Hepatitis B

What Is 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 in infected blood and other bodily fluids such as semen and vaginal secretions. It is spread in the same way that the virus that causes AIDS (HIV) is spread but hepatitis B is 50 to 100 times more infectious. Most people who are infected with hepatitis B in the U.S. do not know they have it.

What Happens to People With Hepatitis B?

In most adult cases (up to 95%), 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. Unfortunately, this is not true in infants and young children in which 90% of infants and 30% to 50% of children will develop a chronic infection.

While the majority of adults with hepatitis B recover completely, a small percentage of them can't shake the disease and become carriers. Carriers can transmit the disease to others even when their own symptoms have vanished.

Some carriers go on to develop chronic hepatitis B. 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?

Approximately 43,000 Americans contract hepatitis B each year. However, rates have greatly declined since the 1980's when around 208,000 Americans were infected each year. This decrease in infection rates is, in large part, due to the increased use of the HBV vaccine.

It's estimated that up to 1.4 million people living with chronic hepatitis B in the U.S.

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What Are the Signs and Symptoms of 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
  • Flu-like symptoms such as fever, loss of appetite, nausea, and vomiting
  • Abdominal pain

Often, symptoms occur one to six months after exposure, with an average of three month. An estimated 30% of those infected do not have any symptoms at all.

How Is Hepatitis B Diagnosed?

If your doctor suspects that you may have hepatitis B, he or she will perform a complete physical exam and order blood tests to look at the function of your liver. Hepatitis B is confirmed with blood tests that detect the virus.

If your disease becomes chronic, liver biopsies (tissue samples) may be obtained to detect the severity of the disease.

How Is Hepatitis B Treated?

If you get to a doctor shortly after the exposure, you'll often receive immediate immunization with the first in a series of three shots with the hepatitis B vaccination and a shot to boost the immune system to fight off the infection.

Also, take extra care of your liver! Now is not the time to drink alcohol, or take Tylenol (acetaminophen) because they can harm the liver. Check with your doctor before taking any other medications, herbal remedies, or supplements as some of them can worsen liver damage.

If your hepatitis persists beyond six months and is active (chronic active hepatitis), your doctor may prescribe much more aggressive treatment. If it's chronic but not active, your doctor may just watch you closely.

People with chronic active hepatitis are treated with a combination of drugs like the following:

  • Interferon. The immune system boosting medicine interferon is injected either daily, several times a week, or weekly for up to a year. Interferon does have some undesirable side effects, including: fatigue, depression, and loss of appetite and it can lower the number of white blood cells. There are two types of interferon: interferon-alfa (Intron) and peginterferon alfa (Pegasys).

  • Lamivudine (Epivir). Another drug often given in combination with interferon is lamivudine (Epivir). This drug is taken orally once a day. Usually, this drug is well tolerated, but it can cause a worsening of liver functioning in rare instances.

  • Adefovir (Hepsera). This drug is taken by pill once a day and works well in people whose disease doesn't respond to Epivir. It can cause kidney problems especially in people that already have kidney disease, but it can occur in anyone.

  • Entecavir (Baraclude). This drug is taken by pill daily and studies are showing it may be one of the most effective antiviral drugs available for hepatitis B.
  • Viread (Tenofovir): a once daily pill. It is also used to treat HIV and is used in patients who have both HIV and Hepatitis B. It can also be used as a single agent for Hepatitis B.

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Can a Pregnant Woman Give Hepatitis to her Baby?

Yes. A pregnant woman can spread the hepatitis B virus to her baby at the time of birth. (It is unlikely that an infected woman will spread the virus to her baby during pregnancy.)

Many babies infected with hepatitis B develop long-term liver problems. All newborn babies should be given the vaccine for hepatitis at birth and two additional booster injections during their first year of life.

How Can I Avoid Becoming Infected, or Infecting Others With Hepaitis B?

The best ways to try and avoid becoming infected with hepatitis B include:

  • Get vaccinated (if you have not already been infected).
  • Use condoms every time you have sex.
  • Wear gloves when touching or cleaning up body secretions on personal items, such as bandages/band aids, tampons, and linens.
  • Cover all open cuts or wounds.
  • Do not share razors, toothbrushes, manicuring tools, or pierced jewelry with anyone.
  • Do not share chewing gum or pre-chew food for a baby.
  • Make certain that any needles for drugs, piercing, or tattooing are properly sterilized.
  • Clean areas with blood on them with one part household bleach and 9 parts water.

Can I Catch Hepatitis B From Blood Transfusions?

The chance of catching hepatitis B from receiving blood transfusions is unlikely because donated blood is tested for the virus. Any infected blood is discarded.

Who Should Be Vaccinated for Hepatitis B?

All adults who are at risk for getting hepatitis B should also be vaccinated. This includes:

  • Everyone 18 years of age and younger, including all newborn babies.
  • People who may be exposed to infected blood or body fluids of friends or family members.
  • People who use needles to take recreational drugs.
  • All people who have sex with more than one person or with people who have hepatitis B.
  • Men who have sex with men.
  • People with kidney or liver disease, or those with HIV.
  • Those under 60 with diabetes.
  • Health care providers who may come in contact with the virus.
  • People working in day care centers and institutions caring for children, the developmentally disabled and prisoners.
  • People who have hemodialysis (a procedure that cleans and filters the blood).
  • International travelers to areas where hepatitis B is widespread.

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Is There a Cure for Hepatitis B?

Currently, there is no cure for hepatitis B. However, the disease is limited in most acute cases in adults and occasionally disappears in those with chronic disease.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on October 14, 2014

Sources

SOURCES: 

The Hepatitis B Foundation. 

The Centers for Disease Control and Prevention.

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