Hepatitis B

What do I need to know about Hepatitis B?

Hepatitis B is a potentially serious form of liver inflammation due to infection by the Hepatitis B virus. It occurs in both rapidly developing (acute) and long-lasting (chronic) forms, and is one of the commonest chronic infectious diseases worldwide (the others are the Hepatitis A virus and the Hepatitis C virus).

What is meant by Hepatitis B carrier?

A person who is chronically infected with the Hepatitis B virus is called a “carrier” of the virus. The risk is maximum for infants born to mothers who are Hepatitis B carriers: without immediate vaccinations, approximately 90% of these babies will develop chronic Hepatitis B infection. Hepatitis B carriers have not developed immunity as a result of infection and may have traces of the Hepatitis B virus in their blood and body fluids for the rest of their lives. At times, there may be ongoing liver damage and at other times, infection may be inactive. Most carriers do not appear sick and remain symptom-free but some will develop cirrhosis and/or liver cancer years after becoming infected with the Hepatitis B virus.

What are the symptoms of Hepatitis B?

Symptoms develop within 30-180 days of exposure to the virus. A majority of people who become infected with Hepatitis B never feel sick and recover completely. Others get a brief, acute illness with fatigue and loss of appetite and their skin and eyes turn yellow (a condition called “jaundice”). Less than 5% of adults who get acute Hepatitis B develop chronic Hepatitis, which can lead to cirrhosis (liver scarring) and/or cancer of the liver later in life.

How does the Hepatitis B virus spread?

The Hepatitis B virus causes Hepatitis B. The virus has an incubation period of two to five months. It replicates in the liver, and virus particles are shed in large amounts into the blood. The blood of infected individuals is thus highly infectious. A person who has acute Hepatitis B or who is a carrier, can spread the Hepatitis B virus to other people through his/her blood and other body fluids or by sexual contact. Hepatitis B does not spread by water, food or by casual contacts that occur at schools or workplaces.

Who can get Hepatitis B?

People without immunization who are at risk are:

• Sexual partners of Hepatitis B carriers.
• Men or women who have multiple sexual partners.
• Babies born to infected mothers.
• Children living in the same household as a carrier.
• People who abuse drugs by injection.
• Anyone whose occupation involves increased exposure to blood and body fluids (e.g. health care workers, law enforcement officers, firefighters, etc.).
• People who live or travel to parts of the world where Hepatitis B is relatively common such as Asia, sub-Saharan Africa and the Pacific Islands. Infection in adults in these areas is by sexual transmission.

How is Hepatitis B diagnosed?

Hepatitis B is diagnosed through blood tests, which can help show if you have chronic Hepatitis B or another type of hepatitis. The diagnosis of Hepatitis B can be made only with specific Hepatitis B virus blood tests

The tests will show one of the following results:

• A completely negative result means that you have never been exposed to the Hepatitis B virus nor been immunized. In that case you can benefit from immunization.
• A positive antibody test (anti-HBs) indicates that you have been infected some time in the past and recovered completely or that you have been successfully immunized against the Hepatitis B infection. You are immune to the Hepatitis B virus. You will not get the Hepatitis B virus infection and you cannot infect anyone. There are several Hepatitis B antibodies but only anti-HBs gives immunity.
• A positive antigen test (HBsAg) shows that you still carry the Hepatitis B virus. Presence of the virus can mean either acute (recent, self-limited) or chronic (long-lasting) infection. If the virus continues to show up in your blood for longer than six months, you have a chronic infection and are a carrier of the Hepatitis B virus.

Is there any treatment for Hepatitis B?

Yes. There are two types of treatment now available: interferon-alpha and direct inhibitors of the virus, such as Lamivudine or Adefovir.

Interferon-alpha is a natural product of the human body, known to interfere with the reproduction of a virus after infection. For treating chronic Hepatitis B, interferon-alpha works by enhancing the body’s immune activity against the Hepatitis B virus. It is only effective once the immune system has become activated against the Hepatitis B virus. Interferon-alpha is administered by injection either daily or three times per week for four to six months. Some patients may need up to two years of therapy. Interferon is effective in rendering the Hepatitis B virus infection inactive in approximately one third of treated patients.

Lamivudine and Adefovir work directly against the Hepatitis B virus. Clinical studies have shown that these drugs may help control disease progression by suppressing viral reproduction in the liver in most treated patients. It leads to an inactive infection in a minority of patients. Both drugs are taken by mouth once a day and are generally well tolerated. However, therapy may be required for years and in some cases indefinitely.

Is Hepatitis B a preventable disease?

Very much so! You can avoid Hepatitis B by,

• Getting the Hepatitis B vaccine, which is safe and works well to prevent the disease. A total of 3 doses of the vaccine are given over six months to provide long-lasting protection against Hepatitis B in the majority of people. A variety of vaccines are available to make immunization fit individual needs.
• Adopting safe sex practices.
• Seeing your doctor right away if you think you have been exposed to the Hepatitis B virus. Administering Hepatitis B immune globulin to anyone who has had recent contact (seven days or less) with infected blood or body fluids may prevent the disease.
• Screening all pregnant women and immunizing babies born to mothers who are Hepatitis B carriers.