What Is Chronic Hepatitis B
Doctors refer to hepatitis B infections as either acute or chronic:
- An acute HBV infection is a short-term illness that clears within 6 months of when a person is exposed to the virus.
- A person who still has HBV after 6 months is said to have a chronic hepatitis B infection. This is a long-term illness, meaning the virus stays in the body and causes lifelong illness. An estimated 850,000 to more than 2 million people in the U.S. have chronic HBV.
The younger someone is when infected, the greater the chances for chronic hepatitis B.
Who Is More Likely To Get Hepatitis B
People are more likely to get hepatitis B if they are born to a mother who has hepatitis B. The virus can spread from mother to child during birth. For this reason, people are more likely to have hepatitis B if they
- were born in a part of the world where 2 percent or more of the population has hepatitis B infection
- were born in the United States, didnt receive the hepatitis B vaccine as an infant, and have parents who were born in an area where 8 percent or more of the population had hepatitis B infection
People are also more likely to have hepatitis B if they
- are infected with HIV, because hepatitis B and HIV spread in similar ways
- have lived with or had sex with someone who has hepatitis B
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have sex with men
- are injection drug users
- work in a profession, such as health care, in which they have contact with blood, needles, or body fluids at work
- live or work in a care facility for people with developmental disabilities
- have been on kidney dialysis
- live or work in a prison
- had a blood transfusion or organ transplant before the mid-1980s
In the United States, hepatitis B spreads among adults mainly through contact with infected blood through the skin, such as during injection drug use, and through sexual contact.12
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Is There A Cure For Hepatitis B
The long and short answer is that there is not yet a cure for hepatitis B. Understanding why requires insight into the virus itself and the challenges cure researchers face.
Hepatitis B is an infectious disease caused by the hepatitis B virus . While most people exposed to hepatitis B will spontaneously clear the virus soon after infection, a proportion will go on to develop a chronic infection.
Of these, around one in four will develop severe liver complications, including cirrhosis and liver cancer, typically years after the initial infection.
Efforts to find a cure for hepatitis B have been underway since the virus was first identified by scientists at the National Institutes of Health in 1966. It soon became clear, however, that numerous hurdles would need to be overcome before an actual cure could be achieved. Chief among these are:
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Treatment For Chronic Hepatitis B Infection
Most people diagnosed with chronic hepatitis B infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others. Treatment for chronic hepatitis B may include:
- Antiviral medications. Several antiviral medications including entecavir , tenofovir , lamivudine , adefovir and telbivudine can help fight the virus and slow its ability to damage your liver. These drugs are taken by mouth. Talk to your doctor about which medication might be right for you.
- Interferon injections. Interferon alfa-2b is a man-made version of a substance produced by the body to fight infection. Its used mainly for young people with hepatitis B who wish to avoid long-term treatment or women who might want to get pregnant within a few years, after completing a finite course of therapy. Interferon should not be used during pregnancy. Side effects may include nausea, vomiting, difficulty breathing and depression.
- Liver transplant. If your liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.
Other drugs to treat hepatitis B are being developed.
What Is Hepatitis B
Hepatitis B is the most common serious liver infection in the world. It is caused by the hepatitis B virus that attacks and injures the liver. Two billion people have been infected and about 300 million people are living with a chronic hepatitis B infection. Each year up to 1 million people die from hepatitis B despite the fact that it is preventable and treatable.
Hepatitis B is transmitted through direct contact with infected blood or certain bodily fluids. The virus is most commonly transmitted from an infected pregnant person to their baby during childbirth, due to the blood exchange that happens between mother and baby. It is also transmitted through unsterile medical or dental equipment, unprotected sex, or unsterile needles, or by sharing personal items such as razors, toothbrushes, nail clippers, body jewelry.
Hepatitis B is a silent epidemic because most people do not have symptoms when they are newly infected or chronically infected. Thus, they can unknowingly spread the virus to others and continue the silent spread of hepatitis B. For people who are chronically infected but dont have any symptoms, their liver is still being silently damaged which can develop into serious liver disease such as cirrhosis or liver cancer.
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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.
Where Is The Hepatitis B Virus Found And How Is It Transmitted
Blood is the major source of the hepatitis B virus in the workplace. It can also be found in other tissues and body fluids, but in much lower concentrations. The risk of transmission varies according to the specific source. The virus can survive outside the body for at least 7 days and still be able to cause infection.
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Whats The Procedure For A Hepatitis B Titer Test
A hepatitis titer test requires a healthcare professional to draw a small amount of blood for testing.
No special preparation is needed beforehand. If needles or the sight of blood make you anxious, you may want to arrange a drive ahead of time in case you feel faint.
Heres what will typically happen during this test:
Home tests that require a fingerpick are also available. The results of your tests are generally available within 3 days.
How Much Does A Hepatitis B Titer Test Cost
The cost of a hepatitis B test varies based on where you get the test. Prices range from roughly $24 to $110.
Your insurance may cover some or all of the cost. Under the Affordable Care Act, all new health plans must cover preventative services including hepatitis B vaccination and testing without a deductible or copay.
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Living With Hepatitis B
Risk of chronic infection caused by hepatitis B is related to your age, according to the Centers for Disease Control and Protection . Approximately 90% of infected infants become chronically infected compared with 2%-6% of adult, reports the CDC.
Chronic hepatitis B infection can lead to serious health issues. If you have it, you should be monitored regularly by a doctor. This means you should check in with your doctor at least once or twice a year. Some people who have chronic hepatitis B infection require medicine, but others do not. Your doctor can discuss treatment options with you.
If you have chronic hepatitis B infection, it will likely stay in your blood and liver for a lifetime, according to The Hepatitis B Foundation. This means that you could pass the virus to others, even if you dont feel sick.
The most important thing to remember is that hepatitis B is a chronic medical condition that can be successfully managed if you take good care of your health and your liver, reports the Hepatitis B Foundation. You should expect to live a long, full life.
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.
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How You Can Get Hepatitis B
You can get hepatitis B from:
- injecting drugs using shared needles
- being injured by a used needle
- having a tattoo or piercing with unsterilised equipment
- having a blood transfusion in a country that does not check blood for hepatitis B. Blood transfusions in the UK are checked for hepatitis B.
If you’re pregnant and have hepatitis B, you can also pass it onto your baby during pregnancy or birth.
Hepatitis B Blood Tests
The Hepatitis B Panel of Blood Tests
Only one sample of blood is needed for a hepatitis B blood test, but the Hepatitis B Panel includes three parts. All three test results are needed to fully understand whether a person is infected or not. Below is an explanation of the 3-part Hepatitis B Panel of blood test results.
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Chronic Hepatitis B Infection
People who test positive for the hepatitis B virus for more than six months are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver.
The risk of developing a chronic hepatitis B infection is also directly related to the age at which one first becomes exposed to the hepatitis B virus:
- 90% of infected newborns and babies will develop a chronic hepatitis B infection
- Up to 50% of infected children will develop a chronic hepatitis B infection
- 5-10% of infected adults will develop a chronic hepatitis B infection
Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life.
There are effective drug therapies that can control and even stop the hepatitis B virus from further damaging a liver. There are also promising new drugs in the research pipeline that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risks.
Newly Diagnosed With Hepatitis B Acute Or Chronic Learning The Hep B Basics
If youve just been diagnosed with hepatitis B after a routine blood test or following a blood donation, you may be feeling overwhelmed with information about this complicated infection and references to acute or chronic hepatitis B.
Here is an explanation of these two terms and what happens when youre first infected with the hepatitis B virus . Hepatitis B is transmitted through blood and sexual fluids. It can be spread during unprotected sex, unsafe medical procedures, exposure to blood that enters your body through a cut, or by sharing personal items such as razors, body jewelry or toothbrushes. Most commonly it is spread during childbirth when the mother is infected.
What is an acute infection? When were infected with HBV as healthy adults, about 90 percent of us are able to get rid of the infection within six months. It can take up to six months for our immune systems to generate antibodies and get rid of the infection in our liver. This short-term infection is called acute hepatitis B.
To determine if you have an acute or chronic infection, you must be tested for hepatitis B over a six-month period. The specific test that indicates if you are infected is the hepatitis B surface antigen test. This antigen covers the surface of the virus and there are usually lots of HBsAg in your blood when youre infected. If you test positive for HBsAg for longer than six months, it means you have a chronic hepatitis B infection.
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Other Body Fluids And Tissues
Synovial fluid , amniotic fluid, cerebrospinal fluid, and peritoneal fluid can contain the hepatitis B virus, but the risk of transmission to workers is not known.
Feces, nasal secretions, sputum, sweat, tears, urine, and vomit have not been implicated in the spread of hepatitis B. Unless they are visibly contaminated with blood, the risk of contracting hepatitis B from these fluids in the workplace is very low.
Hepatitis B is not transmitted by casual contact. For example, hospital employees who have no contact with blood, blood products, or blood-contaminated fluids are at no greater risk than the general public. However, the virus can spread through intimate contact with carriers in a household setting, possibly because of frequent physical contact with small cuts or skin rashes. The virus can also spread through biting and possibly by the sharing of toothbrushes or razors. It is not spread through sneezing, coughing, hand holding, hugging, kissing, breastfeeding, sharing eating utensils, water or food.
How Do I Know If I Have Hbv
A rapid point-of-care test after a finger prick or a simple blood test can tell if you are infected with the hepatitis B virus.
These tests can also help your doctor determine whether you are currently ill with hepatitis B, or if you are a chronic carrier. Although there is no treatment for the disease, bed rest and a good diet are important. Alcohol and medications should be restricted. Follow-up blood tests are necessary to tell if the disease has gone.
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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.