A detail Study of Hepatitis B

What is hepatitis B?

“Hepatitis” means inflammation of the liver. The liver is a vital organ that processes nutrients, filters blood and fights infections. When the liver is inflamed or damaged, its function may be affected. In most cases, hepatitis is caused by a virus.

The viral hepatitis, is caused by different viruses, each is named with a letter of the alphabet. There are four main types:

  • hepatitis A
  • hepatitis B
  • hepatitis C
  • hepatitis D

Is Hepatitis B Contagious?

Yes, hepatitis B is contagious. The most common forms of transmission are:

  • Sexual intercourse: Probably the most frequent form of contagion . Transmission may be through both heterosexual and homosexual relationships.
  • The hepatitis B virus is between 50 and 100 times more infectious than HIV and can be transmitted through the exchange of body fluids such as semen, vaginal discharge and blood.
  • It is considered as a sexually transmitted disease (STD).
  • Blood transfusions:It is currently a form of transmission practically non-existent due to routine blood tests that are used for transfusions.
  • Perinatal transmission:It consists of the transmission of hepatitis B virus from mother to child, usually close to the time of delivery. It is an important route of infection in countries of high prevalence such as China.
  • Injectable drugs:The use of contaminated syringes and / or needles is an important route of infection.
  • Tattoos, piercings or piercings made with non-disposable material.
  • Close contact or horizontal transmission:Infection can occur if blood from an infected person comes into contact with mucous membranes (eyes, mouth, genitals) or small wounds from another person.
  • HBV can survive outside the human body for an extended period; As a result, transmission through contaminated household items such as toothbrushes, razors and even toys may be possible.
  • Medical procedures:The hepatitis B virus can be transmitted by contaminated instruments during invasive medical procedures such as surgeries if the necessary precautions are not followed.

Hepatitis B is not spread through breast milk, nor when sharing utensils to eat, hug, kiss, hold hands, cough or sneeze. Unlike some forms of hepatitis, hepatitis B is also not spread by contaminated food or water.

Who can get hepatitis B? Anyone can get hepatitis B.

But there are some people who are more likely to get this disease. They are called the risk group. In this group are:

  • Health personnel
  • Amazonian indigenous population
  • Staff of the armed forces, police and firefighters
  • People with hemophilia
  • Persons undergoing hemodialysis
  • People with chronic diseases
  • People with HIV
  • People deprived of liberty
  • Sex workers
  • Men who have sex with men

What are the symptoms of hepatitis B?

The signs and symptoms of hepatitis B, ranging from moderate to severe, usually appear one to four months after infection. The signs and symptoms of hepatitis B may include:

  • Abdominal pain
  • Dark urine
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea and vomiting
  • Weakness and fatigue
  • Yellowing of the skin and the whites of the eyes (jaundice)

 

How is Hepatitis B Diagnosed?

Hepatitis B virus infection is usually diagnosed in a person who has symptoms of acute hepatitis, or through investigation of abnormal liver tests in a person without symptoms.

In any case, the doctor will question you about risk factors for acquiring the virus and will look for physical signs that can guide you to the diagnosis.

Because many liver diseases may have clinical manifestations similar to hepatitis B, usually the laboratory tests are the ones that give the definitive diagnosis.

  • Aminotransferases: Also known as transaminases, are tests that allow to estimate the degree of hepatic inflammation.
  • Bilirubin: Its elevation indicates a more important failure of hepatic excretory capacity and manifests as jaundice.
  • Albumin: it is produced in the liver. Its decrease usually indicates significant liver damage.
  • Prothrombin time: is a protein produced by the liver that serves for coagulation.
  • Viral markers: Hepatitis B virus can be detected through a series of tests that directly detect proteins produced by the virus (antigens) or the immune response produced by the body against the virus (antibodies). Hepatitis B surface antigen (HBsAg) is present in both acute and chronic infection. Their stay for more than 6 months defines chronic hepatitis B.
  • Viral load: The detection and quantification of viral DNA (genetic material) is an excellent way to monitor the degree of viral replication. It is often used to monitor response to treatment.
  • Liver biopsy: Obtaining a small piece of liver for microscopic analysis is an excellent way to determine the degree of damage to the liver, important for deciding the treatment.

Hepatitis B Treatment

Acute hepatitis, unless severe, does not need any treatment. Liver function and other bodily functions are monitored by blood tests. The doctor will ask you to rest in bed enough, drink lots of fluids and have a healthy diet.

It is very important to follow a healthy and balanced diet as the liver processes and filters everything we eat and drink. A diet low in fat and salt, rich in complex carbohydrates and containing enough protein is recommended. Proteins derived from birds, fish and vegetables are the most beneficial.

Some patients with chronic hepatitis B can be treated with antivirals. These medicines may decrease or eliminate hepatitis B from the blood. They also help reduce the risk of cirrhosis and liver cancer. The doctor will have to have strict control that allows him to evaluate the response to the medicines that have been prescribed and the functioning of the liver.

It is not always clear which patients with chronic hepatitis B should receive pharmacological treatment and when such treatment should be started. You are more likely to get these medicines if:

  • Liver function is worsening rapidly.
  • Manifest symptoms of long-term liver damage.
  • You have high levels of the hepatitis B virus in your blood.
  • For these drugs to work better, it is necessary to take them as the doctor tells you. Ask what side effects you can expect and what to do if they occur. Not everyone who needs to take these medications responds well.
  • If you have liver failure, you can receive a liver transplant. It is the only cure in some cases of liver failure.
  • Other steps you can take:
  • Avoid alcohol.
  • Talk to your doctor before taking any herbal medicine or over-the-counter supplement. This covers medications such as acetaminophen, acetylsalicylic acid (aspirin) or ibuprofen.
  • Being overweight and obese can be factors that contribute to liver damage.

How is hepatitis B Prevented?

The infection is prevented by the vaccine. Vaccination in infants. All babies have to get the vaccine. The first injection is given at any time between the 4th or 8th week of life, but if the mother is a carrier it is administered at 12 hours of birth; the second, between 30 days and 2 months of age (depending on when the first was administered); and the third, between 6 and 18 months of age.

  • Children and people at high risk of developing hepatitis B should receive the vaccine against this disease.
  • Children under 19 months who have not been vaccinated should receive “recovery” doses.
  • Health workers and those living with someone with hepatitis B should have the vaccine given.
  • Babies born to mothers who have acute hepatitis B or who have had the infection in the past should receive a special hepatitis B vaccine within 12 hours after birth.

Vaccination in older children and adults. Children and adults who have not done so can also be vaccinated. The vaccination takes place during six months, during which three injections have to be done. Children who have not been vaccinated should do so. Moreover, this preventive method, which is known as combined vaccine, is especially indicated in:

  • Travelers in endemic areas of virus A and B: Africa, South America, Eastern Mediterranean, Southeast Asia, China and the Pacific Islands (except Australia, New Zealand and Japan).
  • Male homosexuals with multiple partners.
  • Parental drug users.
  • Hemophilic patients.
  • Hospital sanitary personnel.

Although most children who receive the vaccine do not have any problems as a result of it, sometimes minor problems, such as redness or discomfort at the injection site, can sometimes occur. The most serious problems associated with it are very rare. However, the administration of the vaccine is not recommended:

  • Before any disease more serious than a cold.
  • If an intense allergic reaction occurs after a dose of the vaccine.

All the blood used for blood transfusions is analyzed, so the probability of contracting the virus in this way is very small.

Immunoglobulin vaccine or hepatitis B (IGHB) injection can help prevent infection if you receive it within 24 hours of contact with the virus.

Other prevention measures are:

  • Having sex with a condom.
  • Do not share razor rakes or toothbrushes.
  • Do not share disposable syringes if you use drugs.
  • Avoid promiscuity.
  • Use of disposable gloves when handling biological products such as blood, urine, sperm, genital secretions.

 

Sources

http://www.who.int/mediacentre/factsheets/fs204/en/

 

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