Hepatitis B
Overview
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
- death (Every year, 5,000 people die as a result of liver disease caused by hepatitis B virus.)
Causes
Hepatitis B is caused by the hepatitis B virus. This virus is spread through contact with body fluids of an infected person, such as blood, semen, vaginal fluids, and saliva. A woman infected with hepatitis can pass the virus on to her baby during childbirth.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Coming in contact with the blood or other body fluids of someone infected with hepatitis B increases your risk for infection. Unlike the hepatitis A virus, hepatitis B virus is not spread through contaminated food or water.
The following situations may increase your risk of getting hepatitis B:
- having sex with someone infected with hepatitis B or who is a carrier of hepatitis B
- having been born to a mother who had hepatitis B at the time of your birth
- injecting illicit drugs, especially with shared needles
- having more than one sexual partner
- being a man who has sex with men
- living in the same house with someone who is infected with hepatitis B and sharing items such as toothbrushes or razors
- having a job that involves contact with body fluids, such as:
- first aid or emergency workers
- funeral directors
- medical personnel
- dentists and dental assistants
- firefighters
- police officers
- having a sexually transmitted disease at the time you come in contact with hepatitis B
- traveling to areas where hepatitis B is common, such as China, southeast Asia, and sub-Saharan Africa
- receiving a blood transfusion prior to 1975 (when a screening test was developed for donated blood)
- receiving multiple transfusions of blood or blood products, as hemophiliacs do (risk is greatly reduced with careful blood screening)
- working or being a patient in a hospital or long-term care facility
- working or being incarcerated in a prison
- being bitten (so that the skin is broken) by someone whose saliva contains the virus
- being a hemodialysis patient
Note: It is very important that all pregnant women get a blood test for hepatitis B early in their pregnancy, since a woman who has hepatitis B can spread the virus to her baby during birth.
Symptoms
Symptoms usually appear within 25 to 180 days following exposure 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)
- loss of appetite
- nausea
- vomiting
- joint pain
- low-grade fever
- dark urine and light-colored stool
- widespread itching
- rash
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. Hepatitis B is diagnosed with blood tests, which also are used to monitor its effects on the liver. For chronic cases, a liver biopsy may be needed. A biopsy is the removal of a sample of liver tissue for testing.
Treatment Options
The symptoms of hepatitis B can be treated with medication. Patients with uncomplicated cases can expect to recover completely. Patients with chronic hepatitis B are treated with medication to reduce the activity of the virus and prevent liver failure.
Medications include:
- Interferon alfa-2b (Intron A) injection
- Lamivudine (Epivir-HBV) oral medication
Chronic hepatitis B patients should avoid anything that can further injure the liver, such as alcohol, certain medications, dietary supplements, and herbs. Patients should discuss these substances with their doctor before taking any of the above.
Chronic hepatitis B patients should prevent the spread of their infection by:
- telling their doctors, dentists, and sexual partner(s) that they have hepatitis B
- never donating blood, organs, or tissue
- discussing their hepatitis B status with their doctor during pregnancy or before becoming pregnant to ensure that the baby receives treatment
Prevention
Hepatitis B can be prevented through vaccination, which consists of three injections over a six-month period. Protection is not complete without all three injections. Anyone at increased risk for hepatitis B should be vaccinated.
In addition, to prevent the transmission of hepatitis B:
- Use condoms or abstain from sex.
- Limit your number of sexual partners.
- Do not inject drugs. If you use IV drugs, get treatment to help you stop. Never share needles or syringes.
- Do not share personal items that might have blood on them, such as:
- razors
- toothbrushes
- manicuring tools
- pierced earrings
If you get a tattoo or body piercing, make sure the artist or piercer properly sterilizes the equipment. You might get infected if the tools have someone else's blood on them.
In addition, to prevent the transmission of hepatitis B:
- If you are a health care or public safety worker, get vaccinated against hepatitis B. Always follow routine barrier precautions and safely handle needles and other sharp instruments.
- Wear gloves when touching or cleaning up body fluids on personal items, such as:
- Cover open cuts or wounds.
- Use only sterilized needles for drug injections, blood testing, ear piercing, and tattooing
It is important to remember that HBV cannot be spread by:
- sneezing or coughing
- kissing or hugging
- sharing eating utensils or drinking glasses
- breast-feeding
- food or water
- casual contact (such as an office setting)
If you are expecting
If you are pregnant, have a blood test for hepatitis B. If you are diagnosed as positive, you should be sure that your baby gets a shot called H-B-I-G and the first dose of hepatitis B vaccine within 12 hours of birth. Your baby should get the second dose of hepatitis B vaccine at one to two months old and the third dose at six moths old. Your baby should also get a blood test at nine to 15 months old to be sure your baby is protected.