Hepatitis B
Hepatitis B is a liver disease caused by the hepatitis B virus (HBV) that can range from an acute infection to chronic liver conditions. While many acute infections resolve within one to two months without treatment, chronic hepatitis B can develop if the infection persists for over six months, potentially leading to severe liver complications such as cirrhosis or liver cancer. The virus is transmitted through contact with the body fluids of an infected person, including blood and sexual fluids, but it is not spread through food or water.
Individuals at higher risk include those with multiple sexual partners, injection drug users, and healthcare workers who handle body fluids. Symptoms can take weeks to months to appear and might include jaundice, fatigue, abdominal pain, and loss of appetite. Diagnosis typically involves blood tests, and treatment options vary depending on whether the infection is acute or chronic.
Prevention is effective through vaccination, which consists of three doses and is recommended for infants and high-risk adults. Safe practices, such as using condoms during sex and avoiding shared needles, are crucial in preventing transmission. Public health guidelines emphasize the importance of vaccination and safe handling protocols, especially among healthcare providers and pregnant women.
Hepatitis B
Anatomy or system affected:Abdomen, gastrointestinal system, liver
Also known as: Hep B
Definition
Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). Most hepatitis B infections clear up within one to two 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 (scarring of the liver), liver cancer, liver failure, or death.
Causes
HBV is spread through contact with the body fluids of an infected person. These fluids include blood, semen, vaginal fluids, and saliva. A woman with hepatitis can pass the virus to the fetus during birth. HBV is not spread through food or water.
Risk Factors
In 2020, the CDC reported 2,157 new cases of acute hepatitis B and 11,365 cases of chronic hepatitis B. The following factors may increase one’s 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; and living in the same home with someone who is infected with hepatitis B.
Another risk factor is employment as someone who has contact with human body fluids. These workers include first aid or emergency workers, funeral directors, medical personnel, rescue workers, firefighters, police personnel, dentists, and dental assistants.
Other risk factors are having a sexually transmitted disease when having contact with hepatitis B; traveling to areas of the world where hepatitis B is common, such as China, Southeast Asia, and sub-Saharan Africa; receiving a blood transfusion before 1992 (the year a more reliable test to screen blood was developed); receiving multiple transfusions of blood or blood products, as do hemophiliacs (a risk that has been 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 jail or prison; being bitten so that the skin is broken by someone whose saliva contains the virus; and receiving hemodialysis treatment.
Symptoms
Symptoms may appear about 25 to 180 days after one is exposed 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 of the abdomen), loss of appetite, nausea, vomiting, joint pain, low-grade fever, dark urine and light-colored stool, widespread itching, and rash.
Screening and Diagnosis
A doctor will ask about symptoms and medical history and will perform a physical exam. Hepatitis B is diagnosed with blood tests. These blood tests are also used to monitor the virus’s effect on the liver. For chronic cases, the patient may need a liver biopsy (the removal of a sample of liver tissue for testing).
Treatment and Therapy
If the patient has an uncomplicated case, they can expect to recover completely. Persons with chronic hepatitis B may be treated with medication to help reduce the activity of the virus and also to prevent liver failure. These medications include interferon alfa-2b (Intron A) injection, lamivudine (Epivir-HBV) oral medication, adefovir (Hepsera) oral medication, and entecavir (Baraclude) oral medication.
Persons who have chronic hepatitis B should avoid further injury to the liver by avoiding alcohol and certain medications, dietary supplements, and herbs. One should discuss these supplements and herbs with a doctor before taking them.
One can prevent spreading the infection to others by notifying one’s own doctors, dentists, and sexual partner or partners; by avoiding donating blood or organs for transplant; and by discussing one’s hepatitis B status with a doctor during pregnancy or before becoming pregnant to ensure the baby receives treatment.
Prevention and Outcomes
Hepatitis B can be prevented with a vaccination. It consists of three injections that are given over a period of six months. Protection is not complete without all three injections. The Centers for Disease Control and Prevention (CDC) recommend that all infants receive the vaccine within their first year (the first dose at birth, the second at one to two months, and the third between six and fifteen months), and those who were not vaccinated as infants may be vaccinated up to the age of eighteen. Above the age of eighteen, the vaccine is recommended only for those at increased risk of contracting the disease.
In addition, to prevent the transmission of hepatitis B, one should use condoms during sexual intercourse or should abstain from sex, limit the number of sexual partners, avoid injecting drugs and avoid sharing needles or syringes, and avoid sharing personal items that might have blood on them (such as razors, toothbrushes, manicuring tools, and pierced earrings). Persons who get a tattoo or a body piercing should ensure that the artist or piercer properly sterilizes the equipment. Infection can occur if the tools have another person’s blood on them.
Health care and public safety workers should get vaccinated against hepatitis B; should always follow routine barrier precautions and safely handle needles and other sharp instruments; should wear gloves when touching or cleaning up body fluids on bandages, tampons or sanitary pads, and linens; and should cover open cuts or wounds.
Pregnant women should have a blood test for hepatitis B. Infants born to women with hepatitis B should be treated within twelve hours of birth.
Bibliography
Boyer, Thomas D., Teresa L. Wright, and Michael P. Manns, eds. Zakim and Boyer’s Hepatology: A Textbook of Liver Disease. 6th ed. Philadelphia: Saunders, 2011.
Feldman, Mark, Lawrence S. Friedman, and Lawrence J. Brandt, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. 2 vols. Philadelphia: Saunders, 2010. Print.
Frank, Steven A. Immunology and Evolution of Infectious Disease. Princeton: Princeton UP, 2002. Print.
"Hepatitis B." World Health Organization. WHO, July 2015. Web. 30 Dec. 2015.
Lehrer, Jenifer K. "Hepatitis B." MedlinePlus. Natl. Lib of Health, 20 Nov. 2014. Web. 30 Dec. 2015.
Palmer, Melissa. Dr. Melissa Palmer’s Guide to Hepatitis and Liver Disease. Rev. ed. Garden City Park: Avery, 2004. Print.
Pan American Health Organization. World Health Organization. Control of Diphtheria, Pertussis, Tetanus, “Haemophilus influenzae” Type B, and Hepatitis B Field Guide. Washington, DC: Author, 2005. Print.
“2020 Hepatitis B Viral Hepatitis Surveillance Report.” CDC, 19 Aug. 2022, www.cdc.gov/hepatitis/statistics/2020surveillance/hepatitis-b.htm. Accessed 6 Mar. 2023.
"Viral Hepatitis—Hepatitis B Information." Centers for Disease Control and Prevention. Dept. of Health and Human Services, 31 May 2015. Web. 30 Dec. 2015.