Hepatitis B: causes and minimizing the risk
Hepatitis B is a highly contagious liver infection caused by the hepatitis B virus (HBV). Currently, over 350 million of the global population is chronically infected with HBV, and around 1 million die due to consequences of this infection annually. Bangladesh belongs to the intermediate prevalence region for HBV infection.
Many people have no symptoms during the initial infection. Some develop a rapid onset of sickness with vomiting, yellowing of the skin and eyes (jaundice), dark urine, feeling trouble to stomach, tiredness, dark urine, and tummy (abdominal) pain. It can cause both acute and chronic infections.
Acute hepatitis B is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis B virus. Hepatitis B virus (HBV), a partially double-stranded hepatotropic DNA virus, is the aetiological agent of acute and chronic hepatitis B in humans.
An acute infection can range in severity from a mild illness with few or no symptoms to a serious condition requiring hospitalization. Some people, especially adults, are able to clear the virus without treatment. People who clear the virus to become immune and cannot get infected with the hepatitis B virus again. Acute infection can (but does not always) lead to chronic infection.
Chronic HBV infection is a major public health problem. It is defined as the detection of serum hepatitis B surface antigen (HBs Ag; the viral glycoprotein) after 6 months of infection. Over time, chronic hepatitis B can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death.
The hepatitis B virus is spread when blood, semen, or other body fluid infected with the hepatitis B virus enters the body of a person who is not infected. People can become infected with the virus from Birth (spread from an infected mother to her baby during birth), sex with an infected partner, sharing needles, syringes, or drug preparation equipment, direct contact with the blood or open sores of an infected person, exposure to blood from needle-sticks or other sharp instruments of an infected person.
But, hepatitis B virus is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing.
Although anyone can get hepatitis B, some people are at greater risk including infants born to infected mothers, people who inject drugs or share needles, syringes, or other drug equipment; sex partners of people with hepatitis B, men who have sexual contact with men, people who live with a person who has hepatitis B, health care and public safety workers exposed to blood on the job, hemodialysis patients.
Doctors can usually diagnose hepatitis B with blood tests. To screen for hepatitis B, the doctors perform a series of blood tests.
A hepatitis B surface antigen test shows if the patients are contagious. A positive result means to have hepatitis B and can spread the virus, and a negative result means do not currently have hepatitis B.
The hepatitis B core antigen test shows whether the patients currently infected with HBV. Positive results usually mean to have acute or chronic hepatitis B. It may also mean the recovering from acute hepatitis B.
A hepatitis B surface antibody test is used to check for immunity to HBV, and a positive test means to have immune to hepatitis B. There are two possible reasons for a positive test, either the patient may have been vaccinated, or may have recovered from an acute HBV infection and are no longer contagious.
Liver function tests are important in individuals with hepatitis B or any liver disease. If these tests are positive, the patients might require testing for hepatitis B, C, or other liver infections.
Acute hepatitis B usually doesn't require treatment. Therefore, most people will overcome an acute infection on their own by taking rest and hydration.
On the other hand, Antiviral medications are used to treat chronic hepatitis B to reduce the risk of cirrhosis and liver cancer.
The hepatitis B vaccine is the best way to prevent infection. Vaccination is highly recommended. The World Health Organization (WHO) recommends universal vaccination for HBV and that all infants should receive the first dose of vaccine soon after birth, preferably within 24 hours.
It takes three vaccines to complete the series. The second dose must be taken one month later after taking the first dose. The third and final dose must be taken six months after the first dose.