Hepatitis B Overview

Hepatitis is a general term that means inflammation of the liver. The liver can become inflamed as a result of infection, a disorder of the immune system , or exposure to alcohol, certain medications, toxins, or poisons.

• Hepatitis B is caused by infection with the hepatitis B virus (HBV). This infection has 2 phases: acute and chronic.
  • Acute (new, short-term) hepatitis B occurs shortly after exposure to the virus. A small number of people develop a very severe, life-threatening form of acute hepatitis called fulminant hepatitis.
  • Chronic (ongoing, long-term) hepatitis B is an infection with HBV that lasts longer than 6 months. Once the infection becomes chronic, it may never go away completely.
  • About 90-95% of people who are infected are able to fight off the virus so their infection never becomes chronic. Only about 5-10 percent of adults infected with HBV go on to develop chronic infection.
  • HBV infection is one of the most important causes of infection.
    

People with chronic HBV infectio n are called chronic carriers. About two-thirds of these people do not themselves get sick or die of the virus, but they can transmit it to other people. The remaining one third develop chronic hepatitis B, a disease of the liver that can be very serious.

The liver is an essential organ that the body needs to stay alive. Its most important functions are filtering many drugs and toxins out of the blood, storing energy for later use, helping with the absorption of certain nutrients from food, and p roducing substances that fight infections.

• The liver has an incredible ability to heal itself, but it can only heal itself if nothing is damaging it.
• Liver damage in chronic hepatitis B, if not stopped, continues until the liver becomes hardened and scarlike.
• Hepatitis B is the most common serious liver infection in the world. Worldwide, about 350 million people are chronic carriers of HBV, of whom, more than 250,000 die from liver-related disease each year.

• In the United States, hepatitis B is largely a disease of young adults aged 20-50 years. About 1.25 million people are chronic carriers, and the disease causes about 5000 deaths each year.

• The good news is that infection with HBV is almost always preventable. You can protect yourself and your loved ones from hepatitis B.

Hepatitis B Causes

• The hepatitis B virus is known as a blood-borne virus because it is transmitted from one person to another via blood.
  • saliva, which contain small amounts of blood, also carry the virus.
  • The virus c an be transmitted whenever any of these bodily fluids come in contact with the broken skin or a mucous membrane (in the mouth, genital organs, or rectum) of an uninfected person.

• People who are at increased risk of being infected with the hepatitis B virus include the following:
  • Men or women who have multiple sex partners, especially if they don't use a condom
  • Men who have sex with men
  • Men or women who have sex with a person infected with HBV
  • People with other STD ( sexually transmitted disease)
  • People who inject drugs with shared needles
  • People who receive transfusions of blood or blood products
  • People who undergo for kidney dialysis
  • Institutionalized mentally handicapped people and their attendants and family members
  • Health care workers who are stuck with needles or other sharp instruments contaminated with infected blood
  • Infants born to infected mothers

• In some cases, the source of transmission is never known.

• The younger you are when you become infected with the hepatitis B virus, the more likely you are to develop chronic hepatitis B. The rates of progression to chronic hepatitis B are as follows:
  • 90% of infants infected at birth
  • 30% of children infected at age 1-5 years
  • 6% of people infected after age 5 years
  • 5-10% of infected adults

• You cannot get hepatitis B from the following activities:
  • Being sneezed or coughed on
  • Hugging
  • Handshaking
  • Eating food or drinking water
  • Casual contact (such as an office or social setting)

When to Seek Medical Care

Call your health care provider if you have any of the following:

• Nausea and vomiting that does not go away in 1-2 days
• Yellow skin or eyes
• Dark-colored (like tea or cola) urine
• Pain in the abdomen

Either of these situations also warrants a call to your health care provider:

• You think that you might have been exposed to someone with hepatitis or that you might be at risk for any reason.
• You have other medical problems and think that you might have hepatitis.

If you are unable to reach your health care provider or have any of the following, go immediately to a hospital.

• Vomiting and cannot keep down any fluids

Exams and Tests

Since many people with hepatitis B do not have symptoms, they do not know they have the disease.

• Hepatitis B is often discovered accidentally when you see your health care provider for another reason.
• Blood tests done for an annual check-up, insurance purposes, or before surgery may show abnormalities in the liver blood test results.

If your health care provider determines that you may be at risk for contracting hepatitis, you will have blood drawn.

• The laboratory will examine the blood to determine how well your liver is functioning, if this has not already been done.
• Your blood will be tested to determine whether you have been exposed to certain hepatitis viruses and, possibly, other viruses.
• If you have had a large amount of vomiting or have not been able to take in liquids, your blood electrolytes may also be checked to ensure that your blood chemistry is in balance.
• Other tests may be ordered to rule out other medical conditions.

X-rays and other diagnostic images are needed only in very unusual circumstances.

Once you are diagnosed with chronic hepatitis B, you will see your health care provider regularly.

• At each visit, your blood will be checked to see whether the virus is multiplying in your blood and how quickly.
• Your liver function tests also will be checked each time.
• These results help decide when it is time to start treatment.

Other tests will be done to determine whether you should undergo treatment or to

decide on the best treatment.

• CT scan or ultrasound - These diagnostic imaging tests are used to detect the extent of liver damage.
• Liver biopsy - This involves removal of a tiny piece of the liver. It is usually done by inserting a long needle into the liver and withdrawing the tissue. The tissue is examined under a microscope to detect changes in the liver. A biopsy may be done to detect the extent of liver damage or to evaluate how well a treatment is working.

they have the disease.

• Hepatitis B is often discovered accidentally when you see your health care provider for another reason.
• Blood tests done for an annual check-up, insurance purposes, or before surgery may show abnormalities in the liver blood test results.

If your health care provider determines that you may be at risk for contracting hepatitis, you will have blood drawn.

• The laboratory will examine the blood to determine how well your liver is functioning, if this has not already been done.
• Your blood will be tested to determine whether you have been exposed to certain hepatitis viruses and, possibly, other viruses.
• If you have had a large amount of vomiting or have not been able to take in liquids, your blood electrolytes may also be checked to ensure that your blood chemistry is in balance.
• Other tests may be ordered to rule out other medical conditions.

X-rays and other diagnostic images are needed only in very unusual circumstances.

Once you are diagnosed with chronic hepatitis B, you will see your health care provider regularly.

• At each visit, your blood will be checked to see whether the virus is multiplying in your blood and how quickly.
• Your liver function tests also will be checked each time.
• These results help decide when it is time to start treatment.

Other tests will be done to determine whether you should undergo treatment or to decide on the best treatment.

• Histopathology - This involves removal of a tiny piece of the liver. It is usually done by inserting a long needle into the liver and withdrawing the tissue. The tissue is examined under a microscope to detect changes in the liver. A biopsy may be done to detect the extent of liver damage or to evaluate how well a treatment is working.