Hepatitis B Infection : treatment and prevention

Hepatitis B infection is an inflammation of the liver tissue caused by hepatitis B virus (HBV). Several things like alcohol consumption, certain drugs or when your body develops antibodies that attack the liver tissue (autoimmune hepatitis) can also bring about liver inflammation. There are 5 different viruses that can cause hepatitis of which hepatitis B virus (HBV) is one.

Although this condition is considered as potentially life-threatening, infection with hepatitis B can either be acute or chronic. Acute infection usually last for less than 6 month and resolves on its own, whiles chronic infection can last a life-time leading to fibrosis, cirrhosis and liver cancer.  Hepatitis B is spread through contact with the blood or other body fluids of an infected person. The virus can also be transmitted from mother to child during pregnancy or child birth.

Statistics show that hepatitis B is the most common serious liver infection in the world. Two billion people (or 1 in 3) have been infected and more than 292 million people are living with a chronic hepatitis B infection. In addition, up to 1 million people die from hepatitis B each year despite the fact that it is preventable and treatable. Vaccination is available that can protect both children and adults from the infection.

Who is at Risk?

According to WHO reports, hepatitis B prevalence is highest in the Western Pacific and Africa, where 6.2% and 6.1% of the adult population are infected respectively. Hepatitis B Virus is transmitted through activities that involve parenteral contact with infectious blood or body fluids like semen, vaginal secretions and saliva.

The Centre for Disease and Control (CDC), states that hepatitis B Virus cannot be spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing. The following can put you at risk of being infected by the virus :

  • Being transfused with an infected blood.
  • Sex with an infected partner (male or female).
  • Injecting illicit drugs.
  • Birth to an infected mother.
  • Contact with blood or open sores of an infected person.
  • Needle sticks or sharp instrument exposures.
  • Sharing items such as razors or toothbrushes with an infected person.
  • Being HIV positive.

You should note that The hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. 

Symptoms

Hepatitis B does not always come with noticeable signs or symptoms. Most people get to find out about the infection during a screening test. Children below 5 years don’t tend to show any symptoms. In those above 5 years and adults, symptoms may include the following :

  • Abdominal pain
  • Dark urine
  • Clay-colored bowel movements
  • Joint pain
  • Jaundice

You should see your doctor if you or your child is experiencing the above symptoms for proper diagnosis of hepatitis B and treatment plan.

Diagnosis

WHO says that about 1% of persons living with HBV infection (2.7 million people) are also infected with HIV. Anyone showing symptoms of hepatitis B or who suspects recent exposure to the virus needs to be diagnosed properly at the hospital. The standard diagnosis of hepatitis B involves a proper history taking, physical examination and laboratory screening tests including liver function test.

These tests can be used to confirm the infection or monitor the progress of the disease in an infected person. The common tests for hepatitis B include :

  • Hepatitis B surface antigen (HBsAg): The presence of HBsAg, a protein on the surface of HBV, indicates that the person is infectious. It can be detected in high levels in serum during acute or chronic HBV infection. The body normally produces antibodies to HBsAg as part of the normal immune response to infection. HBsAg is the antigen used to make hepatitis B vaccine.
  • Hepatitis B surface antibody (anti-HBs): The presence of anti-HBs is generally interpreted as indicating recovery and immunity from HBV infection. Anti-HBs also develops in a person who has been successfully vaccinated against hepatitis B.
  • Hepatitis B e antigen (HBeAg): The presence indicates that the virus is replicating and the infected person has high levels of HBV. HBeAg is a secreted product of the nucleocapsid gene of HBV that is found in serum during acute and chronic hepatitis B.
  • Hepatitis B e antibody (HBeAb or anti-HBe): Spontaneous conversion from e antigen to e antibody (a change known as seroconversion) is a predictor of long-term clearance of HBV in patients undergoing antiviral therapy and indicates lower levels of HBV. HBeAb is produced by the immune system temporarily during acute HBV infection or consistently during or after a burst in viral replication.

Treatment and Prevention

Acute hepatitis B does not require any specific treatment. You may asked to have, good rest, eat good nutrition and replace fluid lost through diarrhea and vomiting. Furthermore, you will be asked to stay away from consuming alcohol and drugs like paracetamol (acetamenophen) which can worsen liver destruction.

On the other hand, chronic hepatitis B infection will require treatment with antiviral medications to slow down liver destruction and improve long term survival. Someone with hepatitis B can also get infected with hepatitis D. This co-infection worsens the outcome of the disease. There are many options of antiviral drugs from which your doctor can choose from.

The hepatitis B vaccine is considered very safe and the best prevention against the infection. It is available for both children and adults in 3 doses spread across 6 months. New born babies receive the first shot within 24 hours after birth. The second dose is then given after 4 weeks from the first shot and finally the third dose comes 6 months after the first shot. 

Children and adults at high risk or who have not received the immunization before can do so any time. Your second dose will still come 4 weeks after the first shot and the third dose will come 6 months after the first shot. There is no need to receive vaccination if you have already been diagnosed with hepatitis B.

Other preventive measures you can take will include practicing safe sex, using protective equipment in the hospital, and not sharing syringes, razor or toothbrush.

 

 

Reference

 

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