medications : Several antiviral medications including lamivudine (Epivir), adefovir (Hepsera), telbivudine (Tyzeka) and entecavir (Baraclude) can help fight the body’s immunosystem against the virus and slow its ability to liver damages. Always consult with the doctor about which medication might be right for the patient.
  • Interferon alfa-2b (Intron A) : This synthetic version of a substance produced by the body to fight infection is used mainly for young people with hepatitis B who don’t want to undergo long-term treatment or who might want to get pregnant within a few years. It’s given by injection. Side effects may include depression, difficulty breathing and chest tightness.
  • Liver transplant : If the patient liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their liver.

Prevention of Hepatitis B infection :

The hepatitis B vaccine is typically given as three injections over six months. People can’t get hepatitis B from the vaccine.

The hepatitis B vaccine is recommended for:

  • Newborns.
  • Children and adolescents not vaccinated at birth.
  • Anyone who has a sexually transmitted infection, including HIV.
  • Developmentally disabled people who live in an institutional setting and staff.
  • Health care personals, emergency workers and other people who come into contact with blood.
  • Men who have sex with men.
  • People who have multiple sexual partners.
  • Person with chronic liver disease.
  • People who inject illicit drugs.
  • Person who live with someone who has hepatitis B infection.
  • People with end-stage kidney disease.
  • Sexual partners of someone who has hepatitis B infected.
  • Travelers planning to go to an area of the world with a high hepatitis B infection rate.
  • Take precautions to avoid HBV infection.

Other ways to reduce your risk of HBV include:

  • Know the HBV status of any sexual partner. Don’t engage in unprotected sex.
  • Use a new latex or polyurethane condom every time of intercourse before intercourse always know the health status of the partner. Remember that although condoms can reduce risk of contracting HBV, they don’t eliminate the risk.
  • Stop using illicit drugs. If the person use illicit drugs, get help to stop. If he/she can’t stop, use a sterile needle each time for inject illicit drugs. Never share needles.
  • Be cautious about body piercing and tattooing. If he or she get a piercing or tattoo, look for a reputable shop. Ask about how the equipment is cleaned. Make sure the employees use sterile needles. If the shop personnel can’t get answers, look for another shop.
  • Ask about the hepatitis B vaccine before travel. If the person’re traveling to a region where hepatitis B is common, ask doctor about the hepatitis B vaccine in advance. It’s usually given in a series of three injections over a six-month period.

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