What Is Viral Hepatitis
Viral hepatitis is an inflammation of your liver that’s caused by a virus. There are five types, but the most common ones in the U.S. are hepatitis A, B, and C. All of them affect your liver. Some of the symptoms are similar, but they have different treatments.
Hepatitis A. This type won’t lead to long-term infection and usually doesn’t cause any complications. Your liver heals in about 2 months. You can prevent it with a vaccine.
Hepatitis B. Most people recover from this type in 6 months. Sometimes, though, it causes a long-term infection that could lead to liver damage. Once you’ve got the disease, you can spread the virus even if you don’t feel sick. You won’t catch it if you get a vaccine.
Hepatitis C. Many people with this type don’t have symptoms. About 80% of those with the disease get a long-term infection. It can sometimes lead to cirrhosis, a scarring of the liver. There’s no vaccine to prevent it.
When To Delay Or Avoid Hepb Immunization
Doctors delay giving the vaccine to babies who weigh less than 4 pounds, 7 ounces at birth whose mothers do not have the virus in their blood. The baby will get the first dose at 1 month of age or when the baby is discharged from the hospital.
The vaccine is not recommended if your child:
- is currently sick, although simple colds or other minor illnesses should not prevent immunization
- had a serious allergic reaction after an earlier dose of the vaccine or is allergic to baker’s yeast
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.
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What Are The Risk Factors For Getting Hepatitis B
Due to the way that hepatitis B spreads, people most at risk for getting infected include:
- Children whose mothers have been infected with hepatitis B.
- Children who have been adopted from countries with high rates of hepatitis B infection.
- People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
- People who live with or work in an institutional setting, such as prisons or group homes.
- Healthcare providers and first responders.
- People who share needles or syringes.
- People who live in close quarters with a person with chronic hepatitis B infection.
- People who are on dialysis.
Can Hepatitis B Be Treated
If you know you have been exposed to the hepatitis B virus in the previous seven days or less, you can receive an injection of hepatitis B immune globulin that may prevent you from developing the disease. Besides this, there is no treatment for acute hepatitis B.
If you have chronic hepatitis B, two types of treatment exist interferon which is a medication administered by a needle, and antiviral medicines that are taken by mouth. Current approved hepatitis B oral medications include lamivudine, adefovir, telbivudine, tenofovir, and entecavir. These treatments do not provide a cure, but they offer control of the virus so that further damage to your liver can be prevented. When and how to treat your hepatitis B is a decision between you and your doctor. Availability of the medications listed above may vary from province to province based on provincial government drug plans and individual insurance plans.
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Who Is Most Affected
In the United States, rates of new HBV infections are highest among adults aged 40-49 years, reflecting low hepatitis B vaccination coverage among adults at risk. The most common risk factor among people with new HBV infections is injecting drugs, related to the opioid crisis.
The highest rates of chronic hepatitis B infection in the United States occur among foreign-born individuals, especially people born in Asia, the Pacific Islands, and Africa. Approximately 70% of cases in the United States are among people who were born outside of the United States. CDC developed this map of the geographic distribution of hepatitis B around the world – PDF. Other groups who have higher rates of chronic HBV infection include people who inject drugs and men who have sex with men.
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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Who Are Hepatitis B Carriers
Hepatitis B carriers are people who have the hepatitis B virus in their blood, even though they dont feel sick. Between 6% and 10% of those people whove been infected with the virus will become carriers and can infect others without knowing it. There are over 250 million people in the world who are carriers of HBV, with about 10% to 15% of the total located in India. Children are at the highest risk of becoming carriers. About 9 in 10 babies infected at birth become HBV carriers, and about half of children who are infected between birth and age 5 carry the virus. A blood test can tell you if you are a hepatitis B carrier.
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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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 .
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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Acute Hepatitis B Infection
There is no specific treatment for acute hepatitis B, and most people recover within one to two months. Usually, you can manage symptoms at home with painkillers if necessary. Your healthcare professional should advise you to have regular blood tests and physical check-ups. Most people make a full recovery from acute hepatitis B.
Detection Of Antiviral Resistance
National and international surveillance is performed by the CDC to determine effectiveness of the current FDA-approved antiviral flu drugs. Public health officials use this information to make current recommendations about the use of flu antiviral medications. further recommends in-depth epidemiological investigations to control potential transmission of the resistant virus and prevent future progression. As novel treatments and detection techniques to antiviral resistance are enhanced so can the establishment of strategies to combat the inevitable emergence of antiviral resistance.
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How Can I Avoid Getting Hepatitis B
There is a safe and effective vaccine that can protect you from getting hepatitis B. The vaccine is usually given in three doses over a six month period. The vaccine will give you long-lasting protection. A combined vaccine for hepatitis A and hepatitis B is also available.
Other ways to protect yourself or your loved ones include:
- Adopt safe sex practices.
- Avoid sharing personal hygiene items
- If you have been exposed to the hepatitis B virus , an injection of hepatitis B immune globulin may help protect you.
- If you are pregnant, make sure you are screened for hepatitis B. If the test result shows that you have the virus, make sure your baby receives the free hepatitis B vaccine. If you have hepatitis B, breastfeeding is safe if the baby has received both protective antibody called immune globulin, and the first dose of hepatitis B vaccine within the first 12 hours of life. Talk to your doctor about having your newborn immunized .
- If you decide to have a tattoo, piercing, manicure or pedicure, ensure that the facility uses single-use needles and inks and/or follows proper sterilization procedures.
Who Should Be Vaccinated For Hepatitis B
All newborns should be vaccinated. Also, people who are under 18 who were not vaccinated at birth should also get the vaccine. Other groups who should be sure to be vaccinated are those in certain high-risk categories, such as:
- People who have more than one sexual partner.
- Men who have sex with men.
- Adults with diabetes.
- Sexual partners of infected people and people who share households with infected individuals.
- People who are exposed to blood and other bodily fluids, including healthcare and public safety professionals, and people who work in jails and other places taking care of people who cant take care of themselves.
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Persons With Chronic Diseases
Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional general information about vaccination of people with chronic diseases.
Chronic renal disease and patients on dialysis
People with chronic renal disease may respond sub-optimally to HB vaccine and experience more rapid decline of anti-HBs titres, and are therefore recommended immunization with a higher vaccine dose. Individuals undergoing chronic dialysis are also at increased risk for HB infection. In people with chronic renal disease anti-HBs titre should be evaluated annually and booster doses using a higher vaccine dose should be given as necessary.
People with conditions such as autism spectrum disorders or demyelinating disorders should receive all routinely recommended immunizations, including HB-containing vaccine.
Chronic liver disease
HB immunization is recommended for non-immune persons with chronic liver disease, including those infected with hepatitis C, because they are at risk of more severe disease if infection occurs. Vaccination should be completed early in the course of the disease, as the immune response to vaccine is suboptimal in advanced liver disease. Post-immunization serologic testing may be used to confirm vaccine response.
Non-malignant hematologic disorders
Persons with bleeding disorders and other people receiving repeated infusions of blood or blood products are considered to be at higher risk of contracting HB and should be offered HB vaccine.
Good Nutrition And Rest
- All family members should eat a well-balanced diet that includes foods shown in the graphic MyPlate . You can find more information about balanced nutrition on the website ChooseMyPlate.gov .
- All family members should get at least 8 hours of sleep each night.
- Young children who are ill should rest during the day when possible.
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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.
How To Prevent Hepatitis B
Hepatitis B is a liver infection caused by a virus . It can be serious and theres no cure, but the good news is its easy to prevent. You can protect yourself by getting the hepatitis B vaccine and having safer sex. If you have oral, anal, and vaginal sex, use condoms and dental dams to help stop the spread of hepatitis B and other STDs.
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How Can I Prevent Spreading Hepatitis B To Others
If you have hepatitis B, follow the steps above to avoid spreading the infection. Your sex partners should get a hepatitis B test and, if they arent infected, get the hepatitis B vaccine. You can protect others from getting infected by telling your doctor, dentist, and other health care professionals that you have hepatitis B. Dont donate blood or blood products, semen, organs, or tissue.
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.
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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 .
Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.
Refer to Reporting Adverse Events Following Immunization in Canada and Adverse events following immunization in Part 2 for additional information about AEFI reporting.
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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.