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.
Enhancing Healthcare Team Outcomes
As hepatitis B infection is highly transmissible via accidental needlesticks, healthcare providers involved in taking care of a patient with HBV should exercise caution and practice proper preventative measures such as vaccination. Patient education should also include counseling about HBV transmission. The interprofessional team’s role is crucial in ensuring the best patient outcomes.
The vaccination rate is low in many developing countries, and the majority of patients are undiagnosed. Educational programs and improved awareness among the general public and healthcare providers are necessary to improve the identification of the patients, reduce transmission of the disease, and reduce the complications of hepatitis B infection.
Immunisation For Hepatitis B
Immunisation is the best protection against hepatitis B infection. A course of vaccination is recommended for all babies and people in high-risk groups.
Immunisation can be with a vaccine against hepatitis B alone or with a combination vaccine. To be immunised, contact your doctor or local council.
Protection against hepatitis B is available free of charge under the National Immunisation Program Schedule. In Victoria, immunisation against hepatitis B is free for:
- Babies at birth immunisation against hepatitis B alone as soon as possible after birth.
- Babies at 2, 4 and 6 months combination immunisation in the form of a diphtheria, tetanus, whooping cough, hepatitis B, polio and Haemophilus influenzae type b vaccine .
- Premature babies at 12 months premature babies born under 32 weeks gestation or under 2,000g birth weight receive a single booster dose.
- Children up to and including 9 years of age.
- People aged less than 20 years having a catch-up immunisation.
- Refugees and humanitarian entrants aged 20 years and above.
In Victoria, free hepatitis B vaccine is provided for people who are at increased risk of infection, including:
Immunisation is also recommended, but not necessarily free, for people who are at increased risk of infection, including:
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What Are The Complications Of Hepatitis B
The course of hepatitis B infection depends mostly on the age at which a person is infected.
People infected as infants are likely to develop long term infection and can get complications such as scarring of the liver or liver cancer. Infants have a 9 in 10 chance and children have a 3 in 10 chance of developing a chronic, lifelong infection.
People infected as teenagers or adults are likely to become unwell with symptoms , but have a smaller chance of developing a chronic infection. Others develop a silent infection, without any symptoms.
Most people infected as adults clear the virus from the body within 6 months. They develop immunity to future hepatitis B infections and do not develop long-term liver damage.
However, approximately 1 in 20 adults cannot clear the virus and develop chronic hepatitis B. They are at risk of developing complications such as cirrhosis and liver cancer in the longer term.
Unlikely Sources Of Infection
Trace levels of HBV can also be found in saliva, tears, urine, and feces but in amounts that are highly unlikely to cause infection.
While vaccination remains the cornerstone of HBV prevention, there are ways to further reduce the risk of transmission, especially if you or someone in your household has hepatitis B:
- Wash your hands with soap and water if exposed to blood.
- Avoid sharing razors or toothbrushes.
- Use condoms during sex.
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Who Is At Risk For Hepatitis B
Anyone can get Hepatitis B, but some people are at greater risk and include:
- Infants born to a person infected with hepatitis B
- People who inject drugs or share needles, syringes, or other drug equipment
- Sex with a partner who has hepatitis B
- Men who have sex with men
- People who live with a person who has hepatitis B
- Health care and public safety workers exposed to blood on the job
- People on dialysis
- Developmentally disabled people who live in long-term care facilities
- People in prison
- People with diabetes, chronic liver disease, HIV infection, or hepatitis C infection
- Travelers to countries with high rates of hepatitis B
How Is Hepatitis B Prevented
Testing & Vaccination
- The hepatitis B vaccine offers excellent protection against HBV. The vaccine is safe and highly effective. Vaccination consists of 3 doses of vaccine over the course of 6 months. Protection lasts for 20 years to life.
- The American Academy of Pediatrics recommends that all children should receive hepatitis B vaccine starting at birth. .
- The CDC recommends hepatitis B vaccine for persons traveling to countries where HBV is common .
- If you have one or more risk factors for hepatitis B infection, you should get a simple HBV blood test. The blood test will determine whether you are:
- immune to hepatitis B or
- susceptible to hepatitis B and need vaccination or
- infected with hepatitis B and need further evaluation by a physician
Perinatal Hepatitis
- California law requires testing of all pregnant women for hepatitis B infection
- If the mother is HBV-infected, she will pass the infection to the baby during the birth process, unless the baby gets immunized within hours of birth
- Giving the infant HBIG and HBV vaccine right away will reliably prevent infection of the infant
- Other family members should best tested for hepatitis B too, and given vaccine if they are not already infected or immune
Healthy Habits
After Exposure to Hepatitis B
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Return To School Or Child Care
- Your child may return to normal daily activity when the childs doctor or the doctor who discharges him or her from the hospital says it is OK. This will be when your child is no longer jaundiced or vomiting.
- A child who scratches, bites or “gets into fights, has an overall skin condition, or a bleeding problem should probably not attend child care while he or she has hepatitis. Your childs doctor can help you make this decision.
If you have any questions, be sure to ask your childs doctor or nurse.
HH-I-43 10/76, Revised 10/15 Copyright 1976, Nationwide Childrens Hospital
Hepatitis B Causes And Risk Factors
Itâs caused by the hepatitis B virus, and it can spread from person to person in certain ways. You can spread the hepatitis B virus even if you donât feel sick.
The most common ways to get hepatitis B include:
- Sex. You can get it if you have unprotected sex with someone who has it and your partnerâs blood, saliva, , or vaginal secretions enter your body.
- Sharing needles. The virus spreads easily via needles and syringes contaminated with infected blood.
- Accidental needle sticks.Health care workers and anyone else who comes in contact with human blood can get it this way.
- Mother to child.Pregnant women with hepatitis B can pass it to their babies during childbirth. But thereâs a vaccine to prevent newborns from becoming infected.
Hepatitis B doesnât spread through kissing, food or water, shared utensils, coughing or sneezing, or through touch.
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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.
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.
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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.
Symptoms Of Hepatitis B
Some people who are infected with the hepatitis B virus have mild, flu-like symptoms and some do not become sick at all. Children who are infected are less likely to have an illness or get sick after getting hepatitis B than adults.
In more severe cases, hepatitis B can cause:
- Loss of appetite.
- Pain in the joints.
Normally, these health problems disappear in a few weeks, but even when the person feels much better, they may still be infectious.
Most adults who become infected with the hepatitis B virus recover completely and do not become infected again. A few people become very ill in the time just after infection and need to go to hospital some may even die.
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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.
Whats The Prognosis For Hepatitis B
Your doctor will know youâve recovered when you no longer have symptoms and blood tests show:
- Your liver is working normally.
- You have hepatitis B surface antibody.
But some people don’t get rid of the infection. If you have it for more than 6 months, youâre whatâs called a carrier, even if you donât have symptoms. This means you can give the disease to someone else through:
- Unprotected sex
- Contact with your blood or an open sore
- Sharing needles or syringes
Doctors donât know why, but the disease does go away in a small number of carriers. For others, it becomes whatâs known as chronic. That means you have an ongoing liver infection. It can lead to cirrhosis, or hardening of the organ. It scars over and stops working. Some people also get liver cancer.
If youâre a carrier or are infected with hepatitis B, donât donate blood, plasma, body organs, tissue, or sperm. Tell anyone you could infect — whether itâs a sex partner, your doctor, or your dentist — that you have it.
Show Sources
CDC: âHepatitis B Questions and Answers for Health Professionals,â âHepatitis B Questions and Answers for the Public.â
Mayo Clinic: âHepatitis B.â
UpToDate: âHepatitis B virus: Screening and diagnosis.â
CDC.
HealthyPeople.gov: âHepatitis B in Pregnant Women: Screening.â
Annals of Internal Medicine: âScreening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults: U.S. Preventive Services Task Force Recommendation Statement.â
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Tools To Help You Manage Exposures Hepatitis B And C
Prompt assessment and management of potential hepatitis B and C exposures from needlesticks, splashes, sexual exposure, and human bites is paramount. While each exposure case is unique, there are standard strategies that help you determine who should receive hepatitis B prophylaxis and how to evaluate and monitor hepatitis C exposures. NCCC clinicians have compiled and created tools to assist you in identifying what constitutes an exposure and how to test for and follow up on exposures confidently.
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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What Is Hepatitis
Hepatitis is an infection and inflammation of the liver, an organ located on the upper right side of the abdomen.
There are several types of infectious hepatitis, caused by different viruses. They can cause similar symptoms but can affect the liver in different ways. The three main viral types are:
- Hepatitis A: This is a short-term infection and most patients recover without treatment within about 2 months. It can be prevented with a vaccine.
- Hepatitis B: This can cause acute or chronic infection. Most patients recover within 6 months but some patients develop a long-term infection that can result in liver damage. It can be prevented with a vaccine.
- Hepatitis C: This can cause acute or chronic infection that can lead to liver damage and severe scarring of the liver and an increased risk of liver cancer. There’s no vaccine to prevent it.
Other types of viral hepatitis include hepatitis D, which only develops in people who have hepatitis B, and hepatitis E, which is more common in parts of the developing world where there is poor sanitation.
How To Get Tested
Oftentimes, people with hepatitis B dont have symptoms. That’s why it’s important to get tested if you had unprotected sex or shared a needle with someone who may have been infected. Hepatitis B is detected by a blood test and is usually included in routine sexually transmitted infection screenings.
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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.
What Is Hepatitis B Post
After possible exposure to the hepatitis B virus, hepatitis B post-exposure prophylaxis can be used to decrease the chance of getting hepatitis B.
Hepatitis B PEP does not reduce the risk of infection with other blood borne viruses such as hepatitis C or HIV.
Hepatitis B PEP consists of:
- a single injection of plus
- three injections of hepatitis B vaccine spread over several months.
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