Causes Of Hepatitis B
Hepatitis B is spread through contact with blood that contains the hepatitis B virus. If infected blood or body fluids enter another persons bloodstream, that person may become infected.
The time from exposure to the hepatitis B virus to the appearance of the illness is 45 to 180 days.
Risky activities that can cause infection include:
- Sharing unsterile or unclean equipment for injecting drugs.
- Piercing the skin with equipment that is not properly cleaned, disinfected and sterilised.
- Sharing razor blades or toothbrushes.
- Coming into contact with infected blood through open cuts or the mucous membranes of another person.
- Having unprotected sex , especially if there is blood present.
Mothers who have hepatitis B can pass the virus to their babies or children at the time of birth or after birth. If the newborn baby is quickly immunised with 2 vaccines, they can be protected from getting hepatitis B.
All blood and blood products produced for medical purposes in Australia are carefully screened for hepatitis B and other blood-borne viruses. The risk of getting infected with hepatitis B from a blood transfusion is extremely low .
Other Body Fluids And Tissues
Hepatitis B is found in semen and vaginal secretions. The virus can be transmitted during unprotected sexual intercourse, and from mother to infant during birth.
Synovial fluid , amniotic fluid, cerebrospinal fluid, and peritoneal fluid can contain the hepatitis B virus, but the risk of transmission to workers is not known.
Feces, nasal secretions, sputum, sweat, tears, urine, and vomit have not been implicated in the spread of hepatitis B. Unless they are visibly contaminated with blood, the risk of contracting hepatitis B from these fluids in the workplace is very low.
Hepatitis B is not transmitted by casual contact. For example, hospital employees who have no contact with blood, blood products, or blood-contaminated fluids are at no greater risk than the general public. However, the virus can spread through intimate contact with carriers in a household setting, possibly because of frequent physical contact with small cuts or skin rashes. The virus can also spread through biting and possibly by the sharing of toothbrushes or razors. It is not spread through sneezing, coughing, hand holding, hugging, kissing, breastfeeding, sharing eating utensils, water or food.
Treatment And Manifestation Of Hepatitis A And B
Hepatitis A has an incubation time of two to six weeks. Hepatitis B only manifests after two to six months. Often patients with hepatitis A and B infection have moderate to no signs of the infection.
In persons who show symptoms, they will get flu-like symptoms, which will occur about three to ten days before symptoms of the liver develop.
Thereafter, the urine will darken, and jaundice may grow. With jaundice, the skin and the whites of a person’s eyes have a yellow hue. The inflamed liver cannot conduct its normal biochemical processes, so a material called bilirubin increases in the body.
Typically, you tend to feel healthy when you have jaundice, even though you keep looking worse.
In hepatitis A the jaundice stage only lasts for about one week. After that, you’ll continue to heal and usually feel like your usual self within a month. You are immune for life after recovering from hepatitis A.
In hepatitis B, the jaundice stage is about two weeks.
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What Problems Can Hepatitis B Cause
Hepatitis B is a serious infection. It can lead to cirrhosis of the liver, liver failure, or liver cancer, which can cause severe illness and even death.
If a pregnant woman has the hepatitis B virus, her baby has a very high chance of having it unless the baby gets a special immune injection and the first dose of hepatitis B vaccine at birth.
Sometimes, HBV doesn’t cause symptoms until a person has had the infection for a while. At that stage, the person already might have more serious problems, such as liver damage.
Hepatitis A Immunisation Is Recommended For High
In Victoria, the vaccine is recommended for:
- people travelling to places where hepatitis A is common
- people whose work puts them at increased risk of infection including:
- plumbers and sewage workers
- people who work with children
- people who work with people with developmental disabilities
Remember that immunisation against hepatitis A does not protect you against hepatitis B or hepatitis C.
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For Adults At High Risk Of Exposure
Adults who have not received the hepatitis B vaccine series should be immunized when they have an increased risk of exposure. Job, travel, health condition, or lifestyle all may increase a person’s risk of contracting hepatitis B.
People who live or work where there is risk of exposure include:
- Health care and public safety workers who are likely to be exposed to blood or blood products.
- Clients and staff of institutions or residential settings with known or potential HBV carriers.
- People planning extended travel to China, Southeast Asia, Africa, and other areas where hepatitis B infection is high.
People who have health conditions that put them at high risk for exposure or a severe infection include:
- People who have a severe kidney disease that requires them to have their blood filtered through a machine .
- People who have chronic liver disease.
- People who have hemophilia and other conditions in which they need to have blood products on an ongoing basis.
- People who had a stem cell transplant.
People whose lifestyle puts them at high risk for exposure include:
- People who inject illegal drugs.
- Men who have sex with men.
- People who have had more than one sex partner in the past 6 months or who have a history of sexually transmitted infection.
- Household contacts and sex partners of hepatitis B carriers.
- Prison inmates.
Can Hepatitis B Be Prevented
The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.
The disease has also been more widely prevented thanks to:
- Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
- Safer blood injection practices, using clean needles.
- Safe-sex practices.
You can help prevent hepatitis B infections by:
- Practicing safe sex .
- Never sharing personal care items like toothbrushes or razors.
- Getting tattoos or piercings only at shops that employ safe hygiene practices.
- Not sharing needles to use drugs.
- Asking your healthcare provider for blood tests to determine if you have HBV or if you are immune.
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People With Other Medical Conditions
People with chronic liver disease and/or hepatitis C are recommended to receive hepatitis B vaccine if they are not immune
Hepatitis B vaccination is recommended for people with chronic liver disease and/or hepatitis C who are seronegative for hepatitis B. This is because they may have an increased risk of hepatitis B and/or severe liver disease after hepatitis B.11
Adult-formulation hepatitis B vaccine should be given in a 3-dose schedule. See Table. Monovalent hepatitis B vaccines for adolescents and adults in Vaccines, dosage and administration.
Levels of antibody to hepatitis B surface antigen should be checked after the vaccination course. See Serological testing after hepatitis B vaccination.
The combination hepatitis A-hepatitis B vaccine may be appropriate for people with chronic liver disease and/or hepatitis C if they are not immune to either disease. This is because they have an increased risk of hepatitis B and/or severe liver disease after hepatitis A and B. This is usually given in 3 doses using Twinrix . See Table. Combination hepatitis A-hepatitis B vaccines in Vaccines, dosage and administration.
Low-birthweight and preterm newborns do not respond as well to hepatitis Bcontaining vaccines as full-term infants.12-14
Treatment For Chronic Hbv Infection
For chronic HBV infection, antiviral medications are available.
This is not a cure for chronic HBV. However, it can stop the virus from replicating and prevent its progression into advanced liver disease.
A person with a chronic HBV infection can develop cirrhosis or liver cancer rapidly and without warning. If a person does not have access to adequate treatment or facilities, liver cancer can be fatal within months of diagnosis.
People with a chronic HBV infection require ongoing medical evaluation and an ultrasound of the liver
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Recommended Adult Dosing Volume Of Monovalent Hepatitis B Vaccine
- Age 19 years and younger: Use 0.5 mL per dose .
- Age 20 years and older: 1.0 mL per dose .
For a one-page sheet reviewing the hepatitis B dosing schedule for children and adults, consult IACs Hepatitis A and B Vaccines: Be Sure Your Patients Get the Correct Dose. For complete dosing information, consult the ACIP hepatitis B vaccine recommendations for adults.
Treatments For Hepatitis B
Treatment for hepatitis B depends on how long you have been infected for.
If you have been exposed to the virus in the past few days, emergency treatment can help stop you becoming infected.
If you have only had the infection for a few weeks or months , you may only need treatment to relieve your symptoms while your body fights off the infection.
If you have had the infection for more than 6 months , you may be offered treatment with medicines that can keep the virus under control and reduce the risk of liver damage.
Chronic hepatitis B often requires long-term or lifelong treatment and regular monitoring to check for any further liver problems.
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Treatment For Suspected Exposure
Anyone who has had potential exposure to HBV can undergo a postexposure prophylaxis protocol.
This consists of HBV vaccination and hepatitis B immunoglobin . Healthcare workers give the prophylaxis after the exposure and before an acute infection develops.
This protocol will not cure an infection that has already developed. However, it decreases the rate of acute infection.
Causes Of Hepatitis A
Hepatitis A is caused by a virus. The virus can survive for several hours outside the body but persists on the hands and in food for even longer. It is resistant to heating and freezing.
The virus is spread when it enters the mouth, which can happen when hands, foods or other items are contaminated with the faeces of a person with hepatitis A. The disease can also be spread sexually by oral or anal contact.
A person with hepatitis A is infectious from 2 weeks before they show symptoms to one week after they become jaundiced .
If an infected person has no jaundice, they may pass on the virus until 2 weeks after they first have symptoms . Caution is advised beyond this period as the virus can be shed in stools for longer periods.
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Side Effects Of Immunisation Against Hepatitis A
Immunisations against hepatitis A are effective and safe. All medications can have side effects.
For most people, the chance of a serious side effect from a vaccine is much lower than the chance of serious harm if you catch the disease.
Common side effects from the hepatitis A vaccine include:
- localised pain, redness and swelling at the injection site
- low-grade temperature
How Is Hepatitis B Spread
You can become infected with hepatitis B through exposure to blood, semen and other bodily fluids of an infected person. You can get the infection by:
- Having unprotected sex.
- Sharing or using dirty needles for drug use, tattoos or piercing.
- Sharing everyday items that may contain body fluids, including razors, toothbrushes, jewelry for piercings and nail clippers.
- Being treated medically by someone who does not use sterile instruments.
- Being bitten by someone with the infection.
- Being born to a pregnant woman with the infection.
Hepatitis B is not spread by:
- Kissing on the cheek or lips.
- Coughing or sneezing.
- Hugging, shaking hands or holding hands.
- Eating food that someone with the infection has prepared.
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Emergency Hepatitis B Vaccination
If you’ve been exposed to the hepatitis B virus and have not been vaccinated before, you should get immediate medical advice, as you may benefit from having the hepatitis B vaccine.
In some situations, you may also need to have an injection of antibodies, called specific hepatitis B immunoglobulin , along with the hepatitis B vaccine.
HBIG should ideally be given within 48 hours, but you can still have it up to a week after exposure.
Will My Immunization Be Recorded
Your immunization records are registered in a computerized network known as the Immunization Records and Yellow Cards. While this one is specific to Ontario, each province has their own.
They can use information obtained in these databases to:
- Maintain immunization data
- Inform you whether or when you or your family members need an immunization
- Track how well vaccinations perform to prevent vaccine-preventable infections
You can also share your immunization history with health care providers for the provision of social health services to aid with assessment and treatment and monitor the spread of infectious illnesses.
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How Is It Transmitted
Hepatitis B is highly infectious, and is spread from one person to another through exposure to infected blood and body fluids . It can be spread through:
- blood transfusions or organ transplantation in countries where blood or blood products have not been properly screened for hepatitis B and other viruses transmitted through blood
- unprotected sex with an infected person
- sharing needles or equipment for injecting drugs
- unsterilized medical/dental equipment and shared/contaminated materials or equipment used for tattooing, body piercing or acupuncture
- sharing toothbrushes or razors
- household contact between family members
What Hepatitis B Immunisation Involves
Full protection involves having 3 injections of the hepatitis B vaccine at the recommended intervals.
Babies born to mothers with hepatitis B infection will be given 6 doses of hepatitis B-containing vaccine to ensure long-lasting protection.
If you’re a healthcare worker or you have kidney failure, you’ll have a follow-up appointment to see if you’ve responded to the vaccine.
If you’ve been vaccinated by your employer’s occupational health service you can request a blood test to see if you’ve responded to the vaccine.
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People With Chronic Hepatitis B
The vaccine does not affect people with chronic hepatitis B virus infection there are no therapeutic benefits or associated adverse events. The vaccine is also safe in people who are already immune to hepatitis B through past natural infection, but it offers no additional benefit.
Hepatitis B is an infection caused by hepatitis B virus. It affects the liver.
Immunisation Against Hepatitis A
Immunisation is the best protection against hepatitis A infection and is recommended for people in high-risk groups, and for unvaccinated people who have been in close contact with someone who has hepatitis A.
Immunisation against hepatitis A includes a course of injections over a 6 to 12-month period. Healthy people 12 months of age and over receive 2 doses of hepatitis A vaccine, or 3 doses if the hepatitis A and hepatitis B vaccines are given as a combination.
You can complete any missed vaccine doses, even if the recommended time frame has passed. You do not need to start the vaccine course again.
If you are in close contact with someone who has hepatitis A be sure to have the hepatitis A vaccine if you have not already completed a vaccine course.
Babies under 12 months of age and people who have a weakened immune system who are also in close contact with a person with hepatitis A can have an injection of normal human immunoglobulin instead of the hepatitis A vaccine.
Protection against hepatitis A is available free of charge under the National Immunisation Program Schedule for Aboriginal and Torres Strait Islander children who live in high-risk areas .
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Get The Shot And Stay Informed
The hepatitis A & B virus is silent but violent. The virus is 50 to 100 times more contagious than HIV and can survive outside the body for at least seven days, making it much more infectious then most infectious diseases.
Nobody is immune to the first infection, and once contracted, it can lead to chronic illness and, in extreme cases, even death.
We hope this article answered the question, “How long does Twinrix last?” Also, that it has given you further insight into hepatitis A and B.
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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 alcoholic beverages and tobacco products are crucial components in managing the disease.
You should also visit a doctor familiar with hepatitis B at least annuallythough 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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