CONDITIONS
Hepatitis B infection
Hepatitis B infection
Viral Hepatitis has become increasingly widespread across the world making it a global public health issue. The death rate from viral Hepatitis has been steadily climbing over time with lakhs of deaths per year.
Viral Hepatitis is mostly caused by any of the known five viruses, namely Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Hepatitis D Virus (HDV), and Hepatitis E Virus (HEV). Chronic HBV affects 24 crore persons worldwide. Chronic infections often last a long time and take some time to be completely cured.
In India, the overall percentage of people suffering from HBV are from 0.87% to 21.4%.
Hepatitis B in most people, occurs for a short term (known as acute hepatitis B) lasting for less than six months. But for others, the infection becomes long-term (chronic hepatitis B), meaning it lasts more than six months. Even with severe symptoms, most adults with hepatitis B recover fully.
How is Hepatitis B transmitted?
What are the symptoms of Hepatitis B?
- Jaundice (yellowing of eyes and skin)
- Pain in the belly
- Dark urine
- Light coloured poop
- An upset stomach
- High temperature (Fever)
- Diarrhea or constipation
- Fatigue that lasts for weeks or even months
About one third of the patients may not feel anything untoward or even show symptoms up until 1 to 6 months and find out only after routine blood test.
What are the causes and risk factors of Hepatitis B?
Hepatitis B infection is caused by hepatitis B virus (HBV) and the infection is spread when the virus is passed from person to person through blood, semen or other body fluids. Kissing, food or water, shared utensils, touch, sneezing or coughing does not spread the virus.
Most common ways that HBV can spread are:
- Sex: Unprotected sex with someone infected with the virus and if that partner’s blood, saliva, semen, or vaginal secretions enter the body.
- Sharing needles: Needles and syringes contaminated with infected blood may spread the virus very easily. This happens in case of using recreational drugs.
- Accidental needle sticks: Health care workers and anyone else coming in contact with human blood accidentally may get.
- Mother to child: Pregnant women with hepatitis B infection may pass it to their babies during childbirth. However, there are vaccines to prevent newborn infections.
The risk of hepatitis B infection increases with:
- Unprotected sex with multiple sex partners
- Sharing needles during IV drug use
- Man with man sex
- Living with a person with chronic HBV infection
- Infant born to an infected mother
- Occupation exposing the person to human blood
- Visit to regions with high infection rates of HBV, such as Asia, the Pacific Islands, Africa and Eastern Europe
How is Hepatitis B diagnosed?
The doctor examines and look for signs of liver damage and may also conduct tests that may help diagnose hepatitis B or its complications:
Blood tests: To detect signs of the hepatitis B virus in the body and to conclude if it’s acute or chronic. Simple test to assess if a person has immunity toward the infection is also done where medical history of vaccine is unavailable.
Liver ultrasound: A special ultrasound (transient elastography) shows the extent of liver damage.
Liver biopsy: A small sample of the liver may be removed to test and check for liver damage. This is called a liver biopsy. A thin needle is inserted through the skin and into the liver to remove liver tissue samples for laboratory analysis. This is generally required in chronic cases of Hepatitis B.
How will I tell if I need to undergo Hepatitis B test?
Often, the doctors may ask healthy people to undergo these tests because the virus can damage the liver before showing signs and symptoms. People might be advised testing in cases of:
- Pregnancy
- Living with hepatitis B infected person
- Multiple sexual partners
- Indulged in sex with someone with hepatitis B
- Man having sex with a man
- Living with a history of sexually transmitted illness
- Having HIV or hepatitis C
- Having a liver enzyme test with unexplained abnormal results
- Receiving kidney dialysis
- Taking medications for suppressing the immune system
- Using or used illegal injected drugs
- Are/were in prison
What are the treatment options for Hepatitis B?
Treatment for acute hepatitis B infection:
If the doctor diagnoses the hepatitis B infection as acute, the person not need treatment as it goes away on its own. The doctor may recommend rest, proper nutrition, plenty of fluids and close monitoring while the body fights the infection. In rare cases of severe infections, antiviral drugs or a hospital stay may be required to avoid further complications.
If the infection stays longer than 6 months, it is chronic hepatitis B infection and the doctor will recommend the following treatment plan:
- These patients may need treatment for the rest of their lives. However, this depends on multiple factors including if the infection causing inflammation or scarring of the liver (cirrhosis), or presence of other conditions such as hepatitis C or HIV among others.
- Treatment for chronic hepatitis B may include:
- Antiviral medications that are usually taken by mouth and can help fight the virus and slow its ability to damage the liver
- Interferon injections; these are designed to fight infections and are similar to substances that are present in the body. Usually given to young people who want to avoid long-term treatment or women in their child-bearing age wanting to become pregnant in future. Interferon should not be used during pregnancy and contraceptives should be used during its treatment.
- Liver transplant: In case of severe damage of liver, a liver transplant could be suggested. In liver transplant, the surgeon removes the damaged liver and replaces it with a healthy liver.
How can Hepatitis B be prevented?
- Hepatitis B vaccine (if un-infected): The key to prevention of Hepatitis B is to take a vaccine. Universal hepatitis B vaccination for all adults aged 19 to 59 as well as for adults aged 60 years or older with known risk factors for hepatitis B virus infection is advised by the experts. People who are 60 years or older and without known risk factors should be offered a HepB vaccine series.
- The Hepatitis B is strongly recommended for:
- Newborns
- Children and adolescents not vaccinated at birth
- People living with someone who has hepatitis B
- Health care workers, emergency workers and other people coming in daily contact with blood
- Anyone with a sexually transmitted infection, including HIV
- Men who have sex with men
- People having multiple sexual partners
- People using illegal drugs or share needles and syringes
- People with chronic liver disease
- People with end-stage kidney disease
- Travelers visiting an area with a high hepatitis B infection rate
- The Hepatitis B is strongly recommended for:
- Other ways to prevent Hepatitis B infection are:
- Use condoms while having sex everytime.
- Wear gloves while cleaning up, especially if a person is in a profession where they touch bandages, syringes, needles, tampons, and linens.
- Cover all open cuts or wounds.
- Do not share razors, toothbrushes, nail care tools, or pierced earrings with anyone
- Make sure that any needles for drugs, ear piercings, or tattoos — or tools for manicures and pedicures — are properly sterilized.
Are there any government programs to help with diagnosis and treatment of Hepatitis B?
References
- Kumar D, Peter RM, Joseph A, Kosalram K, Kaur H. Prevalence of viral hepatitis infection in India: A systematic review and meta-analysis. J Educ Health Promot. 2023 Mar 31;12:103.
- Hepatitis B. Mayo Clinic. February 2024. https://www.mayoclinic.org/diseases-conditions/hepatitis-b/symptoms-causes/syc-20366802
- Hepatitis B. WebMD. February 2024. https://www.webmd.com/hepatitis/digestive-diseases-hepatitis-b
- Hepatitis A. NHS UK. February 2024. https://www.nhs.uk/conditions/hepatitis-a/
- 5. Satsangi S, Dhiman RK. Combating the wrath of viral hepatitis in India. Indian J Med Res. 2016 Jul;144(1):1-5.
