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.
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:
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.
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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
Blood Tests To Check For Liver Damage
Blood tests may be done to help find out if your liver has been damaged. They include:
- Bilirubin, albumin, and prothrombin time. These help show how well your liver is working. Cholesterol testing also may be done.
- Alanine aminotransferase , aspartate aminotransferase , alkaline phosphatase, and lactic dehydrogenase . These show whether your liver is damaged or inflamed.
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Preparation Prior To Transport
Label the specimen container with the patients full name, date of collection and one other unique identifier such as the patients date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.
Centrifuge if using SST. Place specimen in biohazard bag and seal. Specimens should be stored at 2-8°C following collection.
Specimens more than the following number of days post collection will not be tested:
- > 6 days for Hepatitis B surface antigen
- > 7 days for Hepatitis B e Antigen and Hepatitis B e Antibody
- > 10 days for Hepatitis B core Antigen and Hepatitis B surface Antibody
What Are The Types Of Hepatitis B
There are two types of hepatitis B infection: acute and chronic.
An acute infection happens at the beginning, when you first get infected with hepatitis B. Many people are able to clear it from their bodies and recover. In fact, this is true of about 4 in 5 adults who are infected.
If you are not able to clear the infection within six months or longer, you have chronic hepatitis B. It is chronic hepatitis B that leads to inflammation and the serious, and possibly fatal, illnesses of cirrhosis of the liver and liver cancer. Treatment can slow disease progress, reduce the chance of liver cancer and increase your chances of surviving.
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What Other Problems Can Hepatitis B Cause
In rare cases, acute hepatitis B can cause liver failure.
If you have ever had hepatitis B, the virus may become active again, or reactivated, later in life. This could start to damage the liver and cause symptoms.
How Is Hepatitis B Transmitted
Hepatitis B is spread in several distinct ways: sexual contact sharing needles, syringes, or other drug-injection equipment or from mother-to-child at birth.
In the United States, in 2018, injection drug use was the most common risk factor reported among people with an acute HBV infection, followed by having multiple sex partners. Less commonly reported risk factors included accidental needle sticks, surgery, transfusions, and household contact with a person with HBV infection. In the United States, healthcare-related transmission of HBV is rare.
Mother-to-child transmission of HBV is especially concerning, because it is preventable. An estimated 25,000 infants are born to mothers diagnosed with HBV each year in the United States, and approximately 1,000 mothers transmit HBV to their infants. Without appropriate medical care and vaccinations, 90% of HBV-infected newborns will develop chronic infection, remaining infected throughout their lives. Up to 25% of people infected at birth will die prematurely of HBV-related causes. For this reason, the standard of care for pregnant women includes an HBV test during each pregnancy so that the appropriate steps can be taken to prevent HBV-positive mothers from transmitting the disease to her infant.
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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.
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.
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Treatment For The Short
No treatment can clear the germ from the body. If you develop symptoms when first infected, treatment aims to help ease symptoms until they go – for example, drinking plenty of water to avoid lack of fluid in the body . Rarely, a severe hepatitis develops which may need hospital care. No treatment can prevent acute hepatitis B from becoming persistent .
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.
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What Are The Symptoms
Many people with hepatitis B don’t know they have it, because they don’t have symptoms. If you do have symptoms, you may just feel like you have the flu. Symptoms include:
- Feeling very tired.
- Tan-coloured bowel movements .
- Dark urine.
- Yellowish eyes and skin . Jaundice usually appears only after other symptoms have started to go away.
Most people with chronic hepatitis B have no symptoms.
Should I Be Screened For Hepatitis B
Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis B. Many people who have hepatitis B dont have symptoms and dont know they are infected with hepatitis B. Screening tests can help doctors diagnose and treat hepatitis B, which can lower your chances of developing serious health problems.
Your doctor may recommend screening for hepatitis B if you9,14
- are pregnant
- were born in an area of the world where 2 percent or more of the population has hepatitis B infection, which includes Africa, Asia, and parts of the Middle East, Eastern Europe, and South America
- 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, which includes sub-Saharan Africa and parts of Asia
- are HIV-positive
- are a man who has sex with men
- have lived with or had sex with a person who has hepatitis B
- have an increased chance of infection due to other factors
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What Hepatitis B Immunisation Involves
Full protection involves having 3 injections of the hepatitis B vaccine at the recommended intervals.
Babies born to mothers with hepatitis B infection will be given 6 doses of hepatitis B-containing vaccine to ensure long-lasting protection.
If you’re a healthcare worker or you have kidney failure, you’ll have a follow-up appointment to see if you’ve responded to the vaccine.
If you’ve been vaccinated by your employer’s occupational health service you can request a blood test to see if you’ve responded to the vaccine.
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
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You Can Have It And Not Know It
What is hepatitis B?
Hepatitis B is a liver disease caused by the hepatitis B virus . HBV is far more infectious than HIV and can be prevented by a vaccine. People who have not been vaccinated may be at risk of getting infected.
About 95 percent of adults will recover within 6 months of becoming infected and as a result will develop lifelong protection against it. The remaining 5 percent are unable to clear the virus and will become chronically infected. Chronic hepatitis B infection is treatable.
It is estimated that less than 1 percent of Canada’s population is infected with either acute or chronic HBV. People who are infected before the age of 7 are at a higher risk of developing chronic infection. In 2011, the overall reported rate of acute hepatitis B infection in Canada was 0.6 reported cases per 100,000 people living in Canada.
Why is hepatitis B a health concern?
Many people infected with HBV do not know they have the virus because symptoms can take two to six months to appear and only about 50 percent of people develop symptoms. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. Potential complications from chronic HBV infection include cirrhosis of the liver, liver failure, liver cancer and premature death.
Why do I need my liver?
How is hepatitis B spread?
HBV is spread through contact with infected blood and body fluids including semen and vaginal fluid.
Transmission Symptoms And Treatment
How is HBV transmitted?
HBV is transmitted through activities that involve percutaneous or mucosal contact with infectious blood or body fluids , including
- sex with an infected partner
- injection-drug use that involves sharing needles, syringes, or drug-preparation equipment
- birth to an infected mother
- contact with blood from or open sores on an infected person
- exposures to needle sticks or sharp instruments and
- sharing certain items with an infected person that can break the skin or mucous membranes , potentially resulting in exposure to blood.
How long does HBV survive outside the body?
HBV can survive outside the body and remains infectious for at least 7 days .
What should be used to clean environmental surfaces potentially contaminated with HBV?
Any blood spills should be disinfected using a 1:10 dilution of one part household bleach to 10 parts of water. Gloves should be worn when cleaning up any blood spills.
Who is at risk for HBV infection?
The following populations are at increased risk for becoming infected with HBV:
- Infants born to infected mothers
- Sex partners of infected people
- Men who have sex with men
- People who inject drugs
- Household contacts or sexual partners of known people with chronic HBV infection
- Health-care and public-safety workers at risk for occupational exposure to blood or blood-contaminated body fluids
- Hemodialysis patients
Who should be screened for HBV?
CDC recommends that the following people be screened for HBV :
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What Increases Your Risk
People who have certain behaviours or certain jobs are at high risk for becoming infected with hepatitis B.
Job risk factors include:
- Handling blood or body fluids as a routine part of your job. This includes health care workers, such as doctors, dentists, nurses, and blood and lab technicians, and students in these jobs. It also includes morticians and embalmers.
- Being an employee or resident of an institution for people who have developmental disabilities.
- Being an employee or inmate of a prison.
Lifestyle risk factors include:
- Being born in, or travelling to, parts of the world where hepatitis B is common or where a large number of people have been infected for a long time. Such areas include Southeast and Central Asia, the islands of the South Pacific, the Amazon River basin, the Middle East, Africa, Eastern Europe, and China.
- Being a man who has sex with men.
- Being sexually active. This includes having unprotected sex with someone who is infected with the virus or whose sexual history is unknown to you.
- Having more than one sex partner.
- Living with someone who has a chronic hepatitis B infection.
- Getting body piercings or tattoos from someone who doesn’t sterilize his or her equipment.
- Sharing needles or other equipment to inject illegal drugs.
Other factors include:
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