How Many People Have Hepatitis B
In the United States, an estimated 862,000 people were chronically infected with HBV in 2016. New cases of HBV infection in the United States had been decreasing until 2012. Since that time, reported cases of acute hepatitis B have been fluctuating around 3,000 cases per year. In 2018, 3,322 cases of acute hepatitis B were reported however, because of low case detection and reporting, the Centers for Disease Control and Prevention estimates that there were 21,600 acute hepatitis B infections. New HBV infections are likely linked to the ongoing opioid crisis in the United States.
Globally, HBV is the most common blood-borne infection with an estimated 257 million people infected according to the World Health Organization .
How Is It Spread
Hepatitis B virus is spread by contact with body fluidsthat carry the virus, such as:
Hepatitis B is spread by contact with infected body fluids, mostly by:
- Sexual contact:
- Vaginal and anal sex
- Sharing unclean sex toys
- Body fluids with hepatitis B can enter tiny breaks or rips in the linings of the vagina, vulva, rectum,or mouth. Rips and tears in these areas can be common and often unnoticed.
- During illegal drug or drug equipment use
- Open sores of an infected person
- Sharing items such as razors or toothbrushes with an infected person
- Being tattooed or pierced with tools that were not properly cleaned
- Hepatitis B can spread to babies during pregnancy and birth.
Infected motherscan pass hepatitisB to their babiesduring childbirth.
Hepatitis B is rarely spread from a blood transfusion because:
- Hepatitis B tests are done on all donated blood.
- Blood and blood products that test positive for hepatitis B are safely destroyed. None are used for transfusions.
- There is no risk of getting hepatitis B when donating or giving blood.
How Do You Get Hepatitis B
Hepatitis B is really contagious. Its transmitted through contact with semen , vaginal fluids, and blood. You can get it from:
having vaginal, anal, or oral sex
sharing toothbrushes and razors
sharing needles for shooting drugs, piercings, tattoos, etc.
getting stuck with a needle that has the Hep B virus on it.
Hepatitis B can also be passed to babies during birth if their mother has it.
Hepatitis B isnt spread through saliva , so you CANT get hepatitis B from sharing food or drinks or using the same fork or spoon. Hepatitis B is also not spread through kissing, hugging, holding hands, coughing, sneezing, or breastfeeding.
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What Are The Symptoms
What happens to you when you contract hepatitis B depends largely on the age at which you first become infected and how well your immune system copes with the virus. If you are infected as an adult, you may have a brief illness with mild or moderate symptoms such as jaundice, dark urine, fatigue, abdominal discomfort, and loss of appetite. As an adult, you have a 95% chance of clearing the infection completely and developing lifelong protection against this virus. The acute infection rarely leads to severe illness that requires a liver transplant.
Most babies and children exposed to this virus never have signs and symptoms. Unfortunately, they are more likely to become carriers of hepatitis B for life because their immune system is unable to fight and clear the virus from their body. In these cases, chronic infections are often not detected or picked up until much later in life when the person becomes seriously ill with liver disease.
Chronic hepatitis B infection goes through different phases that also show how well your body is coping with the virus. Although most people with chronic hepatitis B have an inactive disease and will remain healthy, about one in four will have active disease that may lead to cirrhosis , liver failure, and liver cancer.
People who are healthy with an inactive disease may still be at risk of virus reactivation, especially when their immune system is weakened by medicines such as chemotherapy or by other viral infections.
How To Get Vaccinated Against Hepatitis B
All babies in the UK born on or after 1 August 2017 are given 3 doses of hepatitis B-containing vaccine as part of the NHS routine vaccination schedule. These doses are given at 8, 12 and 16 weeks of age.
Babies at high risk of developing hepatitis B infection from infected mothers are given additional doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.
If you think you’re at risk and need the hepatitis B vaccine, ask your GP to vaccinate you, or visit any sexual health or genitourinary medicine clinic.
If your GP or nurse is unable to offer you the hepatitis B vaccine because of a temporary shortage in supply, you may need to wait longer for the vaccine. For more information, read What to do if you have to wait for a dose of hepatitis B vaccine .
If your job places you at risk of hepatitis B infection, it’s your employer’s responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.
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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.
How Is It Treated
Acute hepatitis B: There are no drugs to treat acutehepatitis B. Doctors usually suggest rest, goodnutrition, and fluids. Some people may need to be inthe hospital.
Chronic hepatitis B: People with chronic hepatitis Bvirus infection should receive care from a provider whohas experience treating hepatitis B. These providerscan be:
- Some internists or family medicine providers
- Infection specialists
If you have chronic hepatitis B, get checked regularlyfor signs of liver disease. Discuss treatment with yourhealth care provider. Not every person with chronichepatitis B needs treatment. If you show no signs ofliver damage, your provider will continue to check youfor liver disease.
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Prevent Hepatitis B Infections In Newborns
If you are pregnant and have hepatitis B, talk with your doctor about lowering the risk that the infection will spread to your baby. Your doctor will check your virus levels during pregnancy. If virus levels are high, your doctor may recommend treatment during pregnancy to lower virus levels and reduce the chance that hepatitis B will spread to your baby. Your doctor may refer you to a liver specialist to find out if you need hepatitis B treatment and to check for liver damage.
When it is time to give birth, tell the doctor and staff who deliver your baby that you have hepatitis B. A health care professional should give your baby the hepatitis B vaccine and HBIG right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.
What Is The Outlook For People With Hepatitis B
The outlook for people with HBV is better now than ever before. You are certainly able to live a full life and help yourself stay healthy. You should make sure to have regular check-ups with a healthcare provider who is qualified to treat hepatitis B, possibly a liver doctor.
Make sure you are vaccinated against hepatitis A. Check with your healthcare provider or pharmacist before taking other medications or over-the-counter products, including supplements and natural products. These could interfere with your medication or damage your liver. For instance, taking acetaminophen in large doses may harm your liver.
Follow the usual guidelines for living a healthy life:
- Eat nutritious foods, choosing from a variety of vegetables, fruits and healthy proteins. It is said that cruciferous vegetables are especially good at protecting the liver.
- Exercise regularly.
- Dont smoke and dont drink. Both tobacco and alcohol are bad for your liver.
- Do things that help you cope with stress, like journaling, talking with others, meditating and doing yoga.
- Avoid inhaling toxic fumes.
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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.
What Is Hepatitis B
Hepatitis B is an infection of your liver. Itâs caused by a virus. There is a vaccine that protects against it. For some people, hepatitis B is mild and lasts a short time. These âacuteâ cases donât always need treatment. But it can become chronic. If that happens, it can cause scarring of the organ, liver failure, and cancer, and it even can be life-threatening.
Itâs spread when people come in contact with the blood, open sores, or body fluids of someone who has the hepatitis B virus.
It’s serious, but if you get the disease as an adult, it shouldnât last a long time. Your body fights it off within a few months, and youâre immune for the rest of your life. That means you can’t get it again. But if you get it at birth, itâ unlikely to go away.
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Hepatitis B In The United States
In the United States, about 862,000 people have chronic hepatitis B.6 Asian Americans and African Americans have higher rates of chronic hepatitis B than other U.S. racial and ethnic groups.10 Researchers estimate that about half of the people living with chronic hepatitis B in the United States are Asian Americans and Pacific Islanders.11 Chronic hepatitis B is also more common among people born in other countries than among those born in the United States.7
The hepatitis B vaccine has been available since the 1980s and, in 1991, doctors began recommending that children in the United States receive the hepatitis B vaccine. The annual rate of acute hepatitis B infections went down 88.5 percent between 1982 and 2015.12 In 2017, the annual number of hepatitis B infections rose in some states.13 Experts think the rise was related to increases in injection drug use. Injection drug use increases the risk of hepatitis B infection.
Complications Of Hepatitis B
In some people, chronic hepatitis can lead to cirrhosis of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The damaged areas of the liver stop working and cant cleanse the body of wastes. Cirrhosis can lead to liver failure and even liver cancer.
If you have hepatitis B, you are also susceptible to hepatitis D . Hepatitis D can only develop in people who already have hepatitis B. It can make your symptoms of hepatitis B or liver disease worse. It is spread through contact with infected blood or other body fluids of people who have hepatitis D.
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If I Have No Symptoms How Would I Know If I Have Hepatitis B
To confirm whether or not you have hepatitis B, you will need blood tests.
If you have at least one risk factor , you should ask your health care provider to be tested for hepatitis B. Also, you should be tested for hepatitis B if:
- you were born in a region where hepatitis B is more common, including Asia, Africa, southern and eastern Europe, the Pacific Islands, the Middle East, and the Arctic
- one or both of your parents immigrated from a region where hepatitis B is more common
- you live or travel to regions where hepatitis B is more common
- you have a family history of liver disease or liver cancer
- you have been in prison
- you are pregnant
- you have ever used injection drugs, even just once
- you have unexplained abnormal liver enzymes or if
- you receive medicines that suppress the immune system.
What Are The Risks Of Hepatitis B
About 90 per cent of adults infected with Hepatitis B recover within six months. However about 90 per cent of infected babies and 10 per cent of infected adults will develop chronic infection for life. Chronic Hepatitis B can cause cirrhosis of the liver, liver cancer, liver failure and death. A person with chronic Hepatitis B also has higher risk of being infected with another viral Hepatitis.
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What Other Problems Can Hepatitis B Cause
In rare cases, acute hepatitis B can cause liver failure.
If you have ever had hepatitis B, the virus may become active again, or reactivated, later in life. This could start to damage the liver and cause symptoms.
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.
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Hepatitis B Vaccination In Pregnancy
Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby. This is why the hepatitis B vaccine is recommended for pregnant women who are in a high-risk category.
There’s no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B. And, as it’s an inactivated vaccine, the risk to the unborn baby is likely to be negligible .
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.
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How Do You Know If You Have Hepatitis B
The only way to know if you have hepatitis B is bya medical exam. There are several blood tests yourhealth care provider can use to diagnose hepatitis B.These tests can tell you:
- If it is an acute or a chronic infection
- If you have recovered from infection
- If you are immune to hepatitis B
- If you could benefit from vaccination
How Do Doctors Treat Hepatitis B
Doctors typically dont treat hepatitis B unless it becomes chronic. Doctors may treat chronic hepatitis B with antiviral medicines that attack the virus.
Not everyone with chronic hepatitis B needs treatment. If blood tests show that hepatitis B could be damaging a persons liver, a doctor may prescribe antiviral medicines to lower the chances of liver damage and complications.
Medicines that you take by mouth include
A medicine that doctors can give as a shot is peginterferon alfa-2a .
The length of treatment varies. Hepatitis B medicines may cause side effects. Talk with your doctor about the side effects of treatment. Tell your doctor before taking any other prescription or over-the-counter medicines.
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About The Hepatitis B Virus
The hepatitis B virus is a small DNA virus that belongs to the Hepadnaviridae family. Related viruses in this family are also found in woodchucks, ground squirrels, tree squirrels, Peking ducks, and herons.
Structure of the Hepatitis B Virus The hepatitis B virus contains an outer envelope and an inner core.
- The outer envelope of the virus is composed of a surface protein called the hepatitis B surface antigen or “HBsAg”. The HBsAg can be detected by a simple blood test and a positive test result indicates a person is infected with the hepatitis B virus.
- The inner core of the virus is a protein shell referred to as the hepatitis B core antigen or “HBcAg,” which contains the hepatitis B virus DNA and enzymes used in viral replication.
Life Cycle of the Hepatitis B Virus
The hepatitis B virus has a complex life cycle. The virus enters the host liver cell and is transported into the nucleus of the liver cell. Once inside the nucleus, the viral DNA is transformed into a covalently closed circular DNA , which serves as a template for viral replication . New HBV virus is packaged and leaves the liver cell, with the stable viral cccDNA remaining in the nucleus where it can integrate into the DNA of the host liver cell, as well as continue to create new hepatitis B virus. Although the life cycle is not completely understood, parts of this replicative process are error prone, which accounts for different genotypes or genetic codes of the hepatitis B virus.