Hepatitis B

Hepatitis B is liver inflammation caused by the hepatitis B virus (HBV). HBV is one of five types of hepatitis virus. The others are hepatitis A, C, D, and E.

The Centers for Disease Control and Prevention (CDC) state that 2,000 to 4,000 people die each year from complications caused by hepatitis B (CDC).

HBV infection can be acute or chronic.

Acute hepatitis B causes symptoms to appear quickly in adults. Children rarely develop acute HBV. Any infections are far more likely to be chronic.

Chronic hepatitis B develops slowly. Symptoms may not be noticeable unless complications develop. According to the CDC, up to 1.4 million people in the United States have chronic hepatitis B (CDC).

HBV is highly contagious. It spreads through contact with infected blood, saliva, and other bodily fluids. Symptoms may not occur for a few days, or longer, after contracting the virus. However, you are still contagious, even without symptoms.

Possible methods of transmission include:

• using an infected toothbrush or razor
• from mother to baby during birth
• being pricked with a contaminated needle
• close contact with a person with HBV
• oral, vaginal, and anal sex

Certain groups are at particularly high risk of HBV infection. These include:

• those traveling to countries with a high incidence of HBV
• men who have sex with other men
• people with multiple sex partners
• people with chronic liver disease
• people with kidney disease
• diabetics over the age of 60

People who develop chronic HBV have a high risk of serious complications. The World Health Organization (WHO) states that 25 percent of adults who develop hepatitis B during childhood will later die from complications (WHO).

Hepatitis B is the most common form of hepatitis in Asia.

Symptoms of HBV may not be apparent for months or years. However, common symptoms include:

• dark urine
• joint pain
• loss of appetite
• fever
• abdominal discomfort
• weakness
• yellow eyes and skin (jaundice)

Any symptoms of HBV should be treated right away. In addition, you should let your doctor know immediately if you have been exposed to hepatitis B. You may be able to prevent infection.

Hepatitis B is usually diagnosed through routine or requested screening tests. People are often screened for HBV when they:

• have come in contact with someone with HBV
• have traveled to a country where HBV is common
• have been in jail
• use drugs
• receive kidney dialysis
• are pregnant
• are men who have sex with men
• have HIV

To screen for HBV, your doctor will perform a series of blood tests. Three tests are used to determine the state of your infection:

A hepatitis B surface antigen test shows if you are contagious. A positive result means you are infected and can spread the virus. A negative result means you don’t have HBV. This test does not distinguish between chronic and acute infection.

Hepatitis B Core Antigen Test

The hepatitis B core antigen test shows whether you are currently infected with HBV. Positive results usually mean you have chronic HBV. It may also mean you are recovering from acute HBV.

Antibody Hepatitis B Surface Antigen Test

An antibody hepatitis B surface antigen test shows whether you are immune to HBV. A positive test means you cannot contract HBV. There are two possible reasons for a positive test. You may have been vaccinated. You may also have recovered from an acute infection with HBV.

Liver Function Tests

HBV symptoms can mimic the symptoms of other conditions, including liver diseases.

Liver function tests check your blood for heightened enzymes from your liver. The results of this test can reveal whether your liver is being stressed. It can also identify signs of disease.

If these tests are positive, you might be tested for HBV. Hepatitis viruses are a major cause of liver damage.  

Hepatitis B Immune Globulin

If you have been in contact with someone who has HBV within the last 24 hours, talk to your doctor immediately. It may be possible to prevent infection with an injection of HBV immune globulin. This is a solution of antibodies against HBV.

Treatment Options for Hepatitis B

Acute hepatitis B usually doesn’t require treatment. Most people will overcome an acute infection on their own. However, bed rest will help you recover.

Chronic HBV may be treated with antiviral medications. These help you fight the virus. They may also reduce the risk of future liver complications.

If your liver has been seriously damaged by HBV, you may need a liver transplant. Your liver will be removed and replaced with a donor liver. Most donor livers come from deceased donors.

If treatment for chronic HBV isn’t administered early, complications may occur.

These include:

• liver scarring (cirrhosis)
• liver failure
• kidney cancer
• kidney failure
• liver cancer

Another possible complication is Hepatitis D infection. This virus is only contracted by people with HBV. A combined infection can cause serious liver problems.

The hepatitis B vaccine is the best way to prevent HBV infection. Vaccination is optional. However, it recommended for the following groups:

• all infants, at the time of birth
• any children and adolescents who weren’t vaccinated at birth
• adults being treated for a sexually transmitted infection
• people living in institutional settings
• people whose work brings them into contact with blood
• HIV positive individuals
• men who have sex with men
• people with multiple sexual partners
• injection drug users
• family members of those with HBV
• individuals with chronic diseases
• people traveling to areas with high HBV rates

In other words, just about everyone should be vaccinated. It is a relatively inexpensive and very safe vaccine.

There are also other ways to reduce your risk of HBV infection. You should always:

• have sexual partners tested for hepatitis
• use a condom when having anal, vaginal, or oral sex
• avoid street drugs
• check whether any international travel is to a place where HBV is common