Hepatitis B

February 2, 2017

Hepatitis B is an infectious liver disease. It is caused by the hepatitis B virus (HBV). Infections of hepatitis B occur only if the virus is able to enter the blood stream and reach the liver. Once in the liver, the virus reproduces and releases large numbers of new viruses into the bloodstream. Hepatitis B is a vaccine-preventable bloodborne infection.

Hepatitis means inflammation of the liver. There are many causes of hepatitis. For example, drinking too much alcohol, various drugs and chemicals, and also several different germs (viruses) can cause hepatitis. One virus that causes hepatitis is called the hepatitis B virus. This leaflet is only about hepatitis B. See separate leaflets called Hepatitis A and Hepatitis C, which are caused by different viruses. Hepatitis B is a virus which is carried in the bloodstream to the liver. It can then affect and damage your liver.

Hepatitis B is a contagious liver disease that results from infection with the Hepatitis B virus. When first infected, a person can develop an “acute” infection, which can range in severity from a very mild illness with few or no symptoms to a serious condition requiring hospitalization. Acute Hepatitis B refers to the first 6 months after someone is exposed to the Hepatitis B virus. Some people are able to fight the infection and clear the virus. For others, the infection remains and leads to a “chronic,” or lifelong, illness. Chronic Hepatitis B refers to the illness that occurs when the Hepatitis B virus remains in a person’s body. Over time, the infection can cause serious health problems.

Hepatitis B is highly infectious. An estimated 700,000 to 1.4 million people in the United States have the virus, and most of them acquired it in childhood.

Causes

The virus is found in the blood or certain body fluids and is spread when blood or body fluid from an infected person enters the body of a person who is not infected. This can occur in a variety of ways including:

  • Unprotected sexual contact
  • Sharing drugs, needles, or “works” when using drugs
  • Poor infection control practices in medical settings, particularly with equipment to test blood sugar
  • Needle sticks or sharps exposures on the job
  • From mother to baby during birth
  • Contact with wounds or skin sores
  • When an infected person bites another person
  • Pre-chewing food for babies
  • Sharing personal-care items, such as razors or toothbrushes

Hepatitis B virus particles can be found on objects, even in the absence of visible blood. The virus can remain infectious and capable of spreading infection for at least seven days outside the human body.

Hepatitis B is not spread through food or water, sharing eating utensils, hugging, kissing, coughing, and sneezing or by casual contact, such as in an office or factory setting.

Risk Factors

Hepatitis B spreads through contact with blood, semen or other body fluids from an infected person. People are at risk of hepatitis B infection increases if they –

  • Have unprotected sex with multiple sex partners or with someone who’s infected with HBV
  • Share needles during intravenous (IV) drug use
  • Are a man who has sex with other men
  • Live with someone who has a chronic HBV infection
  • Are an infant born to an infected mother
  • Have a job that exposes them to human blood
  • Travel to regions with high infection rates of HBV, such as Africa, Central and Southeast Asia, and Eastern Europe

Symptoms

The symptoms of hepatitis B depend on whether a person has acute or chronic hepatitis B infection.

Symptoms of Acute Hepatitis B

Symptoms resulting from acute hepatitis B infection among adults are common, with jaundice occurring approximately 12 weeks after initial infection.

The symptoms of acute hepatitis B include –

  • Loss of appetite
  • Nausea and vomiting
  • Tiredness
  • Abdominal pain
  • Muscle and joint pain
  • Jaundice (yellowish eyes and skin, dark urine and pale-coloured faeces/poo).

Many people with acute hepatitis B have no symptoms and never realise they had the infection. A very small percentage of people with acute hepatitis B become very sick in a short period of time. This happens if there is massive damage to the liver and it stops working. This is called ‘fulminant hepatitis’.

Symptoms of Chronic Hepatitis B

Most people with chronic hepatitis B do not have any symptoms of infection which means they may feel healthy and not be aware they are infected. However, other people may experience symptoms which are similar to those experienced with other forms of viral hepatitis. These can include –

  • Tiredness, depression and irritability
  • Pain in the liver (upper, right side of abdomen)
  • Nausea and vomiting
  • Loss of appetite
  • joint aches and pains.

Complications

Having a chronic HBV infection can lead to serious complications, such as –

  • Scarring of the liver (cirrhosis) – The inflammation associated with a hepatitis B infection can lead to extensive liver scarring (cirrhosis), which may impair the liver’s ability to function.
  • Liver cancer – People with chronic hepatitis B infection have an increased risk of liver cancer.
  • Liver failure – Acute liver failure is a condition in which the vital functions of the liver shut down. When that occurs, a liver transplant is necessary to sustain life.
  • Other conditions – People with chronic hepatitis B may have kidney disease, inflammation of blood vessels or anemia.

Treatment

Treatment for the short-term (acute) phase

No treatment can clear the germ (virus) from the body. If the patient develops symptoms when first infected, treatment aims to help ease symptoms until they go – for example, drinking plenty of water to avoid lack of fluid in the body (dehydration). Rarely, a severe hepatitis develops which may need hospital care. No treatment can prevent acute hepatitis B from becoming persistent (chronic).

 

Treatment for chronic infection

Treatment for hepatitis B does not cure hepatitis B but works to delay or even to prevent complications from developing, like liver damage and scarring of the liver (cirrhosis). People with chronic hepatitis B usually need treatment to stop or to reduce the activity of the virus, so limiting liver damage. A liver specialist will usually advise on when treatment may be beneficial. There are two types of treatment currently given –

Interferon – This medicine is similar to a substance produced in your body, which is also called interferon. It works to fight infections by boosting the immune system. Interferon is usually given as an injection each week.

Antiviral medicines – These work by stopping the hepatitis B virus from multiplying in the body. They include lamivudine, adefovir, tenofovir, and entecavir. The doctor will discuss these in more detail with the patient, as the medicine used can vary between people. A combination of antiviral medicines is sometimes used.

Treatment with medicines is usually continued for many years.

Liver transplant – For some people with advanced scarring of the liver (cirrhosis), liver transplantation may be an option. Although this is a major operation, the outlook following a liver transplant can be very good. However, the new liver may also eventually become damaged by the persisting (chronic) hepatitis B infection.

Diet and alcohol – Most people with chronic hepatitis B will be advised to eat a normal healthy balanced diet. Ideally, anybody with inflammation of the liver should not drink alcohol. If a person already has liver inflammation, alcohol increases the risk and speed of developing scarring of the liver (cirrhosis).

Self Help

  • Avoid sharing needles/syringes, spoons, drug solutions or water, filters, cookers, pipes, straws used for snorting drugs, and other drug related equipment. Cleaning with bleach may not kill HBV;
  • Practice safer sex. Use condoms/dental dams to reduce the risk of acquiring sexually transmitted and blood borne infections (STBBIs) including HBV;
  • Avoid dental, medical or cosmetic procedures that penetrate the skin (e.g., transfusions, acupuncture, piercing or tattooing) unless you are certain that the needles, materials and equipment are sterile;
  • Wear latex gloves if you are likely to be in contact with someone else’s blood or bodily fluids;
  • Don’t share personal items like razors, scissors, nail clippers or toothbrushes; and
  • Be especially careful when travelling abroad in countries where HBV is widespread.

Alternative Treatment

  • Healthy diet emphasizing lots of fruits, vegetables, berries, and nuts.
  • Sunlight
  • Neem
  • Milk thistle
  • Mega-dose of vitamin C
  • Selenium
  • Flax seed oil mixed with yogurt
  • Turmeric or curcumin
  • Get some light exercise every day
  • Arginine
  • Licorice root
  • Dandelion
  • Sea salt
  • Iodine
  • Zinc supplements
  • American ginseng
  • Sophora root

Optional Supplements

  • Glutathione
  • Quercetin
  • CoQ10
  • Green tea
  • DHEA
  • N-acetyl cysteine

Optional for hepatitis mental issues with anxiety, insomnia, and etc –

  • Skullcap
  • Chamomile (may cause drowsiness and avoid if there are ragweed allergies)
  • John’s Wort (unless there is a chance of pregnancy)

 

Reference –

https://umm.edu/health/medical/ency/articles/hepatitis-b

http://www.hopkinsmedicine.org/gastroenterology_hepatology/diseases_conditions/faqs/hepatitis_B_C.html

http://www.hepatitisaustralia.com/hepatitis-b-facts/about-hep-b

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hepatitis-b

http://www.hepfi.org/HEPATITIS/Hepatitis-B.html

http://www.babycenter.com/0_the-hepatitis-b-vaccine_1561.bc

http://www.healthline.com/health/hepatitis-b

http://www.britishlivertrust.org.uk/liver-information/liver-conditions/hepatitis-b/

https://labtestsonline.org/understanding/analytes/hepatitis-b/tab/test/

http://www.phac-aspc.gc.ca/hcai-iamss/bbp-pts/hepatitis/hep_b-eng.php

https://www.aasld.org/sites/default/files/guideline_documents/ChronicHepatitisB2009.pdf

https://www.ccohs.ca/oshanswers/diseases/hepatitis_b.html

http://www.vaccineinformation.org/hepatitis-b/

http://www.itmonline.org/arts/hepb.htm

http://emedicine.medscape.com/article/177632-treatment

http://www.who.int/mediacentre/factsheets/fs204/en/

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