All You Need To Know About Hepatitis B

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Hepatitis B infection is a worldwide healthcare problem, especially in developing countries. It is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). The hepatitis B virus (HBV) is commonly transmitted via body fluids such as blood, semen, and vaginal secretions and is mostly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections, or exposures to sharp instruments.

Hepatitis B is a “silent epidemic” because most people do not have symptoms when they are newly infected or chronically infected. Thus, they can unknowingly spread the virus to others and continue the silent spread of hepatitis B. A safe and effective vaccine that offers 98% to 100% protection against hepatitis B is available. Preventing hepatitis B infection averts the development of complications including chronic disease and liver cancer.

The burden of hepatitis B infection is highest in the Western Pacific Region and the African Region, where 116 million and 81 million people, respectively, are chronically infected.

TYPES

Acute Hepatitis:

An acute hepatitis B infection may last up to six months and infected persons can pass the virus to others during this time. If diagnosed with hepatitis B infection, a simple blood test should be done periodically to know if the hepatitis B virus is still present in the blood or if it has been successfully gotten rid of. Symptoms of acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. Although most people are asymptomatic.

Chronic Hepatitis:

People who test positive for the hepatitis B virus for more than six months are diagnosed as having a chronic infection. This means their immune system was unable to get rid of the hepatitis B virus, which remains in their blood and liver.

TRANSMISSION

Hepatitis B is commonly spread from mother to child at birth or through exposure to infected blood. The development of chronic infection is common in infants infected by their mothers or before the age of 5 years. Hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5% of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95% of cases. This is the basis for strengthening and prioritizing infant and childhood vaccination.

Hepatitis B is also spread by needlestick injury, tattooing, piercing, and exposure to infected blood and body fluids, such as saliva and menstrual, vaginal, and seminal fluids. Transmission of the virus may also occur through the reuse of contaminated needles and syringes or sharp objects either in health care settings, in the community, or among persons who inject drugs. Sexual transmission is more prevalent in unvaccinated persons with multiple sexual partners.

The hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. The incubation period of the hepatitis B virus ranges from 30 to 180 days. The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B, especially when transmitted in infancy or childhood.

RISK FACTORS

  • Health care providers and emergency responders
  • Sexually active individuals (more than 1 partner in the past six months)
  • Men who have sex with men
  • Individuals diagnosed with a sexually transmitted disease
  • Illicit drug users (injecting, inhaling, snorting, pill-popping)
  • Sexual partners or those living in close household contact with an infected person
  • Individuals born in countries where hepatitis B is common (Asia, Africa, South America, Pacific Islands, Eastern Europe, and the Middle East)
  • Anyone diagnosed with cancer before initiation of anticancer treatment
  • Kidney dialysis patients and those in the early kidney (renal) failure
  • Inmates and staff of a correctional facility
  • Residents and staff of facilities for developmentally disabled persons
  • All pregnant women

SIGNS & SYMPTOMS

Signs and symptoms of hepatitis B range from mild to severe. They usually appear about one to four months after you’ve been infected, and some people can be asymptomatic. Signs and symptoms may include:

  • Abdominal pain
  • Dark urine
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea and vomiting
  • Weakness and fatigue
  • Jaundice

CAUSES

Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from person to person through blood, semen, or other body fluids and it does not spread by sneezing or coughing. The common ways that HBV can spread are:

Sexual contact: Having unprotected sex with someone who is infected can cause the infection if the person’s blood, saliva, semen, or vaginal secretions enter the body.

Sharing of needles: HBV easily spreads through needles and syringes contaminated with infected blood. 

Accidental needle sticks: Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.

Mother to child: Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated to avoid getting infected in almost all cases.

DIAGNOSIS

Blood tests: Blood tests can detect signs of the hepatitis B virus in the body and can also show if it’s an acute or chronic infection. A simple blood test can also determine if the person is immune to the condition.

Liver ultrasound: A special ultrasound called transient elastography can show the amount of liver damage.

Liver biopsy: A small sample of the liver is removed for testing to check for liver damage. 

TREATMENT & PREVENTION

  • Treatment to prevent hepatitis B infection after exposure:

An injection of immunoglobulin given within 12 hours of exposure to the virus may help protect you from getting sick with hepatitis B. Because this treatment only provides short-term protection, it is best to also get the hepatitis B vaccine at the same time, if not vaccinated.

  • Treatment for acute hepatitis B infection:

This may not need treatment because it is short-lived and will go away on its own. Instead, proper rest, proper nutrition, and plenty of fluids are recommended while the body fights the infection, and in severe cases, antiviral drugs or a hospital stay is needed to prevent complications.

  • Treatment for chronic hepatitis B infection:

Most people diagnosed with chronic hepatitis B infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents the person from passing the infection to others. Treatment for chronic hepatitis B may include Antiviral medications, Interferon injections, and Liver transplants that might be needed in case of a severely damaged liver.

Prognosis:

Most adults with hepatitis B recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic (long-lasting) hepatitis B infection. A vaccine can prevent hepatitis B, but there’s no cure if you have the condition. 

In Nigeria, hepatitis B is said to have a national prevalence, that is, the proportion of a population who have hepatitis B in a given time period, of 11%. Overall, vaccination to protect against HBV infection is part of the WHO Extended Program for Immunization (EPI) and has been progressively rolled out across Africa since 1995, alongside enhanced interventions for the prevention of mother-to-child transmission. The vaccine is given 3 times at intervals to achieve lifelong immunity against the disease. It is safe and given as an intramuscular injection.

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