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Hepatitis B
Hepatitis B is one type of hepatitis – a liver disease- caused by the hepatitis B virus (HBV). Hepatitis B spreads by contact with an infected person's blood, semen or other body fluid. An infected woman can give hepatitis B to her baby at birth.
If you get HBV, you may feel as if you have the flu, or you may have no symptoms at all. A blood test can tell if you have it. HBV usually gets better on its own after a few months. If it does not get better, it is called chronic HBV, which lasts a lifetime. Chronic HBV can lead to scarring of the liver, liver failure or liver cancer.
There is a vaccine for HBV. It requires three shots. All babies should get the vaccine, but older children and adults can get it too. If you travel to countries where Hepatitis B is common, you should get the vaccine.
Basics: Hepatitis B (HBV)
What is Hepatitis B?
Hepatitis B is an inflammatory liver disease caused by the hepatitis B virus (HBV) that results in liver cell damage. This damage can lead to scarring of the liver (cirrhosis) and increased risk of liver cancer in some people. About 80,000 Americans were newly infected with HBV in 1999.
Who Is At Risk?
One out of every 20 people in the U. S. will become infected with HBV sometime during their lives. Your risk is higher if you:
- Have sex with someone infected with HBV.
- Have sex with more than one partner.
- Are a man and have sex with a man.
- Live in the same house with someone who has chronic HBV infection.
- Have a job that involves contact with human blood.
- Inject illegal substances/drugs. Have hemophilia.
- Travel to areas where HBV is common (this includes all countries except northern and western Europe, Japan, Australia, New Zealand, and North America except Mexico).
Symptoms
Many people with newly acquired hepatitis B have no symptoms at all, or they may be very mild and flu-like – loss of appetite, nausea, fatigue, muscle or joint aches, mild fever, and possibly jaundice (yellowish tinge to the skin). The only way to know if you are currently infected with HBV – or if you still carry the virus – is to ask your doctor to do a specific blood test for hepatitis B (it may not be included in a routine blood test). The test may not show positive during the incubation period (45-180 days).
Diagnosis
There are three standard blood tests for HBV:
- HBsAG (hepatitis B surface antigen):
When this test is positive or reactive, you are infected with HBV and can pass it on to others.
- Anti-HBc (antibody to hepatitis B core antigen):
When you test positive, it means you are currently infected with HBV or have been infected at some point in the past.
- Anti-HBs (antibody to HbsAg):
When this test is positive, it means that you are immune to hepatitis B either as a result of having had the disease or from having been given the vaccine.
How Does It Spread?
HBV is found in blood, seminal fluid, and vaginal secretions. The risk of transmission is increased in these situations:
- Sexual contact with an infected person.
- Living in the same household with an infected individual.
- Contact with infected blood or seminal fluid and contaminated needles, including tattoo/body piercing instruments.
- HBV-infected mother to her newborn at time of delivery (prenatal blood tests for HBV should always be done if there is a suspicion of HBV).
Treating HBV
There are two medications to treat chronic HBV – Interferon (IFN) and Lamivudine. Less than 50% of patients with chronic HBV are candidates for interferon therapy. Initially, 40% of HBV patients who are treated with IFN will respond. However, some will relapse when the treatment is stopped. Overall, about 35% of the eligible patients will benefit. IFN treatments may have a number of side effects, including flu-like symptoms, headache, nausea, vomiting, loss of appetite, depression, diarrhea, fatigue, and thinning hair. Interferon may lower the production of white blood cells and platelets by depressing the bone marrow. Thus, blood tests are needed to monitor blood cells, platelets, and liver enzymes. The response to oral Lamivudine, given for at least one year, may be somewhat lower. In addition, those who are chronically infected with HBV should be vaccinated against hepatitis A. There is no treatment for acute Hepatitis B.
Disease Outcome
- Either you develop immunity to HBV . . . 95% of adults infected develop antibodies and recover spontaneously within six months. Upon recovery, they develop immunity to the virus and they are not infectious to others. Blood tests will always test positive for the HBV antibody. Blood banks will not accept donations of blood from HBV-immune people.
- OR you become chronically infected. About 5% of the time, the virus does not clear the body within six months. If so, a person is considered a carrier – or chronically infected. Chronically infected people may or may not show outward signs or symptoms. The HBV virus remains in blood and body fluids, and can infect others.
Preventing HBV Infection - Things you can do:
- Practice safe sex (use latex condoms).
- Don't share anything that could have an infected person's blood on it, i.e. toothbrushes, razors, nail clippers, body piercing instruments.
- Don't share drug needles, cocaine straws or any drug paraphernalia.
- Cover all sores and rashes and do not touch them.
- Clean up any blood spills with a 10% solution of household bleach. Infected persons should not pre-chew food for babies.
- If exposed to hepatitis B, get an HBIG (hepatitis B immune globulin) injection within 14 days following exposure.
Get an HBV vaccination.
Here's who should be vaccinated without fail:
- All individuals living in the same household with a chronically infected individual.
- All newborns and children up to the age of 19.
- Those who are in positions where they are exposed to blood at work, through drug use, or who have multiple sex partners.
- Individuals with hepatitis C and other chronic liver diseases.
Vaccination provides protection for more than 15 years, and possibly a lifetime. HBV booster shots are not recommended.
Newborn Vaccination
All newborns should get three vaccination doses of the HBV vaccine the first within 12 hours of birth, the second at 1-2 months, and the third at 6 months. In addition, babies born to infected mothers should receive a shot called H-BIG within 12 hours of delivery. Without the above intervention, 90% of babies born to infected mothers will become chronically infected, reducing their life expectancies. A few months after the last dose is given, the doctor will test to see if the baby is making HBV antibodies. If so, the baby will be safe from hepatitis B for life. HBV-infected mothers may nurse their babies. |
