Hepatitis B

Definition

Hepatitis B is a liver disease caused by the hepatitis B virus. Most hepatitis B infections clear up within 1-2 months without treatment. When the infection lasts more than six months, it can develop into chronic hepatitis B, which can lead to:

Hepatitis

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Causes

Hepatitis B is caused by the hepatitis B virus. This virus is spread through contact with body fluids of an infected person, such as blood, semen, vaginal fluids, and saliva. A woman infected with hepatitis can pass the virus onto her baby during childbirth.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Coming in contact with the blood or other body fluids of someone infected with hepatitis B increases your risk for infection. Unlike hepatitis A virus, hepatitis B virus is not spread through contaminated food or water.

The following situations may increase your risk of getting hepatitis B:

  • Having sex with someone infected with hepatitis B or who is a carrier of hepatitis B
  • Injecting illicit drugs, especially with shared needles
  • Having more than one sexual partner
  • Being a man who has sex with men
  • Living in the same house with someone who is infected with hepatitis B
  • Having a job that involves contact with body fluids, such as:
    • First aid or emergency workers
    • Funeral directors
    • Medical personnel
    • Dentists
    • Dental assistants
    • Firefighters
    • Police personnel
  • Having a sexually transmitted disease at the time you come in contact with hepatitis B
  • Traveling to areas where hepatitis B is common, such as China, southeast Asia, and sub-Saharan Africa
  • Receiving a blood transfusion prior to 1992 (the year a more reliable test to screen blood was developed)
  • Receiving multiple transfusions of blood or blood products, as hemophiliacs do (risk is greatly reduced with modern blood screening techniques)
  • Working or being a patient in a hospital or long-term care facility
  • Working or being incarcerated in a prison
  • Being bitten so that the skin is broken by someone whose saliva contains the virus
  • Receiving hemodialysis treatment

Symptoms

Symptoms usually appear within 25 to 180 days following exposure to the virus. The most common symptoms are:

  • Yellowing skin and eyes ( jaundice )
  • Fatigue that lasts for weeks or even months
  • Abdominal pain in the area of the liver (upper right side)
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain
  • Low-grade fever
  • Dark urine and light-colored stool
  • Widespread itching
  • Rash

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Hepatitis B is diagnosed with blood tests, which are also used to monitor its effects on the liver. For chronic cases, a liver biopsy may be needed. A biopsy is the removal of a sample of liver tissue for testing.

Treatment

The symptoms of hepatitis B can be treated with medication. If you have an uncomplicated case, you can expect to recover completely. If you have chronic hepatitis B, you may be treated with medication to reduce the activity of the virus and prevent liver failure.

Medications include:

  • Interferon alfa-2b (Intron A) injection
  • Lamivudine (Epivir-HBV) oral medication
  • Adefovir (Hepsera) oral medication
  • Entecavir (Baraclude) oral medication

If you have chronic hepatitis B, you should avoid anything that can further injure the liver, including:

  • Alcohol
  • Certain medications, dietary supplements, and herbs (Discuss these substances with your doctor before taking them.)

If you have chronic hepatitis B, prevent the spread of the infection by:

  • Telling your doctors, dentists, and sexual partner(s) that you have hepatitis B
  • Never donating blood, organs, or tissue
  • Discussing your hepatitis B status with your doctor during pregnancy or before becoming pregnant to insure the baby receives treatment

Prevention

Hepatitis B can be prevented through vaccination , which consists of three injections over a six-month period. Protection is not complete without all three injections. Anyone at increased risk for hepatitis B should be vaccinated.

In addition, to prevent the transmission of hepatitis B:

  • Use condoms or abstain from sex.
  • Limit your number of sexual partners.
  • Do not inject drugs. If you use IV drugs, get treatment to help you stop. Never share needles or syringes.
  • Do not share personal items that might have blood on them, such as:
    • Razors
    • Toothbrushes
    • Manicuring tools
    • Pierced earrings
  • If you get a tattoo or body piercing, make sure the artist or piercer properly sterilizes the equipment. You might get infected if the tools have someone else's blood on them.
  • If you are a healthcare or public safety worker:
    • Get vaccinated against hepatitis B.
    • Always follow routine barrier precautions and safely handle needles and other sharp instruments.
  • Wear gloves when touching or cleaning up body fluids on personal items, such as:
    • Bandages
    • Band-aids
    • Tampons
    • Linens
  • Cover open cuts or wounds.
  • Use only sterilized needles for drug injections, blood testing, ear piercing, and tattooing.
  • If you are pregnant, have a blood test for hepatitis B. Infants born to mothers with hepatitis B should be treated within 12 hours after birth.

RESOURCES:

American Liver Foundation
http://www.liverfoundation.org

Hepatitis B Foundation
http://www.hepb.org

CANADIAN RESOURCES

Canadian Institute for Health Information
http://www.cihi.ca

Canadian Liver Foundation
http://www.liver.ca/Home.aspx

References:

American Liver Foundation website. Available at: http://www.liverfoundation.org .

Braunwald E, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Longo DL, eds. Harrison's Principles of Internal Medicine. 15th ed. McGraw-Hill; 2001.

Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ .



Last reviewed February 2008 by David L. Horn, MD, FACP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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