Digestive Diseases: Hepatitis B

Hepatitis B is a serious disease caused by the hepatitis B virus (HBV). Infection with this virus can cause scarring of the liver, liver failure, liver cancer and even death.

Hepatitis B is spread by infected blood and other bodily fluids such as semen, vaginal secretions, saliva, open sores, and breast milk.

What Happens to People With Hepatitis B?

In most cases, hepatitis B causes limited infection. Usually people manage to fight off the infection successfully within a few months, developing an immunity that lasts a lifetime. (This means you won't get the infection again.) Blood tests show evidence of this immunity, but no signs of active infection.

However, some people don't get rid of the infection. If you are infected with hepatitis B for more than 6 months, you are considered a carrier, even if you have no symptoms. This means that you can transmit the disease to others by having unprotected sex, deep kissing or sharing food or drinks. Being a carrier also means that your liver may be more prone to injury.

For unknown reasons, the infection eventually goes away in a very small percentage of carriers. For others, the infection becomes chronic. Chronic hepatitis is an ongoing infection of the liver that can lead to cirrhosis. Cirrhosis, or hardening of the liver, causes liver tissue to scar and stop working.

If you are carrying the virus you should not donate blood, plasma, body organs, tissue or sperm. Tell your doctor, dentist, and sex partner that you are a hepatitis B carrier.

How Common Is Hepatitis B?

According to the CDC, the number of people contracting hepatitis B has decreased from an average of 200,000 per year in the 1980's to 73,000 in 2003. The highest rate of infection occurs among those 20 to 49 years old.

Approximately 5%-10% of adults and children over the age of 5 with hepatitis B infection go on to develop chronic infection. These rates climb much higher for children younger than 5 (30%) and even higher for infants infected at birth (90%).

Approximately 1.25 million people in the U.S. are carriers of the hepatitis B virus.

How Do I Know If I Have Hepatitis B?

Symptoms of acute infection (when a person is first infected with hepatitis) include:

• Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine).
• Unusually light-colored stool.
• Unexplained fatigue that persists for weeks or months.
• Gastrointestinal symptoms such as fever, loss of appetite, nausea and vomiting.
• Abdominal pain.

Often, symptoms occur 1-6 months after exposure. An estimated 30% of those infected do not show typical signs or symptoms.

How Is Hepatitis B Diagnosed?

If your doctor suspects that you may have hepatitis B, he or she will perform a complete physical examination and order blood tests to look at the function of your liver. Hepatitis B is confirmed with blood tests that detect the hepatitis virus and various antibodies (infection-fighting cells) against the virus.

If your disease becomes chronic, a liver biopsy (tissue sample) may be obtained to determine the severity of the disease.