Hepatitis B (HBV) is a viral infection affecting liver. It is caused by hepatitis B virus. HBV can be acute or chronic. Acute hepatitis B lasts for sometime after which the patient gets better. Some people get chronically infected with this virus. Chronic infection with HBV can damage the liver and is one of the important causes for cirrhosis of liver and liver cancer. Progression of infection from acute phase to chronic phase in adults is around 5 to 10 %, but HBV tends to become chronic almost in 90% of infected children.
Hepatitis B infection is parenterally transmitted. It means transmission of virus is through blood borne route from infected blood and blood products, intravenous drug abusers etc. Some patients may not develop any symptoms while some may develop. Symptoms when present include dark yellow or brown urine, pain in abdomen, loss of appetite, vomiting and nausea, mild fever, weakness, and jaundice.
Acute HBV infection in majority of cases is self limiting disease and it does not require any treatment. In patients with chronic HBV infection antiviral therapy is needed.
Causes And Risk Factors Of Hepatitis B
Hepatitis B infection is caused by hepatitis B virus.It is a single stranded DNA virus which has tendency to replicate. The virus is transmitted through blood borne route and contact with body fluids. This means a person can be infected if he comes in contact with blood, semen, saliva and other fluids of body of a patient who is suffering from hepatitis B.
The common sources of transmission of hepatitis B are as follows:
- Blood transfusion: Transfusion of blood infected by hepatitis B virus.
- Sexual contact: Unprotected sex with an infected person can transmit the disease to non infected person. The virus can transmit through semen, vaginal secretion or blood of an infected person.
- Sharing of needle and syringes: Sharing needles and syringes contaminated with blood of an infected person can spread HBV infection. This is more common among intravenous drug abusers.
- Needle stick injury: Person may get infected with the virus if he accidentally is exposed to needle prick contaminated with blood of a HBV patient. This is more common among health care workers.
- Shared items: Shared razor blades, shared needles used for tattooing, acupuncture needle, shared tooth brushes, all can transmit the virus.
- Mother to fetal transmission: Vertical transmission from mother to child can occur during childbirth, if mother is infected with HBV infection.
Risk factors for passing hepatitis B virus:
- Sex with multiple partners without taking proper protective measures.
- Unprotected sexual intercourse with a person infected with HBV.
- Anal, oral or vaginal sex. Homosexuals and lesbians are at risk.
- Sharing of needles among intravenous drug abusers.
- Job of health workers, who are exposed to blood and body fluids, for example pathology technicians, nurses and doctors etc.
- Infant born to a mother infected with HBV.
Signs And Symptoms Of Hepatitis B Infection
Hepatitis B is an extremely contagious disease. Some people may experience signs and symptoms while some may not after being infected. The incubation period is between one month and four months. This means the symptoms develop between one to four months after the virus enters into the body.
In majority of adults the infection is acute and the symptoms vanish after a period of time. The immune system of the body kills with virus within 6 months after infection. But in some patients particularly, children the virus survives more than 6 months and remains active or latent for years to cause chronic infection. This may lead to liver damage in later years.
Following symptoms are observed in viral hepatitis B.
- Pain in upper right side of abdomen where the liver is located.
- Dark yellow or brown colored urine.
- Yellow discoloration of white of eye, skin and nails. In medical terminology it is called jaundice.
- Loss of appetite
- Vomiting and nausea
- Immense weakness
- Mild fever
Treatment Guidelines For Hepatitis B
Diagnosis of hepatitis B infection is relied on estimation of antigen and antibodies in blood sera. Presence of HBsAg (Australia antigen) in blood suggests that the patient is infected with hepatitis B virus. Besides various other blood tests such as liver function test, sonography of liver will also help to estimate damage to the liver.
Acute hepatitis B infection generally does not require any specific treatment because the disease is self limiting. The immune system of the body takes care of the virus and destroys it over a period of time. However, careful follow up of blood test after a period of few months is required to know whether the patient has developed chronic disease.
Patient in case of acute hepatitis needs rest, plenty of fluids, and eating healthy food. Patient must avoid drinking alcohol as the liver is already damaged.
The goal of chronic hepatitis is to prevent long term complication, improvement of symptoms, and reduce the mortality from complications. Patients suffering from chronic hepatitis B require antiviral therapy and interferon injections. In case of severe liver damage liver transplant can be thought of.