Chronic Viral Hepatitis B With Delta
- 20162017201820192020202120222023Billable/Specific Code
- B18.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- The 2023 edition of ICD-10-CM B18.0 became effective on October 1, 2022.
- This is the American ICD-10-CM version of B18.0 – other international versions of ICD-10 B18.0 may differ.
- Applicable To annotations, or
Is Hepatitis B Contagious
Hepatitis B is highly contagious. Its transmitted through contact with blood and certain other bodily fluids. Although the virus can be found in saliva, its not transmitted through sharing utensils or kissing. Its also not transmitted through sneezing, coughing, or breastfeeding.
Symptoms of hepatitis B may not appear for 3 months after exposure. Symptoms can last for several weeks.
But even without symptoms, you can still transmit the infection to others. The virus can live outside the body and remains infectious for at least
Hepatitis B is a highly contagious condition. Its associated with many serious complications, some of which can be life threatening.
But there are many treatment options available and multiple ways you can prevent infection, including getting vaccinated.
If you suspect you may have been exposed to hepatitis B, its important to talk with a doctor to prevent infection and determine the best course of treatment for you.
How Is It Spread
Hepatitis A is spread when a person ingests fecal mattereven in microscopic amountsfrom contact with objects, food, or drinks contaminated by feces or stool from an infected person.
- Birth to an infected mother
- Sex with an infected person
- Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
- Sharing personal items such as toothbrushes or razors
- Poor infection control has resulted in outbreaks in health care facilities
Hepatitis C is spread when blood from a person infected with the Hepatitis C virus even in microscopic amounts enters the body of someone who is not infected. The hepatitis C virus can also be transmitted from:
- Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
- Receiving a blood transfusion or organ transplant before 1992
- Poor infection control has resulted in outbreaks in health care facilities
- Birth to an infected mother
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Acute Hepatitis C Vs Chronic Hepatitis C
Acute and chronic hepatitis C are caused by the same virus.
Acute hepatitis C develops after initial infection with the HCV. This stage can last up to 6 months. Many people have no symptoms during the acute stage and never find out that they have the infection.
According to the CDC, of people with acute hepatitis C develop chronic hepatitis C.
The World Health Organization states that 15 to 45 percent of people with acute hepatitis C spontaneously clear the virus within 6 months. This means that the virus goes away even though it hasnt been treated.
The 55 to 85 percent of people who dont clear the virus will develop a chronic HCV infection.
Chronic hepatitis C can be managed with medications and even cured, but its still a serious condition. According to the CDC,
What Are The Treatments For Hepatitis B
If you think you may have been exposed to hepatitis B, its important to talk with a healthcare professional as soon as possible.
A doctor or other healthcare professional may administer the first dose of the hepatitis B vaccine and a shot of hepatitis B immunoglobulin. This is a combination of antibodies that provide short-term protection against the virus.
Though both can be given up to a week after exposure, theyre most effective at preventing infection if administered within 48 hours.
If you receive a diagnosis of acute hepatitis B, a doctor may refer you to a specialist. They may advise you to get regular blood tests to ensure you dont develop chronic hepatitis.
Many people with acute hepatitis B dont experience serious symptoms. But if you do, it can help to:
- get plenty of rest
- take over-the-counter pain mediation, like naproxen, when needed
Other lifestyle changes may also be needed to manage your infection, such as:
- eating a nutritious, balanced diet
- avoiding substances that can harm your liver, such as:
- certain herbal supplements or medications, including acetaminophen
If blood tests show you still have an active infection after 6 months, your doctor may recommend further treatment, including medications to help control the virus and prevent liver damage.
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Hiv And Hbv Coinfection
About 2% of people with HIV in the United States are coinfected with HBV both infections have similar routes of transmission. People with HIV are at greater risk for complications and death from HBV infection. All people with HIV are recommended to be tested for HBV, and if susceptible, are further recommended to receive the hepatitis B vaccination or, if chronically infected, evaluated for treatment to prevent liver disease and liver cancer. For more information about HIV and HBV coinfection, visit HIV.govâs pages about hepatitis B and HIV coinfection.
Who Are Hepatitis B Carriers
Hepatitis B carriers are people who have the hepatitis B virus in their blood, even though they dont feel sick. Between 6% and 10% of those people whove been infected with the virus will become carriers and can infect others without knowing it. There are over 250 million people in the world who are carriers of HBV, with about 10% to 15% of the total located in India. Children are at the highest risk of becoming carriers. About 9 in 10 babies infected at birth become HBV carriers, and about half of children who are infected between birth and age 5 carry the virus. A blood test can tell you if you are a hepatitis B carrier.
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What Is Hepatitis B
Hepatitis B is a type of viral hepatitis. It can cause an acute or chronic infection. People with an acute infection usually get better on their own without treatment. Some people with chronic hepatitis B will need treatment.
Thanks to a vaccine, hepatitis B is not very common in the United States. It is more common in certain parts of the world, such as sub-Saharan Africa and parts of Asia.
How Long Before I Have Symptoms
Many people have mild symptoms or no symptoms, which is why hepatitis is sometimes called a âsilentâ disease.
Hepatitis A. The symptoms usually show up 2 to 6 weeks after the virus enters your body. They usually last for less than 2 months, though sometimes you can be sick for as long as 6 months.
Some warning signs that you may have hepatitis A are:
Hepatitis B. The symptoms are the same as hepatitis A, and you usually get them 3 months after you’re infected. They could show up, though, anywhere from 6 weeks to 6 months later.
Sometimes the symptoms are mild and last just a few weeks. For some people, the hep B virus stays in the body and leads to long-term liver problems.
Hepatitis C. The early symptoms are the same as hepatitis A and B, and they usually happen 6 to 7 weeks after the virus gets in your body. But you could notice them anywhere from 2 weeks to 6 months later.
For about 25% of people who get hep C, the virus goes away on its own without treatment. In other cases, it sticks around for years. When that happens, your liver might get damaged.
Remember, it’s possible to spread all the types of hepatitis even if you don’t show any signs of being sick.
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Chronic Hepatitis Pathology Outlines
Chronic hepatitis is an inflammation of the liver that can last for months or years. The most common form of chronic hepatitis is caused by the hepatitis C virus . Other forms of chronic hepatitis include hepatitis B virus and non-viral causes such as autoimmune hepatitis and chronic alcohol abuse. The liver is a vital organ that plays an important role in metabolism, detoxification, and immunity. Chronic hepatitis can lead to liver damage, scarring , and liver cancer.
How Long Can You Live With Hepatitis B
Most people who contract hepatitis B during adulthood fully recover within 1 to 3 months.
People with chronic hepatitis B may have a higher risk of developing long-term liver problems, like cirrhosis or liver cancer, which require treatment and may be life threatening.
Keep in mind that the risk of developing chronic hepatitis B is higher for babies and children, especially if they have not been vaccinated against the virus.
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Overview Of Hcv Treatment
For genotype 3, first-line treatments include
-
Fixed-dose combination of sofosbuvir 400 mg/velpatasvir 100 mg once a day for 12 weeks
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Fixed-dose combination of glecaprevir 300 mg/pibrentasvir 120 mg once a day for 8 to 16 weeks, depending on history of prior treatment and degree of liver fibrosis
For genotype 4, first-line treatments include
-
Fixed-dose combination of ledipasvir 90 mg/sofosbuvir 400 mg orally once a day for 12 weeks
-
Fixed-dose combination of elbasvir 50 mg/grazoprevir 100 mg orally once a day for 12 weeks
-
Fixed-dose combination of velpatasvir 100 mg/sofosbuvir 400 mg once a day for 12 weeks
-
Fixed-dose combination of glecaprevir 300 mg/pibrentasvir 120 mg once a day for 8 to 12 weeks, depending on degree of liver fibrosis
For genotypes 5 and 6, first-line treatments include
-
Fixed-dose combination of ledipasvir 90 mg/sofosbuvir 400 mg orally once a day for 12 weeks
-
Fixed-dose combination of velpatasvir 100 mg/sofosbuvir 400 mg once a day for 12 weeks
-
Fixed-dose combination of glecaprevir 300 mg/pibrentasvir 120 mg once a day for 8 to 12 weeks, depending on degree of liver fibrosis
Is There A Cure For Chronic Hepatitis B
Currently, there is no complete cure for hepatitis B. But when managed properly, those living with the virus can expect to live a normal life. Maintaining a healthy diet and avoiding beverages that contain alochol and tobacco products are crucial components in managing the disease.
You should also visit a doctor familiar with hepatitis B at least annually though twice a year might be best to monitor your liver through blood tests and medical imaging. As with most diseases, detecting it early leads to a better outcome. If youre exposed to the virus, you should get an antibody injection within 12 hours of exposure.
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How Is Hepatitis B Transmitted
Hepatitis B is spread in several distinct ways: sexual contact sharing needles, syringes, or other drug-injection equipment or from mother-to-child at birth.
In the United States, in 2018, injection drug use was the most common risk factor reported among people with an acute HBV infection, followed by having multiple sex partners. Less commonly reported risk factors included accidental needle sticks, surgery, transfusions, and household contact with a person with HBV infection. In the United States, healthcare-related transmission of HBV is rare.
Mother-to-child transmission of HBV is especially concerning, because it is preventable. An estimated 25,000 infants are born to mothers diagnosed with HBV each year in the United States, and approximately 1,000 mothers transmit HBV to their infants. Without appropriate medical care and vaccinations, 90% of HBV-infected newborns will develop chronic infection, remaining infected throughout their lives. Up to 25% of people infected at birth will die prematurely of HBV-related causes. For this reason, the standard of care for pregnant women includes an HBV test during each pregnancy so that the appropriate steps can be taken to prevent HBV-positive mothers from transmitting the disease to her infant.
How Do Doctors Treat The Complications Of Hepatitis B
If chronic hepatitis B leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, minor medical procedures, and surgery. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order blood tests and an ultrasound or another type of imaging test to check for liver cancer.
If chronic hepatitis B leads to liver failure or liver cancer, you may need a liver transplant.
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What Is Acute Fulminant Hepatitis
Rarely, do individuals with acute infections with HAV and HBV develop severe inflammation, and the liver fails . These patients are extremely ill with the symptoms of acute hepatitis already described and the additional problems of confusion or coma , as well as bruising or bleeding . Up to 80% of people with acute fulminant hepatitis can die within days to weeks therefore, it is fortunate that acute fulminant hepatitis is rare. For example, less than 0.5% of adults with acute infection with HBV will develop acute fulminant hepatitis. This is even less common with HCV alone, although it becomes more frequent when both HBV and HCV are present together.
What Is The Prognosis Of Viral Hepatitis
The prognosis of viral hepatitis for most patients is good however, this prognosis varies somewhat depending on the infecting virus. For example, those patients who develop chronic hepatitis have a worse prognosis because of the potential to develop cirrhosis, liver failure, liver cancer , and occasionally death.
Symptoms of viral hepatitis such as fatigue, poor appetite, nausea, and jaundice usually subside in several weeks to months, without any specific treatment. Virtually all patients with acute infection with HAV and most adults with acute HBV recover completely.
Complete recovery from viral hepatitis means that:
- the hepatitis virus has been eliminated from the liver by the body’s immune system,
- the inflammation in the liver subsides,
- the patient develops immunity to future infection with the same virus, and
- the patient cannot transmit the infection to others.
Unfortunately, not all patients with viral hepatitis recover completely. Five to 10 percent of patients with acute HBV infection and about 75% to 80% of patients with acute HCV infection develop chronic hepatitis. Patients that develop fulminant hepatitis have about an 80% fatality rate. Chronic HCV infections are the leading cause of liver transplants.
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Hepatitis B Surface Antigen Test
A hepatitis B surface antigen test shows if you have an active infection. A positive result means you have hepatitis B and can transmit the virus to others. A negative result means you dont currently have hepatitis B.
This test doesnt distinguish between chronic and acute infection. This test is used together with other hepatitis B tests to determine the state of a hepatitis B infection.
Chronic Hepatitis B Symptoms
Most patients with chronic hepatitis B are asymptomatic unless their disease progresses. Others might have nonspecific symptoms, such as fatigue.
Some patients experience worsening of the infection and develop signs and symptoms similar to acute hepatitis.
If patients with chronic hepatitis B progress to cirrhosis they will develop signs and symptoms of liver failure, including:
- Peripheral edema
- Hepatocellular carcinoma
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Chronic Hepatitis B Complications
Chronic hepatitis B can lead to
- cirrhosis, a condition in which scar tissue replaces healthy liver tissue and prevents your liver from working normally. Scar tissue also partly blocks the flow of blood through the liver. As cirrhosis gets worse, the liver begins to fail.
- liver failure, in which your liver is badly damaged and stops working. Liver failure is also called end-stage liver disease. People with liver failure may require a liver transplant.
- liver cancer. Your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.
Should I Be Screened For Hepatitis B
Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis B. Many people who have hepatitis B dont have symptoms and dont know they are infected with hepatitis B. Screening tests can help doctors diagnose and treat hepatitis B, which can lower your chances of developing serious health problems.
Your doctor may recommend screening for hepatitis B if you9,14
- were born in an area of the world where 2 percent or more of the population has hepatitis B infection, which includes Africa, Asia, and parts of the Middle East, Eastern Europe, and South America
- didnt receive the hepatitis B vaccine as an infant and have parents who were born in an area where 8 percent or more of the population had hepatitis B infection, which includes sub-Saharan Africa and parts of Asia
- are HIV-positive
- are a man who has sex with men
- have lived with or had sex with a person who has hepatitis B
- have an increased chance of infection due to other factors
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Managing Your Health While On Treatment
There are many things you can do to improve your health and feel better while on treatment for your Hepatitis C infection. And by taking good care of yourself, you will increase your chances of be able to take your medication as prescribed.
IMPORTANCE OF DIET AND NUTRITION
Contrary to some claims you might read on the Internet, there is no special Hepatitis C diet. However, a healthy diet can improve liver health in a person with Hepatitis C.
A well-balanced diet can lead to better liver functioning and lowered risk of cirrhosis of the liver. It can also help your immune system fight off illness. People with Hepatitis C tend to have higher rates of diabetes, but a good diet can help control blood sugar and reduce body fat, thereby lowering your risk for becoming diabetic.
Multiple studies have now demonstrated the benefit of drinking coffee to improve liver health in Hepatitis C. Studies suggest you need to drink more than two cups per day to gain this benefit. However, the research is not strong enough to make a recommendation to start drinking coffee and some people do not tolerate it well. But for those who currently do drink coffee enjoy!
General dietary recommendations include the following:
BE CAUTIOUS ABOUT DIETARY SUPPLEMENTS
Certain vitamins and minerals like vitamins A and D, iron and niacin can be harmful to your liver in high doses. Before taking a vitamin or supplement, its best to talk with your doctor, dietician or nutritionist.
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