What is Hepatitis B?

Hepatitis B is a virus that infects the liver camera.gif. Most adults who get it have it for a short time and then get better. This is called acute hepatitis B.

Sometimes the virus causes a long-term infection, called chronic hepatitis B. Over time, it can damage your liver. Babies and young children infected with the virus are more likely to get chronic hepatitis B.

You can have hepatitis B and not know it. You may not have symptoms. If you do, they can make you feel like you have the flu. But as long as you have the virus, you can spread it to others.

Symptoms of Hepatitis B

Half of all people infected with the hepatitis B virus have no symptoms and may never realize that they have been infected. Adults are more likely to develop symptoms than children. For those who do get sick, symptoms usually develop within 1 to 4 months after exposure to the virus. The initial symptoms are often similar to the flu.

Common symptoms of hepatitis B include:

• Appetite loss
• Feeling tired (fatigue)
• Nausea and vomiting
• Itching all over the body
• Pain over the location of the liver (on the right side of the abdomen, under the lower rib cage)
• Jaundice (a condition in which the skin and the whites of the eyes turn yellow in color)
• Dark urine (the color of cola or tea)
• Pale-colored stools (grayish or clay colored)

Other types of acute viral hepatitis such as hepatitis A andhepatitis C have symptoms that are indistinguishable from hepatitis B.

Fulminate hepatitis is a severe form of acute hepatitis that can be life-threatening if not treated right away. Fortunately, fulminate hepatitis is rare. The symptoms of fulminate hepatitis develop very suddenly and may include:

• Mental disturbances such as confusion, lethargy, extreme sleepiness or hallucinations (hepatic encephalopathy)
• Sudden collapse with fatigue
• Jaundice
• Swelling of the abdomen

Prolonged nausea and vomiting can cause dehydration. Individuals with dehydration may notice these symptoms:

• Extreme weakness
• Confusion or trouble concentrating
• Headache
• Lack of urination
• Irritability

Acute Hepatitis B

Acute hepatitis B is a short-term infection. If you have symptoms, they may last several weeks. In some cases, symptoms last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away. Most healthy adults and children older than 5 years old who have hepatitis B get better without treatment.

Chronic Hepatitis B

Chronic hepatitis B is a long-lasting infection. Chronic hepatitis B occurs when your body isn’t able to fight off the virus and the virus does not go away.

Your chances of developing chronic hepatitis B are greater if you are infected with the virus as a young child. About 90 percent of infants infected with hepatitis B develop a chronic infection. About 25 to 50 percent of children infected between the ages of 1 and 5 years develop chronic infections. However, among people infected during adulthood, only about 5 percent develop chronic hepatitis B.

How is the Hepatitis B virus spread?

Hepatitis B is spread mainly by exposure to infected blood or body secretions. In infected individuals, the virus can be found in the blood, semen, vaginal discharge, breast milk, and saliva. Hepatitis B is not spread through food, water, or by casual contact.

In the United States, sexual contact is the most common means of transmission, followed by using contaminated needles for injecting illicit drugs, tattooing, body piercing, or acupuncture. Additionally, hepatitis B can be transmitted through sharing toothbrushes and razors contaminated with infected fluids or blood.

Hepatitis B also may be spread from infected mothers to their babies at birth (so-called ‘vertical’ transmission). This is the most prevalent means of transmission in regions of the world where hepatitis B rates are high. The rate of transmission of hepatitis B from mother to newborn is very high, and almost all infected infants will develop chronic hepatitis B. Fortunately, transmission can be significantly reduced through immunoprophylaxis.

Rarely, hepatitis B can be transmitted through transfused blood products, donated livers and other organs. However, blood and organ donors are routinely screened for hepatitis which typically prevents this type of transmission.

Treatment of Hepatitis B

There is no specific treatment or medication for an acute HBV infection; supportive care is recommended based on presenting symptoms.

For a person who has an unprotected exposure to another individual’s potentially infected blood or body fluid, there is a post-exposure “prophylaxis” protocol consisting of HBV vaccination and HBIG given after the exposure and before acute infection develops. This protocol decreases the rate of acute infection.

For chronic HBV infection, the World Health Organization (WHO) recommend treating the individual with an antiviral medication. Rarely does the treatment cure the virus; instead, it stops the virus from replicating in order to prevent the progression to advanced liver disease.

A chronically infected individual can develop cirrhosis or liver cancer quickly and without warning. In low-income settings, most people with liver cancer die within months of diagnosis.

Persons with chronic HBV infection require ongoing medical evaluation and ultrasound of the liver every 6 months to monitor for liver damage or worsening disease.