Everything you need to know about hepatitis B

Hepatitis B is an infection of the hepatitis B virus ( HBV) in the liver. Without care it can be acute and overcome. Some types can be chronic, however, and this can lead to cirrhosis and hepatic cancer.

HBV is a significant global health concern. In reality, about 887,000 deaths worldwide were caused by liver disease associated with HBV in 2015.

As of 2016, the Centers for Disease Control and Prevention ( CDC) reports that there are 862,000 people living with a chronic HBV infection in the US.

HBV is a short-term illness for most adults and does not cause permanent harm. Nonetheless, 2–6 percent of HBV adults tend to develop a chronic infection that can eventually lead to liver cancer.

About 90 percent of babies will develop a chronic infection with the virus.

Read more about HBV in this post, including the transmission, early symptoms and treatment.

What is hepatitis B?

HBV can cause liver infection and inflammation. A person can have HBV and be able to spread the virus to others without realizing they do.

Some people have no symptoms. Others have just the initial infection that clears afterwards. For others, the condition becomes chronic. In chronic cases, without detection, the virus tends to attack the liver over time , resulting in permanent damage to the liver.

In 2017 the CDC confirmed an HBV infection to 3,407 individuals. Nevertheless, the number of acute HBV infections may have been nearer to 22,100, accounting for people who may not report getting the infection.

Symptoms

Most infection with HBV occurs during infancy or infancy. This is because, during childbirth, a mother will transfer HBV to her child. But in infancy, physicians rarely treat HBV, because it causes few noticeable signs.

In children under 5 years of age or in adults with a suppressed immune system, symptoms of a new HBV infection may not be apparent. Roughly 30–50 percent of those aged 5 years and over will show initial signs and symptoms.

Acute symptoms begin about 60–150 days after virus exposure, which can last from several weeks to six months.

A person with a chronic HBV infection may experience ongoing episodes of abdominal pain, persistent tiredness, and painful joints.

Early symptoms

If HBV does cause symptoms early on, they may include:

• fever
• joint pain
• fatigue
• nausea
• vomiting
• loss of appetite
• abdominal pain
• dark urine
• clay colored stools
• jaundice, or yellowing of the skin and whites of the eyes

Transmission

HBV is transmissible when blood, semen, or other body fluid from a person with the virus comes into an individual’s body that does not have it.

More specifically, infection can occur:

• when a woman with HBV gives birth
• during sexual activity
• as a result of sharing needles, syringes, or other drug injection devices
• as a result of practicing unsafe tattoo techniques
• by sharing personal hygiene items, such as razors and toothbrushes

Health staff may be at risk due to improper medical procedures, such as reusing medical supplies, not using personal security or disposing of sharps improperly.

HBV cannot spread through:

• food or water
• shared eating utensils
• breastfeeding
• hugging
• kissing
• holding hands
• coughing
• sneezing
• insect bites

The virus can live outside the body for a minimum of 7 days. At this time it can also cause infection if it enters a person’s body that has not been vaccinated against it.

Is it curable?

There is currently no cure for HBV but it can avoid initial infection if the vaccine is administered.

Antiviral drugs can cure chronic infections. When chronic HBV begins causing irreversible liver damage, having a hepatic transplant may help improve survival in the long term.

Receiving an effective vaccine and taking antiviral drugs, however, ensures that as a result of chronic HBV, less people may end up having a hepatic transplant.

Treatment

There is no treatment, cure or medication unique to an acute HBV infection. The symptoms rely on supportive treatment.

Treatment for suspected exposure

Anyone that has had suspected HBV exposure could be subject to a “prophylaxis” procedure for post-exposure.

This consists of immunoglobin HBV and immunoglobin hepatitis B (HBIG). After the exposure and before an acute infection occurs, health care professionals send the prophylaxis.

This procedure won’t cure an already existing infection. This does reduce the risk of acute infection, however.

Treatment for chronic HBV infection

Antiviral drugs are available to treat chronic HBV infection.

The cure for chronic HBV is not this. Nevertheless, it will avoid the virus from replicating and prevent advanced liver disease from progressing.

An individual with a chronic HBV infection can rapidly and without warning develop cirrhosis or hepatic cancer. When a person lacks access to appropriate care or services, within months of diagnosis, liver cancer may become lethal.

Persons with a persistent HBV infection need ongoing medical examination and hepatic ultrasound every 6–12 months. This monitoring can help doctors determine whether liver damage is on the rise or whether the condition is getting worse.

Causes

HBV is caused by the hepatitis B virus, which infects the body.

The virus is present in both blood and body fluids. HBV is transmitted by semen, vaginal fluids, and blood. This can also move during childbirth from a mom to a newborn child. They also raise the risk of sharing needles and having sex without contraceptives.

Persons may also contract HBV while visiting a part of the world where infection is more prevalent.

An individual that spread the virus without being conscious, as there may be no symptoms to it.

Diagnosis

Screening for people at higher risk of an HBV infection or complications due to an undiagnosed HBV infection is given. When a person has HBV, the doctor can evaluate for damage to their liver.

Hepatitis B test

A blood test can help a doctor diagnose acute and chronic HBV infection.

If the test confirms the presence of HBV, the doctor may request follow-up blood tests to confirm:

• whether HBV infection is in its acute or chronic stage
• the person’s risk of liver damage
• whether or not treatment is necessary

For people with chronic HBV a doctor may prescribe routine testing. It can change over time, once the condition reaches a chronic stage.

Hepatitis B vs. hepatitis C

There are several different forms of hepatitis here. HBV and the hepatitis C (HCV) virus also have acute and chronic forms.

Whether they move from person to person is the principal distinction between HBV and HCV. It is rare since HCV is transmissible via sexual activity. HCV typically spreads when blood carrying the virus comes into contact with blood not carrying it.

Hepatitis B during pregnancy

When a woman with HBV gets pregnant, they will pass the virus on to their infant. Women will tell the health care worker who delivers their baby that they have HBV.

The infant should be given 12–24 hours of birth with an HBV vaccine and HBIG. It greatly decreases their risk of developing HBV.

The HBV vaccine is safe to take during pregnancy.

Risk factors

People with a high risk of HBV include:

• the infants of mothers with HBV
• the sexual partners of people with HBV
• people who engage in sexual intercourse without contraception and those who have multiple sexual partners
• men who have sex with men
• people who inject illicit drugs
• those who share a household with a person who has a chronic HBV infection
• healthcare and public safety workers who are at risk of occupational exposure to blood or contaminated bodily fluids
• people receiving hemodialysis, which is a type of kidney treatment
• people taking medications that suppress the immune system, such as chemotherapy for cancer
• people with HIV
• those who come from a region with a high incidence of HBV
• all women during pregnancy

Prevention

People can prevent HBV infection by:

• wearing appropriate protective equipment when working in healthcare settings or dealing with medical emergencies
• not sharing needles
• following safe sexual practices
• cleaning any blood spills or dried blood with gloved hands using a 1:10 dilution of one part household bleach to 10 parts water

Vaccine

A vaccine against HBV has been available since 1982.

People who should receive this vaccine include:

• all infants, children, and adolescents without a previous vaccination
• all healthcare workers
• those who may have had exposure to blood and blood products through work or treatment
• people undergoing dialysis and the recipients of solid organ transplants
• residents and staff of correctional facilities, halfway houses, and community residences
• those who inject drugs
• people who share a household or engage in sexual intercourse with someone who has a chronic HBV infection
• those with multiple sexual partners
• people who travel to countries where HBV is common

Schedule

The HBV vaccine comes in three doses. A person at any age can be given the first injection, but babies should be given the first injection soon after birth. The second shot should take place at least 1 month after the first one.

Adults can take the third dose at least 8 weeks after the second and 16 weeks after the first dose. Kids will not be given the third dose until they reach 24 weeks.

How long does it last?

According to the World Health Organization (WHO), in over 95 percent of the babies, teenagers, and adolescents who receive it, “the full vaccine series induces protective antibody levels.”

Immune memory caused by the HBV vaccine will last in healthy people for at least 30 years. That said, studies are ongoing on the duration of the safety provided by the vaccine.

Side effects

The HBV vaccine is well tolerated by many.

According to the CDC the fever and soreness at the injection site are the most common side effects of the HBV vaccine. In this area too, a person can experience swelling , redness and hard skin.

Very rarely, a severe form of allergic reaction called anaphylaxis may be caused by HBV vaccination.

Is it live?

No live virus is found on the HBV vaccine. It means women are safe to obtain during pregnancy and lactation.

Dangers

HBV infections can cause a range of life threatening complications, including:

• Cirrhosis. This causes scarring on the liver and inhibits liver functions. It can lead to liver failure.
• Liver failure. Also known as end stage liver disease, this can progress either rapidly or over a longer period. The liver cannot replace damaged cells or function.
• Liver cancer. Chronic HPV increases the risk of liver cancer.

While HBV is a major health issue around the world, the vaccine offers effective protection against the virus for most people.