Hepatitis B Definition Symptoms Diagnosis Treatment And Prevention

Definition:

Hepatitis B is an infectious liver disease. It is caused by the hepatitis B virus (HBV). Infections of hepatitis B occur only if the virus is able to enter the blood stream and reach the liver. Once in the liver, the virus reproduces and releases large numbers of new viruses into the bloodstream.

 White blood cells, which protect the body from infections, attack and destroy the infected liver cells. The body also produces antibodies which circulate in the blood to destroy the virus and protect against future infections of hepatitis B. During the infection and recovery process, the liver may not function normally causing illness that affects the entire body.

Hepatitis B is the most common serious liver infection in the world. Worldwide, about 350 million people are chronic carriers of HBV, of whom, more than 620,000 die from liver-related disease each year. 

This infection has two possible phases;

• Acute  hepatitis B :

Acute hepatitis B refers to newly acquired infections. Affected individuals notice symptoms approximately 1 to 4 months after exposure to the virus. In most people with acute hepatitis, symptoms resolve over weeks to months and they are cured of the infection. However, a small number of people develop a very severe, life-threatening form of acute hepatitis called fulminant hepatitis. 

•  Chronic  hepatitis B 

Chronic hepatitis B is an infection with HBV that lasts longer than 6 months. Once the infection becomes chronic, it may never go away completely.

Sign And Symptoms:

• A sudden onset of fever
• Extreme tiredness
• Nausea
• Lack of appetite
• Abdominal pain (stomach pain)
• Yellowing of the skin or whites of the eyes (jaundice).

Hepatitis B  is transmitted as follows:

• Sexual contact:

It may become infected if unprotected sexual contact with an infected partner whose blood, saliva, semen or vaginal secretions enter in body.

• Sharing of needles:

 HBV is easily transmitted through needles and syringes contaminated with infected blood. Sharing intravenous (IV) drug paraphernalia puts 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 child birth.

• Being on hemodialysis
• Blood transfusions

Diagnosis:

 Diagnosis of hepatitis B virus (HBV) infection was revolutionized by the discovery of Australia antigen, now called hepatitis B surface antigen (HBsAg).

The following tests are done to identify and monitor liver damage from hepatitis B:

• Albumin level
• Liver function tests
• Prothrombin time
• Antibody to HBsAg (Anti-HBs) -- a positive result means  hepatitis B in the past, or have received a hepatitis B vaccine.
• Antibody to hepatitis B core antigen (Anti-HBc) -- a positive result means recent infection or an infection in the past.
• Hepatitis B surface antigen (HBsAg) -- a positive result means  an active infection

Treatment:

Acute hepatitis needs no treatment other than careful monitoring of liver and other body functions with blood tests. You should get plenty of bed rest, drink plenty of fluids, and eat healthy foods.In the rare case that you develop liver failure, you may need a liver transplant. A liver transplant is the only cure in some cases of liver failure.

Chronic hepatitis may be treated with antiviral medications or a medication called peginterferon. These medications can decrease or remove hepatitis B from the blood and reduce the risk of cirrhosis and liver cancer.

• Liver transplantation is used to treat severe, chronic hepatitis B liver disease.

• Patients with chronic hepatitis should avoid alcohol and should always check with their doctor or nurse before taking any over-the-counter medications or herbal supplements. This even includes medications such as acetaminophen, aspirin, or ibuprofen. 

Prevention 

• Getting enough calories.

 Many people with hepatitis B -- especially those taking medication -- get nauseous. In order to get enough calories, try eating several small meals throughout the day, instead of three large meals a day. If feel sick in the morning, try eating some crackers or dry toast before getting out of bed. It may also help to drink lemon water or have a lemon drop.

 

• Getting plenty of rest.
   
• Drinking plenty of fluids.

 Try to drink at least 10 to 16 glasses a day of water, clear juices, or other drinks that do not have caffeine in them.

 

• Avoiding medicines that can harm the liver.

 Talk with healthcare provider about all of the medicines  including prescription and over-the-counter medicines, as well as vitamins and herbal remedies.

 

• Avoiding alcohol.

 Alcohol poisons for liver and can cause even more damage to the cells that are already fighting the hepatitis B virus. The exact amount of alcohol that will harm the liver isn't known. Therefore, it's generally recommended that people with hepatitis B avoid alcohol completely.

 

• Exercising regularly.

 Light-to-moderate exercise for 30 minutes a day. Walking is one example of an activity that can provide light-to-moderate exercise.

 

There are also things that a person with chronic hepatitis B can do to help stay healthy both during and after treatment. Some of these things include:

• Avoiding unsafe sex
• Avoiding sharing needles
• Asking doctor about tests to check for liver damage
• 
  
• Learning how to protect from other hepatitis viruses
• Joining a support group for people with chronic hepatitis B.

Complication:

•  Hepatocellular carcinoma
• Chronic persistent hepatitis
• Cirrhosis
• Fulminant hepatitis, which can lead to liver failure and possibly death.

About Hepatitis B Vaccination:

Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. The vaccine contains one of the viral envelope proteins, hepatitis B surface antigen (HBsAg). It is produced by yeast cells, into which the genetic code for HBsAg has been inserted A course of three (3) vaccine injections are given with the second injection at least one month after the first dose and the third injection given six months after the first dose Afterward an immune system antibody to HBsAg is established in the blood stream. The antibody is known as anti-HBsAg. This antibody and immune system memory then provide immunity to hepatitis B infection.

 The first vaccine became available in 1981.A range of vaccines are available in the market. Presently recombinant DNA vaccines are available, which means they are produced by inserting the gene for HBV into common baker's yeast where it is grown, harvested, and purified. HBV infection cannot occur from receiving hepatitis B vaccine. The common brands available are Engerix-B (GSK), Elovac B (Human Biologicals Institute, A division of Indian Immunologicals Limited), Genevac B (Serum Institute), Shanvac B etc. These vaccines are given intramuscularly.

The hepatitis B vaccination is recommended for:

• Those who may be exposed to blood or blood products through their occupation, e.g. healthcare workers, ambulance crews, carers of high-risk or known patients, and morticians.
• Travellers who intend to stay for long periods in high-prevalence areas.
• Those considered to be at risk of hepatitis B through their planned activities, e.g. volunteers undertaking manual work, taking part in contact sports, involvement with casual sex.
• Those individuals who change sexual partners frequently.
• Travellers with pre-existing medical conditions, who may be at higher risk of requiring medical procedures abroad, e.g. pregnancy. (Pregnancy is not a contra-indication to immunisation.)
• Injecting drug users.
• Partners and children of injecting drug users.
• Non-injecting drug users who live with injecting drug users.
• Individuals in residential accommodation for those with learning difficulties.
• People travelling to or going to reside in areas of high or intermediate prevalence..
• Haemophiliacs requiring treatment and those who are receiving regular blood or blood products.
• Prisoners and prison officers.
• Family contacts of those with chronic hepatitis B infection.
• Those patients with chronic kidney disease or chronic liver disease.
• All pregnant women should be screened for hepatitis B virus (HBV)
• If positive, the baby should receive vaccination soon after birth.
• Babies born to highly infectious mothers should also receive hepatitis B immunoglobulin.