Immunise Test And Treat
Before chronic hepatitis B can be cured, we need to know who is infected and their stage of disease. Only 10% of the estimated number of individuals living with HBV infection in 2016 knew of their status, and of those diagnosed, only 5% of those who were eligible for treatment actually received treatment. WHO aims to eliminate viral hepatitis as a major public health threat by 2030, and while increasing preventive vaccine coverage is the main cornerstone of this global effort to achieve elimination, WHO also proposes an increase of the proportion of eligible individuals treated for chronic hepatitis B to 80%. This will require a concomitant increase in global HBV testing worldwide. Priority should be given to development of rapid point-of-care tests for use in countries of low and middle income, where HBV is highly endemic. Since there are already effective treatments that have a marked effect on HBV replication and liver disease, increased efforts must be made to improve access globally. Large-scale accessible diagnosis and treatment facilities in countries of low and middle income should be established to reduce mortality and ensure HBV cure preparedness, while also investing in HBV cure strategies, which could allow important cost-savings for health systems in the long run.
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How Do You Test For Hepatitis B
A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given extra tests to see if your liver is damaged.
If youve got hepatitis B you should be tested for other STIs. Its important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis B dont notice anything wrong, and by telling them you can help to stop the virus being passed on. This can also stop you from getting the infection again.
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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Is Hepatitis B Preventable
Chronic hepatitis B infection affects at least 250 million people worldwide, causing over 880,000 deaths annually. It is also the major cause of liver cancer, the second leading cause of cancer-related deaths in the United States.
Unlike its cousin hepatitis C, hepatitis B can be prevented with vaccines. If you are accidentally exposed to the virus, there are also drug therapies you can takeâcalled postexposure prophylaxisâto avert the infection.
How Is Hepatitis C Diagnosed
Hepatitis C is typically diagnosed following routine blood tests or when donating blood. More often than not, those living with Hepatitis C may not even know that they have the infection until their blood labs show abnormalities. A variety of lab tests used to assess liver damage can identify the extent to which Hepatitis C has affected your liver.
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Is Hepatitis B Curable
Theres no cure for hepatitis B. The good news is it usually goes away by itself in 4 to 8 weeks. More than 9 out of 10 adults who get hepatitis B totally recover.
However, about 1 in 20 people who get hepatitis B as adults become carriers, which means they have a chronic hepatitis B infection. Carriers are more likely to pass hepatitis B to other people. Most carriers are contagious meaning they can spread hepatitis B for the rest of their lives.
Hepatitis B infections that last a long time may lead to serious liver diseases like cirrhosis and liver cancer. About 1 in 5 people with chronic hepatitis B die from it. There are medicines that can help treat chronic hepatitis B infections.
Most babies who get hepatitis B during birth develop chronic infection, unless they get treated right away. But treatments are almost always effective if your baby gets them quickly. Thats why its important for pregnant people to get tested for hepatitis B.
Management Of Inactive Hbsag Carrier
Differentiation from chronic HBsAg negative hepatitis B, requires serial testing of ALT and HBV DNA for one year before designating carrier state . In subject with inactive carrier state testing of HBV DNA and liver biopsy are not recommended. Treatment is not recommended as there is no evidence that available therapy affects HBsAg status. Family screening with HBsAg and anti-HBs, if negative vaccinate them and success of vaccination should be confirmed with anti-HBs testing. Protected sexual intercourse until partner has developed protective antibodies. The offspring need active and passive vaccination . Use of alcohol should be avoided, possibility of reactivation or super infection by other viruses and advised if there is jaundice, malaise or increased fatigue. Regular follow-up at every 612 months intervals with ALT . If the age of the patient is more than 50 yrs family history of HCC-AFP and ultrasonography every 612 monthly should be done. Universal precaution should be taken while treating these patients in the hospital. They should not be allowed to donate the blood or organ or semen. For pregnant women vaccinate the new born at birth with active and passive immunization with in 12 hours of the birth, close monitoring required if undergoing chemotherapy or immunosuppressive medication.
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Should All Patients With Chronic Hepatitis B Be On Treatment
Not all patients with chronic hepatitis B need to be on treatment. The decision to treat HBV is based on several factors including blood tests results, the patient’s age, and the risk of developing cirrhosis or liver cancer. Sometimes a liver biopsy is needed to see if there is significant liver damage to make a decision.
Hepatitis B medications are recommended for patients with detected HBV virus on a blood test and evidence of liver damage. Liver damage can be detected with a liver enzyme known as ALT. People with cirrhosis should be considered for treatment even if the liver enzymes appear normal.
Chronic hepatitis B may change over time. Patients can go through different phases with low amounts of virus and normal level of ALT followed by high viral loads and ALT levels. These bursts of virus activity usually don’t cause any symptoms but may cause liver damage overtime. It is important that people with chronic hepatitis B have blood tests on a regular basis to see if treatment is needed.
There are some medications which can cause hepatitis B “reactivation” which can lead to life threatening liver failure. These medications are used to treat some cancers, inflammatory conditions and hepatitis C. Reactivation reactions can be prevented and it is important to let your provider know you have HBV before you start any new medications.
Vaccination And Other Prevention Measures
Vaccination is a safe and effective way of preventing the spread of hepatitis B. Since 1985, the hepatitis B vaccine has been part of the national immunisation schedule. In 1988, New Zealand was one of the first countries to introduce universal infant hepatitis B immunisation.The vaccine is given to babies at age six weeks, three months, and five months. Babies born to mothers with hepatitis B receive an extra dose of the vaccine at birth as well as a dose of hepatitis B-specific immune globulin.In children and adolescents who did not receive the hepatitis B vaccine in the first year of life, the full three-dose course is recommended.Hepatitis B immunisation is recommended and publicly funded for all infants and children up to their 18th birthday, household and sexual contacts of people with acute or chronic hepatitis B, and certain other high-risk populations. Measures that can help prevent the spread of the hepatitis B virus include:
- Teaching children not to touch the blood or wounds of others
- Covering cuts, scratches, and grazes
- Not sharing personal items such as razors and toothbrushes
- Never sharing needles or syringes if you use intravenous drugs
- Practising safe sex, including the use of condoms
- Seek assurance that body piercing and tattooing needles and equipment are sterile.
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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.
Possible Complications Of Hepatitis A
Hepatitis A can cause more serious health problems. Keep in mind all that these are rare and more likely to happen in people who are over 50.
- Cholestatic hepatitis. Occuring in about 5% of patients, this means the bile in your liver is obstructed on its way to the gallbladder. It can cause changes in your blood and result in jaundice fever and weightloss
- Relapsing hepatitus. More common in the elderly, The symptoms of liver inflamation such as jaundice, reoccur periodlically but are not chronic.
- Autoimmune hepatitis. this triggers your own body to attack the liver. If left untreated, it could result in chronic liver disease, cirrhosis and ultimately liver failure.
- Liver failure. Happens in less than 1% and this usually affects people who are:
- Older
- Already have another type of liver disease
- Have a weakened immune system
If your doctor feels your liver isnât working well, they may admit you to the hospital to keep an eye on how well your liver is working. In severe cases, you might need to have a liver transplant.
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How Is It Currently Treated
There is no cure for chronic hepatitis B virus.
In most cases, treatment requires taking a pill every day for life to remain effective and to reduce the risk of liver cancer. Even then, it doesnt eliminate the risk.
Chronic hepatitis B hasnt been cured so far in part because current therapies have failed to destroy the viral reservoir, where the virus hides in the cell.
This is in contrast to hepatitis C virus, which has no such viral reservoir and can now be cured with as little as 12 weeks of treatment.
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Despite the huge human and economic toll of chronic hepatitis B, research to cure the disease remains underfunded. There is a misconception that because there is a vaccine, hepatitis B is no longer a problem.
The availability of effective cures for the unrelated hepatitis C virus has also led people to believe that viral hepatitis is no longer a problem.
Experts estimate that liver cancer deaths will substantially increase in coming decades without a cure for hepatitis B, despite deaths from most cancers decreasing.
How Is Acute Hepatitis B Treated
Acute hepatitis B doesnt always require treatment. Most of the time, a doctor or healthcare professional will recommend monitoring your symptoms and getting regular blood tests to determine whether the virus is still in your body.
While you recover, allow your body to rest and drink plenty of fluids to help your body fight off the infection. You can also take an over-the-counter pain reliever to help with any abdominal pain you have. Speak with a doctor about which medications can help your symptoms.
See a doctor if your symptoms are severe or seem to be getting worse. You may need to take a prescription antiviral medication to avoid potential liver damage.
Like acute hepatitis B, chronic hepatitis B may not require medical treatment to avoid permanent liver damage. For some people, monitoring their symptoms and getting regular liver tests is an appropriate care regimen.
Treatment generally involves antiviral medications, such as:
- peginterferon alfa-2a injections
- antiviral tablets, such as tenofovir or entecavir
Antiviral medications can help to reduce your symptoms and prevent liver damage, but they rarely completely get rid of the hepatitis B virus. Instead, the goal of treatment is for you to have the lowest viral load possible. Viral load refers to the amount of a virus in a blood sample.
You can lower your risk of developing hepatitis B or spreading the virus to others by:
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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.
âHepatitisâ means inflammation of the liver. There are other types of hepatitis. Those caused by viruses also include hepatitis A and hepatitis C.
What Is The Difference Between Acute And Chronic Hbv
Acute HBV lasts for a short time. A person has chronic HBV when they have had the infection for 6 months or more. A person with chronic HBV might carry the infection indefinitely.
Acute HBV can develop into chronic HBV. A persons risk of developing chronic HBV is relative to the age at which they first developed the infection.
Newborns and young children with HBV have a higher risk of developing a chronic infection. According to the :
- around 9 in 10 infants with acute HBV will develop chronic HBV
- roughly 1 in 3 children who contract the infection before the age of 6 will develop chronic HBV
- almost all adults and children older than 6 with HBV will recover completely
- eating a nutritious diet
People with more severe symptoms may need to go to the hospital.
Doctors recommend having regular blood tests to check whether the infection has resolved or developed into chronic HBV.
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What Causes Hepatitis B
Hepatitis B is caused by the hepatitis B virus. It can happen through exposure to infected blood and other bodily fluids in the following situations:
- sharing needles and other injecting drug equipment
- sharing razors, toothbrushes or nail clippers
- sexual contact
- tattooing with unsterilised needles and equipment
- close family contact with someone who has hepatitis B
- being born to a mother with hepatitis B
- accidental exposure such as a needle stick injury or being splashed with infected blood or body fluid
- blood transfusion this is now very rare as blood in Australia is screened for hepatitis B
You cannot catch hepatitis B through being coughed or sneezed on by infected people or by consuming contaminated food and drink. You cannot catch the virus from saliva, breast milk or tears.
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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What Is Involved In A Liver Transplant
A liver transplant is considered necessary when the liver is damaged and cannot function or in some cases of liver cancer. Your liver is very important. It is responsible for many functions related to making sure that your body stays healthy and is able to digest foods.
You may be eligible for a transplant if you have chronic hepatitis B infection or some of the diseases that may result from it, including liver cancer and cirrhosis. You will have to complete testing and be evaluated before being approved for a transplant. It is likely that you will be placed on a waiting list while an appropriate organ is found.
Donated livers come from two types of donors: living and deceased. Because the liver can regenerate, it is possible to use part of a liver for transplant. The remaining sections in both the donor and the receiver will grow into livers of adequate size.
People who get liver transplants must take anti-rejection drugs for the rest of their lives. These drugs make you more susceptible to infection. However, liver transplants have become more successful over time and continue to improve.
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