Hepatitis B virus is the primary cause of liver disease in Asians. In the United States, chronic hepatitis B is the leading cause of liver cancer, and is the second-leading cause for liver transplantation. While there is no cure for hepatitis B, there is a vaccine that prevents infection. Unfortunately, many susceptible people are not receiving vaccination to prevent this serious disease.
The Silent Killer -- A significant portion of patients who are chronically infected with hepatitis B are unaware of their illness which will progress and cause major health problems such as liver failure and liver cancer.
Symptoms -- Many patients with chronic hepatitis B do not have symptoms and feel healthy. When symptoms do appear, it is often in the late stage of liver disease when treatment may be less effective.
Early diagnosis -- If untreated, it is estimated that hepatitis B will lead to cirrhoses or liver cancer in as many as 1 in 4 individuals.
Screening for hepatitis B -- Screening is done by performing a simple and inexpensive blood test, hepatitis B surface antigen (HBgAg).
DEFINITION
Hepatitis B is an inflammation (damage and swelling) of the liver that is caused by the hepatitis B virus (HBV).
MODES OF INFECTION
The hepatitis B virus spreads through blood and other body fluids. Infection from one person to another can occur by:
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| Hepatitis B is also known as serum hepatitis and is spread through blood and sexual contact. It is seen with increased frequency among intravenous drug users who share needles and among the homosexual population. This photograph is an electronmicroscopic image of hepatitis B virus particles. (Image courtesy of the Centers for Disease Control and Prevention.) |
- A mother who has HBV infection to her infant during birth
- Person-to-person through open wounds
- Unsafe sex with an infected person
- Shared needles during drug use
- Contact with blood in healthcare setting
- Transfusion with blood or blood products
TYPES OF HEPATITIS B INFECTION
Acute hepatitis B
The time from first infection to symptoms to acute hepatitis is 1-6 months. Early symptoms may include:
- Loss of appetite
- Fatigue
- Nausea and vomiting
- Yellow skin and dark urine
- Muscle and joint pain
Chronic hepatitis B
Approximately 5-10% of adults who contract acute hepatitis B will develop chronic hepatitis, which is defined as persistent viral production by the liver cells and may last a lifetime. Patients with chronic hepatitis may gradually progress to worsening liver disease, cirrhoses, and may develop a primary liver cancer that is called hepatocellular carcinoma.
DIAGNOSIS
The diagnosis of chronic hepatitis B is by simple blood test.
- Hepatitis B surface antigen -- (HBsAg) tells you that the virus is circulating in the blood
- Anti-HBg (Antibody to the hepatitis B surface antigen)tells you that you are immune to infection by this virus
Liver-function tests
- An increase in the AST and ALT levels tells you the liver has inflammation
- A low albumin level tells you that the liver cells are not adequately making enough protein
- A high bilibrubin level tells you that the liver cells are not adequately detoxifying waste productes of the body
TREATMENT
Acute hepatitis requires no specific treatment other than rest and careful monitoring of liver functions by blood test. In very rare cases, acute liver failure may occur which will require immediate admission to the hospital Intensive Care Unit or a liver transplant may be necessary and live saving.
Chronic hepatitis may initially have no symptoms, however, because of continual damage to liver cells, a person may have gradual onset of fatigue, loss of appetite and jaudice. If these symptoms occur, the patient should seek immediate medical help. Fortunately, there are medications suchs as oral anti-viral pills and injectable medicine called interferon that kill the hepatitis B virus and significantly reduce the liver inflammation and damage. If necessary, liver transplanation is used to treat the end-stage liver disease caused by hepatitis B infection.
