Overview
The term hepatitis refers to inflammation of the liver, and hepatitis B is a liver disease caused by the hepatitis B virus (HBV). In most cases, hepatitis B infection is acute and leaves the body in a few weeks. In some cases, however, it becomes chronic and can cause severe complications such as liver scarring, liver failure, or even liver cancer.
Hepatitis B Causes
Hepatitis B is caused by the hepatitis B virus (HBV). You can contract this virus in the following ways:
- Sexual intercourse with a partner infected with HBV, in which the infected person’s body fluids, such as semen, saliva, or vaginal fluid, enters your body.
- Sharing a syringe while injecting IV drugs.
- Sharing toothbrushes, nail cutters, or shaving razors that may be contaminated with infected blood.
- Getting a tattoo with equipment that is not sterilized properly.
- Transmission of the virus from an infected mother to the newborn during childbirth.
- Accidental prick with a contaminated needle. Healthcare workers and caretakers are especially prone to this.
Contact your physician immediately if you are suspicious that you might have been exposed to the virus by any of the above methods.
It is noteworthy to mention that the hepatitis B infection does not spread by:
- Kissing
- Sharing utensils
- Touching
- Coughing
Hepatitis B Symptoms
Acute hepatitis B may not always show symptoms, especially in children under 5. It may take 1 to 6 months for the symptoms to appear after the infection. Symptoms are worse in elderly patients above 60.
The most common symptoms of hepatitis B include:
- Jaundice (yellowing of the skin, nails, eyes, and urine)
- Fever
- Chronic fatigue
- Stomach ache
- Nausea or vomiting
- Decreased appetite
- Joint pain
Hepatitis B Diagnosis
Hepatitis B is diagnosed with the help of blood tests. However, your doctor may also do a physical exam, a liver ultrasound, and liver function tests (LFTs) to assess the functional status of the liver.
The blood tests used for diagnosis of hepatitis B include:
- Hepatitis B surface antigen test: This test detects the presence of antigens specific to the hepatitis B virus. Thus, a positive test implies an active infection, which means you have the virus in your body and can transmit it to others. After exposure, it takes 1 to 10 weeks for the antigens to appear in the blood. The antigens disappear in 4 to 6 months.
- Hepatitis B surface antibody test: A positive hepatitis B surface antibody test indicates a prior exposure to the hepatitis virus, which may be due to vaccination or a previous infection. The presence of antibodies suggests that you are immune to the virus and will not transmit the virus.
Hepatitis B Treatment
As an immediate first line of treatment, your doctor will administer the first dose of the hepatitis B vaccine and also inject hepatitis B immune globulin. These stimulate the immune system to fight against the virus and clear it from the body. This mode of treatment is most effective if administered within 48 hours of exposure to the virus, though it can be given within a week. Therefore, it is vital to visit your doctor at the earliest.
Your doctor will conduct certain blood tests at regular intervals to check if you still have the virus in your body. You may be treated with medications if your tests are positive even after six months. Some common medications used for the treatment of hepatitis B are:
- Oral antiviral drugs such as entecavir, adefovir dipivoxil, tenofovir, telbivudine. These medications reduce the viral load and help with the symptoms of hepatitis B.
- Injectable interferon therapy such as interferon alfa or Pegylated Interferon. They boost the immune system and also help with liver inflammation.
Possible Complications of Hepatitis B
Chronic hepatitis B can cause severe complications, some of which can even be life-threatening. The complications include:
- Liver cirrhosis
- Liver failure
- Liver cancer
- Hepatitis D
Prevention of Hepatitis B
Vaccination is key in preventing hepatitis B. CDC recommends that all babies get vaccinated with the HBV vaccine and all children below 19 years of age if not already exposed to the virus. Additionally, high-risk people should also take the vaccine.
Other ways to prevent hepatitis B are:
- Use a condom during sexual intercourse.
- Avoiding sharing needles, toothbrushes, nail clippers, and razors.
- Getting ear piercings or tattoos done only from hygienic centres that properly sterilize the equipment.
- Wearing gloves while taking care of the patients.
How Prevalent is Hepatitis B?
The WHO (World Health Organization) estimates that around 29.6 crore individuals are living with hepatitis B globally, and about 15 lakh people were newly diagnosed with chronic hepatitis B in 2019.
The good news is that the rates have gone down with more people getting vaccinated. It was an average of 2 lakh per year in the 1980s and has dropped to about 20,000 in 2016.
What is the Expected Prognosis of Hepatitis B?
One of the major factors in determining the prognosis is the age at which you contract the infection. If you were infected as an adult, there is a 95% chance that the infection will get completely cured. However, 90% of the infants infected with HBV develop chronic hepatitis and may have liver problems lifelong.