CONDITIONS

What Is Hepatitis B

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Hepatitis B is a viral infection of the liver that causes severe inflammation and liver damage. The virus that causes hepatitis B, HBV, is extremely contagious – in fact, it is 50-100 times more contagious than the AIDS virus – and is transmitted through contact with infected bodily fluids.

In some cases of hepatitis B infection, the body is able to clear the infection and make a full recovery. This is known as acute hepatitis B. In other cases, the virus remains in the body and continues to cause damage to the liver. This is known as chronic hepatitis B.

The Word Health Organization estimates that 240 million people world wide who are chronically infected with hepatitis B.  In the US, it is estimated that nearly 20,000 new cases of Hepatitis B occurred in 2011.

What Causes Hepatitis B

Hepatitis B is caused by infection with the hepatitis B Virus or HBV. The HBV virus is a member of a family of viruses that cause hepatitis (inflammation of the liver) including the Hepatitis A, C, D, & E viruses. Transmission of the HBV virus occurs through contact with infected bodily fluids. The Center for Disease Control and Prevention (CDC) reports that the most common forms of HBV transmission include:

  • Sexual contact with an infected person
  • Childbirth by a mother who is infected or a carrier of the virus, which is referred to as vertical transmission
  • Using shared needles or syringes
  • Contact with the blood of an infected person
  • Using shared items such as razors or toothbrushes

The HPV virus can survive outside the body for as long as a week and may be spread through contact with bodily fluids that have remained on surfaces.

Risk Factors For Hepatitis B

There are several factors that can increase your risk of hepatitis B infection. These include:

  • Age. Infants, children, and the elderly are at a greater risk of developing HBV infection due to weakened immune systems.
  • Travel history. Travelling to a country or region with a high rate of HBV infection can increase your risk of contracting the HBV virus. For a list of regions with high rates of HBV, visit the CDC.
  • Number of sexual partners. Having more than one sexual partner, or being in a non-monogamous relationship increases the risk of HBV transmission via contact with infected sexual fluids.
  • Drug use. Those who use inject drugs are at a higher risk of contracting the HBV virus due to the risk of transmission via the use of shared needles and syringes.
  • Occupation. Health care workers that frequently come into contact with the bodily fluids of HBV-positive patients are more susceptible to contracting the virus.
  • Infected family. Children of infected mothers are at a very high risk of contracting the HBV virus during childbirth. Living with a family member infected with HBV can also increase your risk of developing the virus.

Diagnosing Hepatitis B

The symptoms of hepatitis B can be signs of many different illnesses. Before arriving at a hepatitis B diagnosis, a doctor must first conduct blood tests to check for the presence of HBV-specific antibodies and antigens, specialized immune proteins that help the body fight infection. The type of immune proteins present in the body can reveal whether or not a patient is infected, and to what extent the body was able to fight off the infection.

According to the CDC, the following are the immune proteins associated with HBV infection:

  • Hepatitis B surface antigen (HBsAg), which is found on the surface of HBV and indicates contagious acute or chronic HBV infection.
  • Hepatitis B surface antibody (anti-HBs), which is typically produced when the body has fought the HBV virus and become immune to it.
  • Total hepatitis B core antibody (anti-HBc), which indicates infection with HBV but does not differentiate between past and present infection.
  • IgM antibody to hepatitis B core antigen (IgM anti-HBc), which indicates acute infection with HBV.

Individuals acutely infected with HBV will be:

  • positive for the HBsAg, anti-HBc, and IgM anti-HBc and
  • negative for anti-HBs.

Individuals chronically infected with HBV will be:

  • positive for HBsAg and anti-HBc and
  • negative for IgM anti-HBc.

Individuals immune to HBV infection due to hepatitis B vaccination will be:

  • positive for anti-HBs and
  • negative for HBsAg and anti-HBc.

Individuals immune to HBV infection due to natural HBV infection will be:

  • positive for anti-HBc and anti-HBs and
  • negative for HBsAg.

Symptoms of Hepatitis B

Symptoms of hepatitis B develop an average of 90 days after exposure to the HBV virus. Some patients, especially children under the age of five and immunosuppressed individuals, are less likely to experience symptoms than others. According to the CDC, the following are the most common signs and symptoms of HBV infection:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored bowel movements
  • Joint pain
  • Jaundice

Prognosis

The prognosis of hepatitis B depends on several different factors, including the age of the person infected and the ability of the person’s immune system to fight off the infection. The majority of acute HBV cases do not result in severe liver damage; less than 1% of acute hepatitis B cases result in fatality. The CDC reports that 95% of adults infected with HBV make a full recovery and do not progress to the chronic form of the disease. Infants and young children are far more likely to develop chronic hepatitis B, with 90% of infants and 25-50% of children under the age of five going on to develop chronic hepatitis B. 2,000 to 4,000 deaths per year are associated with complications due to chronic HBV infection.

Living With Hepatitis B

If you have been diagnosed with hepatitis B, consider the following in your journey through treatment and recovery:

  • Know the facts. Educating yourself on the basics of hepatitis B can help you better understand your disease and treatment. While facts on the disease can be helpful, however, remember that they are not always universal. Talk openly with and listen to your doctor about the specifics of your hepatitis b case.
  • Refrain from smoking and drinking alcohol. Both of these can put excess stress on your liver and worsen your condition.
  • Share your diagnosis with the necessary people. Not everyone needs to know about your diagnosis, but you should share it with past and/or current sexual partners, and with the people you live with. They should get tested for HBV if there is a chance they have come into recent contact with your body fluid.
  • Talk about contagiousness. HBV is extremely contagious, but a hepatitis B diagnosis shouldn’t be cause for panic. Talk to those close to you about behaviors that cannot transmit HBV (sharing food/water, breastfeeding, hugging, kissing, coughing, sneezing, hand holding) and those that can (contact with infected blood/bodily fluids, childbirth, sharing of needles/syringes).

Screening

Hepatitis B vaccination is recommended for all infants in the United States and required for entry into many schools, universities, and other institutions. As well, the NIH recommends that all children and adolescents younger than 19 years of age who have not yet gotten the HBV vaccine should also be vaccinated. “Catch-up” vaccination is recommended for children and adolescents who were never vaccinated or who did not get the entire vaccine series.

Hepatitis B is rarely screened for in the general population. However, the US Preventive Services Task Force does recommend regular screening for people at high risk for infection. This includes people who were not vaccinated as infants, those who have infected family members, and those who have recently travel led to a high-risk HBV area.

Prevention

The hepatitis B vaccine is the most effective way to prevent the contraction of the hepatitis B virus. The World Health Organization reports that the vaccine is 95% effective in preventing HBV infection and the progression of HBV infection to chronic hepatitis and/or liver cancer.

The vaccine is recommended to be administered to all newborn infants within 24 hours of birth (if possible). Vaccination administration is also recommended for adult individuals who have not yet received the vaccination and are planning on travelling to a high risk area.

Recent controversy surrounding a possible link between autism and the hepatitis B vaccine has led some parents to withhold their children from vaccination. However, many medical institutions, including the Centers for Disease Control and Prevention (CDC), have reported that vaccines do not cause autism. Withholding your child from the hepatitis B vaccination can put your child at risk. The HBV virus is extremely contagious (up to 100x more contagious than HIV) and infection with the virus before the age of 5 is likely to lead to chronic hepatitis.

Medication And Treatment

There is no known cure for acute or chronic hepatitis B. Treatment for acute hepatitis B is focused on supporting the body in its fight against infection, which typically involves symptom-oriented treatment to help reduce nausea, vomiting, fever, etc. Treatment for chronic hepatitis B is focused on the suppression of HBV virus reproduction and prevention of damage to liver tissues.

Complementary and Alternative Treatment

The Institute for Traditional Medicine of Portland, Oregon reports that the following traditional Chinese herbs can successfully treat liver disease:

  • Licorice root, which contains glycyrrhizin, a substance which is known to have antiretroviral and anti-inflammatory properties.
  • Schizandra, a fruit from Schizandra sinensis, which contains components known to prevent and reverse damage to liver cells.
  • Salvia, which helps to restore circulation within the liver and decreases the severity of cirrhosis (scarring) of the liver.
  • Curcuma, which contains curcumin, a substance that is a powerful anti-inflammatory and anti-viral agent.

There is limited clinical evidence to support the efficacy of alternative treatments for hepatitis B, including the use of traditional Chinese herbs. Do not attempt to treat yourself or a loved one with herbal medicine without first consulting both a certified traditional Chinese medicine practitioner and a trusted medical doctor. Certain herbs can have severe and potentially fatal interactions with other medications. Before beginning any alternative treatment routine, consult with your doctor.

When To Contact A Doctor

If you feel that you are experiencing any of the symptoms or warning signs of hepatitis B, contact your doctor immediately.

If you are undergoing treatment for hepatitis B and experience any of the following, contact a doctor immediately:

  • Fever
  • Changes in appetite
  • Nausea
  • Persistent headaches
  • Abdominal pain
  • Confusion
  • Dizziness

To find a general practitioner in your area, visit www.healthgrades.com

To find a doctor specializing in hepatitis B treatment, visit the Hepatitis B Foundation

Questions For A Doctor

You may want to ask your doctor the following questions:

  • Is my HBV infection chronic or acute?
  • Is my HBV infection likely to become acute in the future?
  • To what extent has HBV damaged my liver?
  • Am I likely to make a full recovery?
  • Am I contagious or will I be contagious in the future?
  • Is my family or partner at risk of contracting HBV?
  • What are the available treatments for hepatitis B?
  • What are the side effects for the available hepatitis B treatments?
  • What lifestyle changes can I make to help in my recovery