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.
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.
Help And Support For Hbv
Liver care is important: Avoid drinking alcohol and do not take prescription drugs without consulting your physician, get yourself tested for hepatitis A and C. vaccinated for hepatitis A if you are not exposed.
Be in touch with your family & friends: we can not get Hepatitis B through casual contact, so dont cut yourself off from people who can offer support.
Take of your health: Eat more fruits, and green vegetables, exercise, regularly, and sleep well at least 8 hours daily,
Do not share: Never share your personal belonging with anyone including grooming products such as razor blades and which might have a bloodstain on them.
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How Do I Get Hepatitis B Treatment
Usually for adults, hepatitis B goes away on its own and you wont need treatment. Your doctor might tell you to rest, eat well, and get plenty of fluids. You may also get medicines to help with any symptoms you might have but be sure to talk with your doctor or nurse before taking anything.
If you have chronic hepatitis, there are medicines you can take to treat it. Your doctor will tell you about your options and help you get whatever treatment you need.
Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
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Is The Vaccine Safe
The vaccine is safe. It’s been used in Canada for many years and it’s one of the safest vaccines around. It might cause minor side effects – maybe redness, warmth or slight swelling where the needle went in, maybe tiredness or slight fever for a day or so. More serious reactions occurring within 15 days should be reported to your doctor or local health unit. These include breathing trouble, swelling of face or mouth, a fever over 39°C, hives or rashes.
The risk from hepatitis B is much greater than the risk from the vaccine, however, some people should not have this vaccine.
You won’t be vaccinated if you have a fever or anything more serious than a minor cold. Tell your doctor if you’ve had a past allergic reaction to a vaccine. You should always discuss the benefits and risks of any vaccine with your doctor.
Viral Hepatitis B And C
Hepatitis B virus and hepatitis C virus infections affect the liver and the acute infection may become chronic hepatitis disease, with very serious potential consequences on the liver such as cirrhosis or liver cancer that can be challenging to treat and may require liver transplant or lead to death.
Current transmission of hepatitis in Europe occurs sexually or via injecting drug use through the sharing of injection equipment, with nosocomial transmission remaining a key reported route of transmission in a few countries.
Viral hepatitis continues to have a serious disease burden in the EU. As hepatitis is mostly asymptomatic until there is serious damage to the liver, it is dubbed the silent killer, making it difficult to gauge the exact breadth of the epidemic. Testing and early diagnosis is therefore important, especially amongst at-risk groups such as people who inject drugs, prisoners, migrants from high endemic countries and men who have sex with men.
While for hepatitis B, effective antiviral treatment does exist, there is currently no permanent cure. However, there is a vaccine and most European countries have a universal infant vaccination programme in place with high levels of coverage. For hepatitis C there is currently no vaccine, but there is a very effective treatment available which provides a cure for the patient.
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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.
Virion Structure And Genome
HBV particles, also known as Dane particles , were firstly identified by Dane and colleagues in 1970 . Their shape is spherical, with a diameter of â¼42 nm. They consist of an outer envelope, which is a host-derived lipid bilayer containing three different-sized HBV surface antigens âlarge , middle and small âsurrounding the viral nucleocapsid. The nucleocapsid is icosahedral and comprises the HBV core protein , as well as the viral DNA genome and the viral DNA polymerase . The virus also secretes a wide range of defective particles , including enveloped nucleocapsids that are empty or contain defective immature genomes and subviral lipid particles containing the viral surface antigens. The subviral particles are secreted along with the infectious virions at levels that are thousands of times higher, and they play an important role in suppressing antibody responses to the virus .
Hepatitis B Virus particles. Infectious HBV virion . The lipid envelope, bearing three types of surface proteinsâsmall , middle and large âsurrounds the nucleocapsid, consisting of HBV relaxed circular DNA , the viral DNA polymerase , and the core protein . Non-infectious HBV particles enveloped nucleocapsids containing immature or defective DNA/RNA, subviral particles, and naked nucleocapsids.
Hepatitis B Virus genome. Partially double-stranded, relaxed circular DNA with four overlapping open reading frames .
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Is There A Hepatitis C Vaccine
No vaccine exists for hepatitis C right now. While efforts to develop a vaccine for this specific strain are ongoing, it’s proven challenging. That’s because hepatitis C tends to avoid immune responses. In other words, a person can catch hepatitis C repeatedly despite past infection, which is what makes it hard to create a vaccine that works for this virus.
There is an effective treatment for hepatitis C, though, and it involves direct-acting antivirals . Thanks to this treatment, WHO aims to cut 80% of hepatitis C cases worldwide by 2030. Researchers across the globe think that a vaccine is needed to accomplish this goal, so creating one is a high priority.
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.
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Antiviral Medication For Hepatitis B
Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.
Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.
NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.
There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait-and-see approach with a person who has a healthy liver and whose blood tests indicate a low viral load, the number of copies of the hepatitis B virus in your bloodstream.
Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.
The Time To Cure Hepatitis B Is Now
Nature Reviews commentary lays groundwork for the momentum behind hepatitis B cure research
On the eve of World Hepatitis Day, the International Coalition to Eliminate HBV , a global group of researchers, patient representatives and health organisations, has called for the integration of a hepatitis B cure in global plans to eliminate viral hepatitis.
More than 290 million people worldwide are chronically infected with the HBV, a viral infection that attacks the liver and can cause both acute and chronic disease. Last year, nearly 900 000 people died from the disease.
A safe and effective vaccine to prevent HBV infection exists and its universal delivery is essential for the elimination of HBV as a public health threat. Lifelong treatment is also needed for those already chronically infected but currently is only accessed by some five per cent of the 94 million people who need it.
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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.
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
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
Diagnosis Of Hepatitis B
Hepatitis B is diagnosed by the presence of Hepatitis B surface antigen and IgM antibody to Hepatitis B core antigen which develop in the serum in the early stages of infection at the time symptoms appear. Antibody to HBsAg develops after active infection and serves as an indicator of immunity.
Anti-HBs + – the individual has been vaccinated, has received immune globulin, is immune, or is an infant who has received antibodies from his/her mother. Anti-HBc + – indicates a past or present infection and lasts indefinitely.
May be detected in an infant who has received antibodies from its mother. IgM anti-HBc + – indicates recent infection with HBV, usually within 4-6 months. HBeAg + – indicates active viral replication and high infectivity. HBsAg + HBV – acute or chronic HBV persistence for 6 months after acute infection indicates progression to chronic HBV.
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Further Support And Information
The Hepatitis Foundation can offer support and information on hepatitis B.
The Hepatitis Foundation of New ZealandFreephone: 0800 33 20 10Website: www.hepfoundation.org.nzFor information about hepatitis B vaccination, consult a doctor or contact the:Immunisation Advisory CentreWebsite: www.immune.org.nz
How Is Acute Hepatitis B Treated
Acute hepatitis B doesnt always require treatment. In most cases, a doctor 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, such as ibuprofen , to help with any abdominal pain you have.
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. In some patients, monitoring symptoms and getting regular liver tests is appropriate.
Treatment generally involves antiviral medications, such as:
- peginterferon alfa-2a injections
- antiviral tablets, such as tenofovir or entecavir
Antiviral medications can help to reduce symptoms and prevent liver damage. But they rarely completely get rid of the hepatitis B virus. Instead, the goal of treatment is to have the lowest viral load possible. Viral load refers to the amount of a virus in a blood sample.
Theres no cure for hepatitis B, but the condition is easily preventable by taking a few precautions. Hepatitis B is often spread through sexual contact, shared needles, and accidental needle sticks.
You can reduce your risk of developing hepatitis B or spreading the virus to others by:
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Disease Affecting 257 Million People Needs Better Treatment
This article is a collaboration between MedPage Today and:
VIENNA The International Liver Conference kicked off here today with a push to find a cure not just maintenance treatment for the one quarter billion people living with hepatitis B virus infection, but researchers said that finding a cure could be elusive, and it certainly won’t come quickly.
“I think we are still at least 3 years away from starting a Phase III clinical trial that would probably include a combination therapy,” said Massimo Levrero, PhD, a member of the governing body of the International Coalition to Eliminate HBV and director of the Cancer Research Centre of Lyon in France.
Levrero, one of several participants in a press conference at the start of the 5-day annual meeting of the European Association for the Study of the Liver, told MedPage Today that there are numerous drug treatment candidates being tested to attack various structures of the virus, but he compared HBV to HIV rather than hepatitis C virus for which an 8-week functional cure is now available.
“Hepatitis B is very different than hepatitis C, and it is very difficult to eradicate, as is HIV,” he said.
He noted that antivirals can suppress the virus but do not affect the risk of causing liver cancer. Levrero said that when people have to take drugs for long periods of time sometimes decades in the case of HBV treatment there is a waning of compliance, which makes the need for a cure more imperative.
European Commission And Thervacb Join Forces
The role of viral hepatitis as a public health threat has long been underestimated. Only very recently, the United Nations in their 2030 Agenda for Sustainable Development called for international action to combat viral hepatitis and reduce the disease burden. The major killer is the hepatitis B virus causing liver cirrhosis and liver cancer. Worldwide 880,000 humans die each year from the consequences of an HBV infection.
A prophylactic vaccine is available to prevent HBV infection, but more than 3% of the worlds population are chronically infected and do not profit from that vaccine anymore. For those suffering from chronic hepatitis B, until today no curative treatment option exists.
The European Commission therefore selected the project TherVacB led by Helmholtz Zentrum München for a five-year funding within the Horizon 2020 program. A consortium of leading virologists, immunologists and physicians specialized in treating viral hepatitis, will use a newly designed therapeutic vaccine, TherVacB, as an immunotherapy to cure HBV. TherVacB will be evaluated in a three-year clinical trial starting in 2022 conducted in Europe and in Africa. Integration of a partner site in Tanzania shall help building local capacities for diagnosing and treating hepatitis B and support an important goal of the consortium to raise awareness for hepatitis B.
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