Hepatitis B

Hepatitis B

Hepatitis B refers to the inflammation and swelling (known as inflammation) of the liver caused by an infection with the hepatitis B virus (HBV).

Other forms of viral hepatitis encompass:

• Hepatitis A
• Hepatitis C
• Hepatitis D

Causes, Incidence, and Risk Factors

The transmission of hepatitis B infection can occur through contact with the blood, semen, vaginal fluids, and other bodily fluids of an individual already infected with hepatitis B.

Modes of transmission include

• Blood transfusions (less common in the United States)
• Direct exposure to blood in healthcare environments
• Sexual intercourse with an infected individual
• Tattooing or acupuncture with contaminated needles or instruments
• Sharing needles during drug use
• Sharing personal items (such as toothbrushes, razors, and nail clippers) with an infected person

The hepatitis B virus can be transmitted to an infant during childbirth if the mother is infected.

Risk factors for hepatitis B infection include

• Being born in or having parents from regions with high infection rates (including Asia, Africa, and the Caribbean)
• Co-infection with HIV
• Undergoing hemodialysis
• Engaging in sexual activity with multiple partners
• Men having sex with men

Most of the liver damage caused by the hepatitis B virus arises from the body's immune response to the infection. Upon detecting the infection, the immune system dispatches specialized cells to combat it, which can lead to liver inflammation.

Symptoms

Following the initial infection with the hepatitis B virus:

• Some individuals may exhibit no symptoms
• Others may experience sickness for a period ranging from days to weeks
• In severe cases, individuals may become very ill, a condition termed fulminant hepatitis

If the body successfully fights off the hepatitis B infection, any associated symptoms should resolve over several weeks to months.

For some individuals, the hepatitis B infection persists, resulting in chronic hepatitis B. Many affected individuals may remain asymptomatic, unknowingly harboring the virus and potentially transmitting it to others. However, some early symptoms may manifest, including:

• Loss of appetite
• Fatigue
• Low-grade fever
• Muscle and joint pain
• Nausea and vomiting
• Jaundice, characterized by yellowing of the skin and dark urine

Individuals with chronic hepatitis may not exhibit symptoms despite ongoing liver damage. Over time, some may develop signs of chronic liver damage and cirrhosis.

Signs and Tests

Various tests are employed to detect and monitor liver damage caused by hepatitis B, including:

• Albumin levels
• Liver function tests
• Prothrombin time

Additional tests help diagnose and monitor individuals with hepatitis B:

• Antibody to HBsAg (Anti-HBs) to determine past infection or vaccination
• Antibody to hepatitis B core antigen (Anti-HBc) to detect recent or past infection
• Hepatitis B surface antigen (HBsAg) to confirm active infection
• Hepatitis E surface antigen (HBeAg) to identify individuals more likely to transmit the infection through sexual activity or needle sharing

Patients with chronic hepatitis require ongoing blood tests for monitoring.

Treatment

Acute hepatitis generally requires no specific treatment beyond careful monitoring of liver and overall bodily functions through blood tests. Adequate rest, hydration, and a nutritious diet are recommended.

In rare instances of liver failure, a liver transplant may be necessary, serving as the only cure in certain cases.

Some patients with chronic hepatitis may receive antiviral medications or peginterferon to reduce hepatitis B levels in the blood, lowering the risk of cirrhosis and liver cancer.

Liver transplantation may be indicated for severe cases of chronic hepatitis B liver disease.

Patients with chronic hepatitis should abstain from alcohol consumption and consult their healthcare provider before taking any over-the-counter medications or herbal supplements, including common pain relievers like acetaminophen, aspirin, or ibuprofen.