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Hepatitis B

Overview
Diagnosis
Treatment
Prevention

Hepatitis B Overview

Hepatitis B is a liver disease caused by the hepatitis B virus.

Most hepatitis B infections clear up, without treatment, within one to two months.

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 the hepatitis B virus)

Causes of hepatitis B

Hepatitis B is caused by the hepatitis B virus (HBV).

This virus is spread through contact with body fluids of an infected person, such as:

Blood
Semen
Vaginal fluids
Saliva

A woman infected with hepatitis B can pass the virus on to her baby during childbirth.

HBV cannot be spread by:

Sneezing or coughing
Kissing or hugging
Sharing eating utensils or drinking glasses
Breastfeeding
Food or water
Casual contact (such as an office setting)

Risk factors of hepatitis B

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, HBV 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 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 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
Sub-Saharan Africa

Receiving a blood transfusion prior to 1975 (when a screening test was developed for donated blood)
Being bitten (so that the skin is broken) by someone whose saliva contains the virus

People at risk include:

Those who have jobs that involve contact with body fluids, such as:
- First aid or emergency workers
- Funeral directors
- Medical personnel
- Dentists and dental assistants
- Firefighters
- Police officers
Employees or patients in hospital or long-term care facilities
Prison employees and prisoners
Hemophiliacs receiving multiple transfusions of blood or blood products (risk is greatly reduced with careful blood screening)
Hemodialysis patients

Note: It is important that all pregnant women get a blood test for hepatitis B early in their pregnancy since the hepatitis B virus can be spread to babies during birth.

Diagnosing Hepatitis B

Hepatitis B symptoms usually appear within 25 to 180 days following exposure to the hepatitis B virus (HBV).

Symptoms of hepatitis B

The most common symptoms are:

Jaundice (yellowing of the eyes and skin)
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
Darker colored urine
Light-colored stool
Widespread itching
Rash

Testing for hepatitis B

To diagnose hepatitis B, your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

Blood tests — to look for HBV and monitor its effects on the liver
Liver biopsy (for chronic hepatitis B cases) — removal of a sample of liver tissue to be examined

If you are expecting

If you are pregnant, have a blood test for hepatitis B.

If you are diagnosed as positive, be sure that your baby receives a vaccination called H-B-I-G, and the:

First dose of hepatitis B vaccine within 12 hours of birth
Second dose of hepatitis B vaccine at 1 to 2 months of age
Third dose at 6 months of age

Your baby should also get a blood test at age 9 to 15 months to be sure he/she is protected.

Hepatitis B Treatment

The symptoms of hepatitis B can be treated with the following medicines:

Interferon alfa-2b (Intron A), given by injection
Lamivudine (Epivir-HBV), given orally

People with uncomplicated cases can expect to recover completely.

Those who have chronic hepatitis B are treated with medicine to reduce the activity of the virus and prevent liver failure.

People with chronic hepatitis B should avoid anything that can further injure the liver, such as:

Alcohol
Certain medicines
Dietary supplements
Herbs

Before taking any of the above substances, discuss them with your doctor.

Learn more about treatments at the UPMC Liver Cancer Center.

Hepatitis B Prevention

The hepatitis B virus (HBV) is spread through contact with body fluids of an infected person.

Hepatitis B can be prevented through vaccination, consisting of three injections over six-months. 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:

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.

Health care and public safety workers should:

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.

If you have hepatitis B

If you have chronic hepatitis B, you can prevent the spread of your infection by:

Telling your doctors, dentist, and sexual partner(s) that you have hepatitis B.
Never donating blood, organs, or tissue.
Discussing your hepatitis B status with your doctor during pregnancy, or before becoming pregnant, to ensure that your baby receives treatment.

Contact the UPMC Liver Cancer Center

To schedule an appointment, or for more information, call the UPMC Liver Cancer Center at 412-692-2001.