Hepatitis-B

Hepatitis B is a major health concern worldwide. According to the World Health Organisation (WHO), there were around 8,87,000 deaths caused due to liver diseases related to hepatitis B virus worldwide, with almost 240 million people infected with chronic HBV infection. According to the reports of the World Health Organisation, around 1,15,000 Indians die of hepatitis B and its related complications. It is estimated that there are over 40 million carriers of HBV infection. Out of these carriers, the prevalence of hepatitis B surface antigen (HBsAg) is around 3-4%. However, hepatitis B viral infection is contagious, and it can get transferred from one person to another through body fluids. It can be difficult to control the spread of the viral infection in the long run; thus, the awareness of hepatitis B viral infection should be spread among the population.

With the increasing seriousness of hepatitis B viral infection, it is important to inform the population in detail about hepatitis B infection. In this article, let us talk in detail about hepatitis B, what it is, hepatitis B symptoms, hepatitis B causes, hepatitis B treatment, and hepatitis B meaning.  

Hepatitis B

What is hepatitis B?

Hepatitis B is a viral infection caused by the hepatitis B virus (HBV) in your liver. Hepatitis B can be acute or chronic. Acute hepatitis B generally doesn’t need any treatment. The chronic forms of hepatitis B are liver cancer and cirrhosis. According to the Centres for Disease Control Prevention (CDC), chronic hepatitis B infection can infect around 2-6% of the adults infected with HBV. The hepatitis B virus is classified into genotypes ranging from A to J. The most common genotype in the Indian population is genotype D, followed by A and C. The hepatitis virus causes inflammation to your liver and can also transmit to other people without knowing that you are infected. If the infection is chronic and undiagnosed for a long time, it can lead to irreversible liver damage. 

Acute hepatitis B virus infection

The acute infection does not last for more than 6 months. The acute hepatitis B infection can get completely treated from your body, and you may recover from the infection within 6 months. In adults, acute hepatitis B infection occurs more commonly, but it can also lead to chronic infection.

Chronic hepatitis B virus infection

A chronic hepatitis B infection lasts for more than 6 months. Chronic infection generally happens because your body’s immune system is not able to fight with it. Chronic hepatitis B infection can last for a lifetime, leading to serious health conditions like liver cancer and cirrhosis. The risk of developing chronic hepatitis B infection increases if you get the infection early in your life, that is, newborn babies, if diagnosed with hepatitis B infection at less than 5 years of age, can lead to a higher risk of the infection becoming chronic.

What are the symptoms of hepatitis B?

The infection of hepatitis B virus can be asymptomatic, that is, you do not experience any symptoms of the infection at all. The mild hepatitis infection can be treated independently without presenting any symptoms. Thus, you may have acute hepatitis infection, which you do not know. In case of severe or chronic infection, you can experience some symptoms of the infection. The infection of hepatitis B virus gets worse as you reach over 60 years of age. Some of the common symptoms of hepatitis infection include:

  • Dark urine
  • Fatigue
  • Loss of appetite
  • Pain in the muscles and joint
  • Discomfort in the abdominal area
  • Fever
  • Jaundice, that is, the whites of your eyes and skin turns yellow
  • Weakness 

What are the causes of hepatitis B?

The main causative agent responsible for hepatitis B is the hepatitis B virus (HBV). The hepatitis infection is contagious, that is, it can pass from one person to another through body fluids like blood or semen. Remember, the virus only spreads through bodily fluids, not coughing or sneezing. Some of the common causes or ways of the spread of the virus includes:

  • Sexual contact: Unprotected sex with an infected individual can cause you infection. This hepatitis B virus passes from an infected individual to a healthy person through saliva, blood, vaginal secretions, and semen.
  • Sharing of needles: It is very important to maintain sanitation and hygiene. The needles used during medical treatment should not be shared between patients as it can increase the risk of spread of infection. Hepatitis B virus also spreads through syringes and needles that are contaminated with the infected blood. You are at a higher risk of hepatitis B infection by sharing IV drug paraphernalia.
  • Accidental needle sticks: If you are a healthcare worker or a professional that comes in contact with the blood of other people, then it brings you at a higher risk of viral infection.
  • Mother to child transfer: If a pregnant woman is infected with the hepatitis B, there are high chances that the virus may pass from the infected mother to the newborn babies as well. However, in such cases, the infection can be prevented if the newborn baby is vaccinated for hepatitis infection. Consult your doctor if you are hepatitis B positive and plan your pregnancy. 

Who is at a greater risk of hepatitis B viral infection?

Hepatitis B viral infection can occur in any individual. However, a certain group of people are at a higher risk of developing hepatitis B viral infection. Doctors generally recommend the blood test to screen patients with hepatitis B viral infection. The screening test is generally done for people who are prone to hepatitis B. Screening is important to isolate or alert the people infected with the virus so that the transmission of the virus can be controlled. The people at a greater risk of developing hepatitis B viral infection include:

  • People who use injection drugs.
  • People who are on kidney dialysis
  • If you are born in a country with high cases of hepatitis B
  • If you come in contact with someone infected with the virus
  • If you are sexually involved with an infected individual.
  • If you take immuno-suppressants, that is, the medicines that suppress your immune system.
  • If you donate your blood or any organ.
  • If you are born to parents who are hepatitis B positive
  • If your liver enzymes are elevated in any of the blood tests
  • If you are pregnant
  • The infection can commonly occur if you are a male and in sexual contact with another male.
  • If you live in an institutional setting
  • If your profession brings you close contact with other people’s blood.
  • If you already have hepatitis C infection, you are also more prone to developing hepatitis B infection.
  • If you have sexual contact with multiple people
  • If you are undergoing treatment for any sexually transmitted infections.
  • If you are already suffering from any chronic liver disease

How is hepatitis B diagnosed?

The diagnosis of hepatitis B is done through a series of blood tests. Apart from blood tests, your doctor may also advise you for an ultrasound or other imaging tests. The blood tests that are generally done for the diagnosis of hepatitis B viral infection are:

Hepatitis B surface antigen test

This test is used to diagnose active infection, that is, whether or not you can transmit the infection to others. A positive hepatitis B surface antigen test indicates that you have an active infection and can transmit it to other people. A negative hepatitis B viral infection indicates that you do not have an active viral infection. Since this test does not differentiate between acute and chronic infection, other tests are done in combination with the hepatitis B surface antigen test to determine the state of viral infection.

Hepatitis B core antibody test

This screening test diagnoses whether or not you are currently living with the virus. A positive hepatitis B core antibody test generally interprets if you have an acute or chronic hepatitis B infection. The test results can also mean that you are currently recovering from acute viral hepatitis B.

Hepatitis B surface antibody test

This test predicts your immunity against the hepatitis B virus. A positive hepatitis B surface antibody test means you are immune to hepatitis B. You can get a positive surface antibody test in two cases:

  • If you have got yourself vaccinated for hepatitis B
  • If you have recovered from a hepatitis B viral infection and cannot transmit the infection to others.

Liver function tests

Liver function tests are important diagnostic tests that are prescribed for all liver-related disorders, including hepatitis B. The liver function tests evaluate the level of enzyme present in your blood. The high levels of enzymes present in your liver indicate an inflamed or damaged liver. The results obtained from these tests also help predict the part of your liver functioning abnormally. If you have an increased level of liver enzymes in your report, you might further need testing for hepatitis B, c, and any other liver infection. The most common cause of liver damage around the world is hepatitis B and C. 

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Hepatitis B viral infection is dangerous and can be fatal as well if not diagnosed at the right time. Often, the viral infection can be asymptomatic. Therefore, you might be hepatitis B positive without you even knowing about it. This makes the diagnosis of hepatitis B even more challenging. Therefore, it is always wise to get yourself diagnosed if you suspect you have been exposed to the infection. The early diagnosis of hepatitis B viral infection can make effective treatment of the infection possible. There are higher chances of chronic hepatitis B infection, and hepatitis-related complications occur if the treatment is delayed.

How is hepatitis B treated?

The hepatitis B infection is treated through over-the-counter medicines and lifestyle modifications. Early diagnosis and regular monitoring are very important to ensure that the acute hepatitis B infection does not lead to chronic infection. Take consultation from an expert healthcare professional if you suspect that you have been exposed to a viral infection. Generally, if you have been exposed to the viral infection within a week, your doctor might give you the first dose of the hepatitis B vaccine and hepatitis B immunoglobulin shot to give you short-term protection against the virus. The immunoglobulin shot is most effective if administered within 48 hours of the infection. Regular blood tests are done to ensure your infection does not develop into a chronic form. Lifestyle modifications and medicines play an important role in treating hepatitis B viral infection. 

Lifestyle modifications

The major modifications that you need to do if in case you have been diagnosed with hepatitis B include:

  • Give your body adequate rest
  • Make sure to wear loose clothes
  • Maintain a cool environment around yourself
  • Eat a balanced and nutritious diet
  • Avoid alcohol consumption, and if not that at least limit its intake
  • Herbal supplements and medicines can also help cure the infection
  • Take over-the-counter medicines prescribed by your doctor.

Medicines

If in case the viral infection persists for more than 6 months, your doctor can prescribe you medicines to control the viral infection and prevent damage to the liver. Some of the most commonly used medicines for the treatment of chronic hepatitis B include:

  • Entecavir (Baraclude): It is the most common antiviral tablet prescribed for the treatment of chronic hepatitis B viral infection.
  • Peginterferon alfa-2a (Pegasys): It is a type of interferon that stimulates your body’s immune function so that it can fight the hepatitis B virus more efficiently. Generally, injections of peginterferon alfa-2a are given for 6 months to 1 year, once a week.
  • Adefovir dipivoxil (Hepsera): It is an oral medicine belonging to the class known as nucleotide analogs. It reduces the load of the hepatitis B virus in your body to treat a chronic infection.
  • Tenofovir (Vemlidy, Viread): It is an oral antiviral tablet that is taken daily to reduce the symptoms of chronic viral infections like HIV or HBV.
  • Lamivudine (Epivir-HBV): It is an antiretroviral medicine that is commonly known as 3TC. This medicine is present in the form of a tablet or liquid. There is a possibility that people can deliver drug resistance against Lamivudine in the future years.
  • Telbivudine (Sebivo or Tyzeka): This medicine is available as a pill that needs to be taken daily. This medicine is prescribed by the doctor only when all the other treatment options have been ruled out.
  • Interferon alfa-2b (Intron A): This medicine comes in the form of an injection that enhances the functioning of your immune system to help your body fight chronic hepatitis B. 

What are the future complications related to hepatitis B infection?

Generally, an acute hepatitis B viral infection doesn’t lead to any complications, but if your infection becomes chronic, it can cause you some serious health complications. The future complications associated with hepatitis B infection include:

  • Cirrhosis or scarring of the liver: The inflammation caused due to the hepatitis B viral infection can cause extensive scarring of your liver called cirrhosis. The extensive scarring can impair the ability of your liver to function properly.
  • Liver cancer: Chronic hepatitis B viral infection increases your risk of liver cancer as well.
  • Liver failure: It is a condition wherein the vital functions of your liver cease. In case of liver failure, a liver transplant is the last treatment resort.
  • Other complications: People with chronic hepatitis B viral infection can lead to other health complications as well including inflammation of the blood vessels or occurrence of kidney disease.

How can hepatitis B viral infection be prevented?

Precaution is always better than cure. Therefore, it is better that you take measures to prevent hepatitis B viral infection than to go for its treatment at a later stage. The precautionary steps that you can take to prevent the viral infection include:

  • You must know the HBV status of your sexual partner. Ensure you do not indulge in unprotected sex with anyone before knowing their HBV test reports. Use a polyurethane or latex condom during intercourse.
  • Do not get yourself indulged in illegal drugs. Some drugs make you more prone to infection, especially when using injectable drugs.
  • Be cautious if you are getting a tattoo or body piercing done. Go to a reputed shop to get a tattoo or piercing done. Ensure that only sterile needles and properly cleaned equipment are used while tattooing and body piercing.
  • Make sure that you know about the vaccine for hepatitis B before you travel to a region where hepatitis B infection is very common. Ask your doctor whether you should get a hepatitis B vaccine in advance or not. The Hepatitis B vaccine is given over a period of 6 months in three injections.

Takeaway 

Hepatitis B is a common viral infection that affects many people. It is a contagious infection that rapidly spreads from an infected person to a healthy individual. The infection can be acute or chronic. Acute infection can get treated on its own, whereas chronic infection persists lifelong and can be fatal as well. Hepatitis B virus spreads through body fluids thus, you should be cautious when you come in contact with the other person. Hepatitis B infection is curable at the acute stage only. Therefore, it is very important that you get the infection diagnosed at an earlier stage so that its effective treatment is possible. Now that you know everything about hepatitis B viral infection, including its symptoms, causes, risk factors, complications, diagnosis, treatment, and prevention, make sure that you always remember these things. Make sure you get yourself diagnosed if you suspect you have been exposed to the hepatitis B virus. Also, take preventive steps to prevent yourself from infection as well to avoid future complications.

Frequently Asked Questions (FAQs)

  • How long can a hepatitis B patient live?

According to research, the estimated life expectancy of a hepatitis B virus carrier is around 71.8 years.

  • Can hepatitis B affect sperm?

Yes, hepatitis B can be a reason for male infertility by affecting sperm quality. However, in most cases, a male living with hepatitis B infection can have children.

  • Can a hepatitis B patient have a child?

Yes, hepatitis B-positive patients and couples can successfully have a child.

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Prekshi Garg is a young, dynamic, energetic, and meritorious professional biotechnologist. She is a merit rank holder in her post-graduation and a skilled bioinformatician with great zeal to do her best in neurosciences. She is currently working in the area of Neurotranscritomics dealing with neurodevelopmental and neurodegenerative disorders. She has presented many papers at different scientific forums and is awarded ‘Representing the Institution in Scientific Events’ citation by Amity University Uttar Pradesh and Top position in Student Assistantship Program held at Amity University in addition to awards won for oral presentations in different scientific deliberations. Prekshi has published a good number of papers and book chapters during the start of her academic career itself. Her tremendous skills and knowledge make her a good blend of biotechnology and bioinformatics.

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