Hepatitis B

1 What is Hepatitis B?

Hepatitis B is a very serious liver condition  caused by the hepatitis B  virus or HBV. In some individuals, this infection become chronic , meaning it lasts more than six months.

Having chronic hepatitis B increases the risk of developing liver failure, liver cancer or cirrhosis, which is the permanent scarring of liver tissue. Most individuals affected with hepatitis B as adults recover fully regardless of the severity of their condition. Infants and children are more likely to develop chronic hepatitis B infection.

There is a vaccine that can help prevent hepatitis B, but no cure is available. For infected individuals, taking certain precautions can help prevent spreading HBV to others.

2 Symptoms

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

Hepatitis

The signs and symptoms of hepatitis B include:

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3 Causes

Hepatitis B is caused by the hepatitis B virus. This virus is passed from one individual to another through blood or any other body fluid.

HBV can be trasmitted through the following ways: 

  • having unprotected sex with an infected individual whose blood, saliva, semen or vaginal secretions enter the body.
  • needles and syringes that have been contaminated with infected blood.
  • sharing intravenous drug objects also puts on at a high risk of infection.

Hepatitis B is a concern for health workers and anyone who comes in contact with human blood. Pregnant women with the HBV can pass it to their babies during childbirth.  However, the newborn can be vaccinated to avoid getting infected in almost all cases. Talking  to a doctor about being tested for hepatitis B for women who are pregnant or simply have the desire to be. 

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

Acute hepatitis B infection lasts  for a period less than six months. The immune system likely can clear acute hepatitis B from the body, and one 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 your 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 one is when is when they get hepatitis B — particularly newborns or children younger than 5 — the higher their risk the infection becoming chronic. Chronic infection may go undetected for decades until a person becomes seriously ill from liver disease.

4 Making a Diagnosis

Making a diagnosis of hepatitis B is done by performing several tests.

One is initially likely to start by seeing their family doctor or general practitioner. However, in some situations, a reference can be made to a specialist. Doctors who specialize in treating hepatitis B include: 

  • Doctors who treat digestive diseases or gastroenterologists,
  • doctors who treat liver diseases or hepatologists and
  • doctors who treat infectious diseases.

The following information can prepare one for their appointment with a doctor:

  • When making plans,  it is vital to ask if anything can be done in advance, such as making diet restrictions.
  • One must also take the time to write down their symptoms including those that may seem unrelated to the reason for the appointment.
  • Writing down key personal information such as major stresses  and any recent life changes is important as well.
  • One must also make a list of all medications, vitamins and supplements that they are taking.
  • It is always beneficical to consider bringing a family member or friend along. They can remember any information that can be overlooked or forgotten.

Another stage is writing down the questions to ask the doctor, these questions may include:

  • What is likely causing my symptoms or condition?
  • Other than the most likely cause, what are other possible causes for my symptoms or condition?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • Has the hepatitis B damaged my liver or caused other complications, such as kidney problems?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there restrictions that I need to follow?
  • Should I see a specialist?
  • Should my family be tested for hepatitis B?
  • How can I protect people around me from hepatitis B?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there brochures or other printed material I can have?
  • What websites do you recommend?

One must always expect questions from their doctor, ome of these question include:

  • When did your symptoms begin?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have you ever had a blood transfusion?
  • Do you inject drugs?
  • Have you had unprotected sex?
  • How many sexual partners have you had?
  • Have you been diagnosed with hepatitis?

If a doctor suspects one to to be having hepatitis B, he or she will examine the individual and likely order blood tests. Blood tests can determine the presence of the virus in the system and whether it's acute or chronic.

The doctor might also want to remove a small sample of the liver for testing (liver biopsy) to determine whether you have liver damage. During this test, a thin needle is inserted through the skin and into the liver and a tissue sample is removed for laboratory analysis.

Doctors sometimes test certain healthy people for hepatitis B infection because the virus can damage the liver before causing signs and symptoms.

5 Treatment

Treatment of hepatitis B infection depends on how active the virus is and whether you are at risk for liver damage such as cirrhosis.

If one knows that they have been exposed to hepatitis B virus, they must call the doctor immediately. Also, if one is not vaccinated or isn't sure they have been vaccinated or not knowing whether they respond to the vaccination, receiving an injection of hepatitis B immune globulin within 12 hours of coming in contact with the virus may help protect one from developing hepatitis B.

If one's doctor has determined that the hepatitis B infection is acute, they may not require treatment as the infection is short-lived and will go away on its own. Instead, the doctor might recommend rest and adequate nutrition and fluids while the body fights the infection.

On the other hand, if one has been diagnosed with chronic hepatitis B infection, treatment may be given to reduce the risk of liver disease and prevent one from passing the infection to others. Treatments include:

  • Several antiviral medications — including lamivudine (Epivir), adefovir (Hepsera), telbivudine (Tyzeka) and entecavir (Baraclude) which  can assist in the fight against the virus and slow its ability to damage the liver.
  • If the liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes a damaged liver and replaces it with a healthy one. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.

Other drugs to treat hepatitis B are being developed.

6 Prevention

A vaccine exists that can help prevent hepatitis B.

The hepatitis B vaccine is usually given as three or four injections  during a period of over six months. 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 workers, emergency workers and other people who come into contact with blood.
  • Homosexual men People who have multiple sexual partners
  • People with chronic liver disease
  • People who inject illicit drugs
  • People who live with someone who has hepatitis B
  • People with end-stage kidney disease.
  • Sexual partners of someone who has hepatitis B.
  • Travelers planning to go to an area of the world with a high hepatitis B infection rate take precautions to avoid HBV.

Other ways to reduce your risk of HBV include:

  • Know the HBV status of any sexual partner. Using a new latex or polyurethane condom every time you have sex if the health status of a partner is not known.
  • Remember that although condoms can reduce your risk of contracting HBV, they don't eliminate the risk.
  • Stop using illicit drugs. Avoiding the use of illicit drugs.
  • If one finds it difficult stop, a sterile needle must be used each time illicit drugs are injected into the body.
  • If you 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 you can't get answers, look for another shop. 
  • If you're traveling to a region where hepatitis B is common, ask your doctor about the hepatitis B vaccine in advance. It's usually given in a series of three injections over a period of six months.

7 Lifestyle and Coping

Lifestyle modifications are necessary in order to reduce the risk of passing hepatitis B to others.

If one has been infected with the virus, it is very wise to secure others from from getting infected by their blood. 

This can be done in the following ways: by making sex safer.

An individual with HBV must inform their partner about it, including the risk of transmitting it to them. Having protected sex must be widely encouraged. However, it is always beneficial to keep in mind that condoms do not eliminate the risk but merely reduce it. It is not advisable to share needles or syringes or other objects like razors and toothbrushes which may carry traces of infected blood.

8 Risks and Complications

There are several risks and complications associated with hepatitis B.

Hepatitis B is spread through contact with blood, semen or any body fluid from an infected individuals.  The risks of getting infected with hepatitis B increase when: 

  • One has unprotected sex with man partners or with an infected individual. 
  • If one has shared needles during intravenous drug use.
  • Homosexual men also have a high risk of being infected. 
  • An infant with a mother with the infection is also likely to be infected.
  • Medical care workers who are regularly exposed to human blood.
  • Travelling to region with high  infection rates of HBV such as Eastern Europe, Africa, Southeast and Central Asia may increase the risk of hepatitis B infection. 

Having a chronic HBV  usually results in very serious complications which include:

When that occurs, a liver transplant is necessary to sustain life. People with chronic hepatitis B may have kidney disease, inflammation of blood vessels or anemia.

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