How Do People Get The Hbv Virus
Hepatitis B virus is found in the blood of people with HBV infection. It enters the body through blood-to-blood contact.
Reliable blood tests for HBV were developed many years ago. Since blood donors and blood products are tested for HBV, this is no longer the typical means of infection.
In many parts of the world, hepatitis B virus infects more than 8% of the population. HBV-infected women pass the infection to their babies during the birth process. People can also get hepatitis B by sharing needles for injection drug use, through sexual contact with an infected person, by an accidental needlestick with a contaminated needle, or from improperly sterilized medical, acupuncture, piercing, or tattooing equipment.
When Should You Contact Doctor If You Think You Have Hepatitis
Fortunately, for some types of hepatitis , there are preventative treatments. Consequently, if a person suspects that they may have been recently exposed to any type of infectious hepatitis, they should contact their health-care professional quickly to prevent liver damage.
If a person has the following symptoms for days, they should seek medical care urgently.
Eating Diet And Nutrition For Hepatitis B
If you have hepatitis B, you should eat a balanced, healthy diet. Obesity can increase the chance of nonalcoholic fatty liver disease , and NAFLD can increase liver damage in people who have hepatitis B. Talk with your doctor about healthy eating and maintaining a healthy weight.
You should also avoid alcohol because it can cause more liver damage.
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Diagnosis Of Hepatitis B
Blood tests are available to determine if you are or have been infected with hepatitis B. It may take 6 months from the time of infection before a blood test can detect antibodies to hepatitis B, so follow-up testing may be required. During this 6-month period, until you know whether you are infected or not, take action to prevent potential infection of other people.
There are also tests that can assess liver damage from hepatitis B. The interpretation of these tests can be complicated and specialist advice is needed, so talk to your doctor.
All pregnant women are tested for hepatitis B. If you are found to have chronic hepatitis B, your doctor can help reduce the risk of transferring the infection to your newborn child.
How Is Hepatitis B Diagnosed
There are three main ways to diagnose HBV infection. They include:
- Blood tests: Tests of the blood serum shows how your bodys immune system is responding to the virus. A blood test can also tell you if you are immune to HBV.
- Abdominal ultrasound: An ultrasound uses sound waves to show the size and shape of your liver and how well the blood flows through it.
- Liver biopsy: A small sample of your liver tissue is removed though a tiny incision and sent to a lab for analysis.
The blood test that is used to diagnose hepatitis B is not a test that you get routinely during a medical visit. Often, people whove become infected first learn they have hepatitis B when they go to donate blood. Blood donations are routinely scanned for the infection.
The virus can be detected within 30 to 60 days of infection. About 70% of adults with hepatitis B develop symptoms, which tend to appear an average of 90 days after initial exposure to the virus.
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Parenteral Routes: Transmission Of Hepatitis B Hepatitis D And Hepatitis C
Hepatitis B, C, and D viruses are all transmitted by what is known as the parenteral route. Parenteral simply means that these viruses can be introduced by all routes except through the intestinal tract, which leaves the door wide open in terms of possible exposure. Let’s look at the possible transmission routes for each of these types of hepatitis virus more closely.
Chronic Hepatitis B Infection
If you develop chronic hepatitis B, youll be given treatment to reduce the risk of permanent liver damage and liver cancer. Treatment does not cure chronic hepatitis B and most people who start treatment need to continue for life.
Without treatment, chronic hepatitis B can cause scarring of the liver , which can cause the liver to stop working properly.
A small number of people with cirrhosis develop liver cancer, and these complications can lead to death. Other than a liver transplant, there is no cure for cirrhosis. However, treatments can help relieve some of the symptoms.
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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.
How Common Is Hepatitis B
The number of people who get this disease is down, the CDC says. Rates have dropped from an average of 200,000 per year in the 1980s to around 20,000 in 2016. People between the ages of 20 and 49 are most likely to get it.
About 90% of infants and 25-50% of children between the ages of 1-5 will become chronically infected. In adults, approximately 95% will recover completely and will not go on to have a chronic infection.
As many as 1.2 million people in the U.S. are carriers of the virus.
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What Is The Treatment For Hepatitis B
Prevention is recommended by receiving a vaccine for HBV.
Receiving an injection of the hepatitis B immune globulin within 12 hours of coming in contact with the virus may help prevent the development of the disease.
At present, there is no specific treatment for patients with acute hepatitis B. Acute infection is usually short and will often resolve on its own. Your health care provider may recommend rest, and adequate nutrition and fluids to help your body fight the infection. Hospitalization may be required for patients who suffer from severe vomiting and who are unable to maintain adequate nutritional levels. It may also be required to prevent the development of complications.
While chronic infection cannot be cured, there are two standard treatments in Canada that may control the virus and prevent further damage to the liver.
- Antiviral medications can fight the virus and slow damage to the liver.
- Interferon which may be given for short periods and if effective, results in suppression of the virus.
How Hcv Is Spread
The hepatitis C virus is transmitted primarily through blood to blood contact, meaning that a person can become infected with the virus should the blood of a person who carries the virus be introduced into another person’s bloodstream.
Therefore, as with hepatitis B, blood transfusions , tattooing and body piercing, occupational exposure, medical procedures, and intravenous drug use can all lead to possible exposure to the virus. Unlike hepatitis B, however, sexual contact and childbirth have both been shown to be an inefficient route of exposure to HCV.
The hepatitis G virus is thought to be transmitted in a similar way to HCV.
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Prevent Infection After Contact With The Virus
If you think you have been in contact with the hepatitis B virus, see your doctor right away. Doctors typically recommend a dose of the hepatitis B vaccine to prevent infection. In some cases, doctors may also recommend a medicine called hepatitis B immune globulin to help prevent infection. You must get the vaccine dose and, if needed, HBIG shortly after coming into contact with the virus, preferably within 24 hours.
When Should I Contact A Health
Any infant, child, or adult that has not been vaccinated against HBV should be vaccinated especially if they have had any close association with HBV-infected individuals.
An individual with chronic hepatitis B infection is advised to
- have follow-up every 6-12 months to maximize their health,
- get vaccinated against hepatitis A, and
Discuss diet, lifestyle changes, and ways to prevent transmission of their disease to others with your health-care professional.
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Who’s Most At Risk Of Hepatitis B
People at highest risk of hepatitis B include:
- people born or brought up in a country where the infection is common
- babies born to mothers infected with hepatitis B
- people who have ever injected drugs
- anyone who has had unprotected sex, including anal or oral sex particularly people who have had multiple sexual partners, people who have had sex with someone in or from a high-risk area, men who have sex with men, and commercial sex workers
- close contacts, such as family members, of someone with a long-term hepatitis B infection
The risk of getting hepatitis B for travellers going to places where the infection is common is generally considered to be low if these activities are avoided.
Your GP can arrange for you to have a blood test to check for hepatitis B and have the hepatitis B vaccination if you’re at a high risk.
What Treatments Are Available For Chronic Hepatitis B If Medications Dont Work
If you have advanced hepatitis B, you might also become a candidate for a liver transplant. This path does not always result in a cure because the virus continues in your bloodstream after a transplant. To prevent being infected again after your transplant, you may be prescribed hepatitis B immunoglobulin with an antiviral agent.
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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.
How Is The Hepatitis B Vaccine Given
The hepatitis B vaccine is a “recombinant vaccine,” which means that it is a fragment of the hepatitis B virus that has been produced in a laboratory. The vaccination for hepatitis B is given as 3 injections over a 6-month period – an initial dose, followed by a second dose 1 month later, and a third dose 5months after the second.
If you need hepatitis A vaccination in addition to hepatitis B, you can do these individually or as a combined vaccine that covers both. The combination vaccine is given as 3 injections over a 6-month period – an initial dose, followed by a second dose 1 month later, and a third dose 5 months after the second.
If you are not able to get the shots on time, it is not necessary to restart the series, but you should continue from the last dose given.
You will NOT get hepatitis B from the vaccine.
You will be protected for about 13 years. If it has been many years since you received your hepatitis B vaccination, or if you do not know when you were vaccinated, ask your doctor to check to see if you have antibodies against hepatitis B.
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Complications Of Hepatitis B
A small proportion of people who become infected with the hepatitis B virus develop a long-term hepatitis B infection. They may have the virus in their bloodstream for most of their life without realising they are infected.
People with chronic hepatitis B infection may not notice any health problems until they develop liver problems such as liver disease or liver cancer later in life. Treatment for hepatitis B is essential because it is not possible to be a healthy carrier of the hepatitis B virus. Chronic hepatitis B infection occurs more commonly in some communities, including:
- Aboriginal and Torres Strait Islander communities.
- In people from parts of the world where hepatitis B is more common, such as:
- North-East Asia
- Sub-Saharan Africa.
How Do You Know If You Have Hepatitis B
Signs and symptoms can vary, in particular by the age of the individual. Many individuals may not show symptoms . When symptoms develop, they include fever, joint pain, abdominal pain, fatigue, lack of appetite, nausea, vomiting, dark urine, clay-coloured bowel movements, or jaundice.
Most infections are asymptomatic or mild. Occasionally, people with serious cases of hepatitis B require hospitalization. A very small proportion of these patients develop a critical form of the disease called “fulminant” hepatitis B. This condition results from a sudden breakdown of liver function.
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Who Should Get The Hepatitis B Vaccine
All newborn babies should get vaccinated. You should also get the shot if you:
- Come in contact with infected blood or body fluids of friends or family members
- Use needles to take recreational drugs
- Have sex with more than one person
- Are a health care worker
- Work in a day-care center, school, or jail
What Is My Risk
Your risk depends of several factors: destination, length of stay, what you do when you are travelling and whether you have direct contact with blood or other body fluids. In certain destinations, your risk may be higher, as some areas have higher numbers of people with chronic hepatitis B in the general population.
The risk increases with certain activities, such as unprotected sex, sharing needles, tattooing and acupuncture.
Aid and health care workers and anyone who receives medical or dental care with unsterilized or contaminated equipment in a country where hepatitis B occurs are also at greater risk.
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What Other Problems Can Hepatitis B Cause
In rare cases, acute hepatitis B can cause liver failure.
Chronic hepatitis B can develop into a serious disease that causes long-term health problems such as cirrhosis , liver cancer, and 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.
Can You Be A Blood Or Organ Donor
People with hepatitis C cant currently donate blood. The American Red Cross eligibility guidelines prohibit people who have ever tested positive for hepatitis C from donating blood, even if the infection never caused symptoms.
According to the Department of Health and Human Services , information on organ donation, those with underlying medical conditions shouldnt rule themselves out as organ donors. This reflects new guidelines for organ donation announced by the HHS.
People with HCV are now able to be organ donors. This is because advances in testing and medical technology can help the transplant team determine which organs or tissues can be safely used for transplantation.
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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
- childbirth
- household contact between family members
What Should You Know About Hepatitis B Before You Travel
Hepatitis B is quite common in China and other Asian countries, where as many as 1 in 12 people have the virus, though many dont know it. Before traveling to those places, you should make sure youve been vaccinated against the virus.
In addition to getting the vaccine, you can take these additional precautions to reduce your risk of contracting the virus:
- Refrain from taking illegal drugs.
- Always use latex or polyurethane condoms during sex.
- Make sure new, sterile needles are used during all piercings, tattoos and acupuncture sessions.
- Avoid direct contact with blood and bodily fluids.
- Know the HBV status of all your sexual partners.
- Ask your doctor about possible vaccination before you travel to a place where hepatitis B is common.
A note from Cleveland Clinic
Hepatitis B is a liver disease that can cause serious damage to your health. One reason that is dangerous is that it can easily go undetected for years while damaging your liver. Talk with your healthcare provider about being tested for hepatitis B if you have any reason to believe that you were not vaccinated or if you have engaged in risky behavior. If you do test positive, follow the directions from your healthcare provider so that you can live a longer, healthier and happier life.
Last reviewed by a Cleveland Clinic medical professional on 07/09/2020.
References
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Who Is At Risk For Hepatitis B
Anyone can get hepatitis B, but the risk is higher in:
- Infants born to mothers who have hepatitis B
- People who inject drugs or share needles, syringes, and other types of drug equipment
- Sex partners of people with hepatitis B, especially if they are not using latex or polyurethane condoms during sex
- Men who have sex with men
- People who live with someone who has hepatitis B, especially if they use the same razor, toothbrush, or nail clippers
- Health care and public-safety workers who are exposed to blood on the job
- Abdominal pain
- Yellowish eyes and skin, called jaundice
If you have chronic hepatitis B, you may not have symptoms until complications develop. This could be decades after you were infected. For this reason, hepatitis B screening is important, even if you have no symptoms. Screening means that you are tested for a disease even though you don’t have symptoms. If you are at high risk, your health care provider may suggest screening.