Screening Healthy People For Hepatitis B
Health care providers sometimes test certain healthy people for hepatitis B infection because the virus can damage the liver before causing signs and symptoms. Talk to your provider about screening for hepatitis B infection if you:
- Live with someone who has hepatitis B
- Have had many sexual partners
- Have had sex with someone who has hepatitis B
- Are a man who has sex with men
- Have a history of a sexually transmitted illness
- Have HIV or hepatitis C
- Have a liver enzyme test with unexplained abnormal results
- Receive kidney dialysis
- Take medications that suppress the immune system, such as those used to prevent rejection after an organ transplant
- Use illegal injected drugs
- Were born in a country where hepatitis B is common, including Asia, the Pacific Islands, Africa and Eastern Europe
- Have parents or adopted children from places where hepatitis B is common, including Asia, the Pacific Islands, Africa and Eastern Europe
Who Is At A Greater Risk Of Hepatitis B Viral Infection
Hepatitis B viral infection can occur in any individual. However, a certain group of people are at a higher risk of developing hepatitis B viral infection. Doctors generally recommend the blood test to screen patients with hepatitis B viral infection. The screening test is generally done for people who are prone to hepatitis B. Screening is important to isolate or alert the people infected with the virus so that the transmission of the virus can be controlled. The people at a greater risk of developing hepatitis B viral infection include:
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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.
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Check If You Have Hepatitis B
Symptoms of hepatitis B infection include:
- a high temperature
- pain in your upper tummy
- feeling sick or being sick
- patches of raised skin that may be itchy
- yellowing of the skin and whites of the eyes
The infection usually lasts for 1 to 3 months and most people either have no symptoms or mild symptoms. If the infection lasts longer than 6 months it is called chronic hepatitis B.
Antiviral Medication For Hepatitis C
For people with hepatitis C, the goal of treatment with antiviral medication is to prevent the virus from replicating, or copying itself, and to eliminate the virus from the bloodstream. If the hepatitis C virus has been in the body for more than six months, the infection is considered chronic. Without treatment, most people with acute hepatitis C develop the chronic form of the disease.
Your doctor decides which antiviral medicationor combination of medicationsto prescribe based on the results of a blood test called a genotype test. There are six genotypes, or strains, of the hepatitis C virus, and people with certain genotypes respond more quickly to medical treatment.
For many years, the standard treatment for chronic hepatitis C consisted of the antiviral medications pegylated interferon and ribavirin. Ribavirin is taken by mouth every day, and interferon is an injection that you or a caregiver can administer once a week at home.
In 2013 and 2014, the U.S. Food and Drug Administration approved a group of new medications for the treatment of hepatitis C. These medications, which include sofosbuvir, are very effective and have fewer side effects than older medications, particularly interferon.
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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
Hepatitis B Adult Vaccine Dosing Information
Usual Adult Dose for Hepatitis B Prophylaxis:
Primary Vaccination:Engerix-B:19 years and younger: Three doses intramuscularly on a 0, 1, and 6 month schedule20 years and older: Three doses intramuscularly on a 0, 1, and 6 month scheduleHeplisav-B: Two doses intramuscularly one month apartRecombivax-HB: 19 years and younger: Three doses intramuscularly on a 0, 1, and 6 month schedule 20 years and older: Three doses intramuscularly on a 0, 1, and 6 month schedule Known or Presumed Hepatitis B Exposure:Engerix-B : Use recommended doses of on a 0, 1, and 6 month schedule OR a 0, 1, 2, and 12 month schedule.Recombivax-HB: Refer to recommendations of the Advisory Committee on Immunization Practices
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Treatment For Hepatitis B In Patients With Drug Resistance
Frank Tacke, Daniela C. Kroy
Department of Medicine III, RWTH Aachen University Hospital, Aachen, Germany
Contributions: Conception and design: All authors Administrative support: None Provision of study materials or patients: None Collection and assembly of data: None Data analysis and interpretation: None Manuscript writing: All authors Final approval of manuscript: All authors.
Correspondence to:
Keywords: Hepatitis B virus antiviral drug resistance polymerase
Submitted Jul 28, 2016. Accepted for publication Aug 24, 2016.
doi: 10.21037/atm.2016.09.19
This Vaccine Side Effects
Get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .
You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.
Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.
Hepatitis B adult vaccine may cause serious side effects. Call your doctor at once if you have:
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a light-headed feeling, like you might pass out
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seizure-like muscle movements or
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redness, pain, swelling, or a lump where the shot was given.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.
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Hepatitis B Treatment: Medication
There are five FDA-approved oral medications and one injection available to treat hepatitis B. The newer oral medications are stronger and less likely to develop viral resistance and have very few side effects.
The medication cannot cure the disease, but can help reduce the number of viruses in the body and the risk of complications. You may undergo periodic blood tests to monitor drug resistance and determine whether the medication is having an effect.
Cytotoxic T Lymptocyte Based Therapy
A lipopeptide-based vaccine containing one CTL epitope from the HBV core region has been shown to induce a HBV-specific CTL response in healthy volunteers to levels comparable to those observed during acute HBV infection . A follow-up phase II trial in CHB patients did not show any therapeutic efficacy to this approach . Although immunomodulatory therapies are attractive, they are far from being ready for direct clinical application.
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What Do I Need To Know About Having Hepatitis B
If you have chronic hepatitis B, getting the right medical care can help you stay healthy. Taking good care of your liver is important. Talk with your doctor before you take any prescription medication, over-the-counter drugs, vitamins, or nutritional supplements to make sure they wont hurt your liver. You should also stay away from alcohol, because drinking can damage your liver.
Take Precautions To Avoid Hbv
Other ways to reduce your risk of HBV include:
- Know the HBV status of any sexual partner. Don’t engage in unprotected sex unless you’re absolutely certain your partner isn’t infected with HBV or any other sexually transmitted infection.
- Use a new latex or polyurethane condom every time you have sex if you don’t know the health status of your partner. Remember that although condoms can reduce your risk of contracting HBV, they don’t eliminate the risk.
- Don’t use illegal drugs. If you use illicit drugs, get help to stop. If you can’t stop, use a sterile needle each time you inject illicit drugs. Never share needles.
- Be cautious about body piercing and tattooing. If you get a piercing or tattoo, look for a reputable shop. Ask about how the equipment is cleaned. Make sure the employees use sterile needles. If you can’t get answers, look for another shop.
- Ask about the hepatitis B vaccine before you travel. If you’re traveling to a region where hepatitis B is common, ask your provider about the hepatitis B vaccine in advance. It’s usually given in a series of three injections over a six-month period.
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Is Hepatitis B Curable
Theres no cure for hepatitis B. The good news is it usually goes away by itself in 4 to 8 weeks. More than 9 out of 10 adults who get hepatitis B totally recover.
However, about 1 in 20 people who get hepatitis B as adults become carriers, which means they have a chronic hepatitis B infection. Carriers are more likely to pass hepatitis B to other people. Most carriers are contagious meaning they can spread hepatitis B for the rest of their lives.
Hepatitis B infections that last a long time may lead to serious liver diseases like cirrhosis and liver cancer. About 1 in 5 people with chronic hepatitis B die from it. There are medicines that can help treat chronic hepatitis B infections.
Most babies who get hepatitis B during birth develop chronic infection, unless they get treated right away. But treatments are almost always effective if your baby gets them quickly. Thats why its important for pregnant people to get tested for hepatitis B.
Key Points About Drug
- Drug-induced hepatitis is a redness and swelling of the liver.
- It is a rare condition caused by harmful amounts of certain medicines, vitamins, herbal remedies, or food supplements.
- In most cases, you may be taking a medicine for several months before it reaches a toxic level and affects your liver.
- You may also get the condition if you take too much of some medicines, such as acetaminophen. This can happen quickly.
- You must stop taking the medicine that is causing the disease.
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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.
Hepatitis B Treatment Outcomes
Effective hepatitis B treatment suppresses hepatitis B virus reproduction, and reducing hepatitis B viral load can reduce inflammation and bring liver enzyme levels back to normal. Less often, treatment can lead to loss of hepatitis B antigens and promote production of antibodies .
The most effective antiviral drugs usually produce low or undetectable hepatitis B viral load in most people who receive treatment. However, people with HBeAg-negative hepatitis B are more likely to respond to treatment. For example, one study found that among HIV-negative people treated with tenofovir, around 95% of HBeAg-negative people and 75% of HBeAg-positive people had undetectable hepatitis B virus DNA after one year. A majority of both groups still had hepatitis B suppression after eight years on treatment.
Most people taking antivirals alone do not experience hepatitis B antigen loss or seroconversion. Pegylated interferon strengthens the immune response against hepatitis B, but usually does not lead to a cure. Some studies show that adding pegylated interferon to antivirals increases the likelihood of these outcomes. For people with co-infection, seroconversion appears to be more likely if they are also on HIV treatment.
effectiveness
How well something works . See also ‘efficacy’.
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World Health Organization Recommendations
The 2015 WHO guidelines for the prevention, care, and treatment of persons with chronic hepatitis B infection indicate treatment priority for individuals of all ages who have chronic hepatitis B infection and clinical evidence of compensated/decompensated cirrhosis , regardless of their levels of ALT or HBV DNA, or their HBeAg status.
Treatment is recommended for adults with chronic hepatitis B infection without clinical evidence of cirrhosis , but who have all of the following features , and regardless of HBeAg status :
- Are older than 30 years
- Have persistently abnormal ALT levels
- Have evidence of high-level HBV replication .
Treatment For Chronic Hepatitis B Infection
Most people diagnosed with chronic hepatitis B infection need treatment for the rest of their lives. The decision to start treatment depends on many factors, including: if the virus is causing inflammation or scarring of the liver, also called cirrhosis if you have other infections, such as hepatitis C or HIV or if your immune system is suppressed by medicine or illness. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others.
Treatment for chronic hepatitis B may include:
Other drugs to treat hepatitis B are being developed.
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How Is It Spread
Hepatitis A is spread when a person ingests fecal mattereven in microscopic amountsfrom contact with objects, food, or drinks contaminated by feces or stool from an infected person.
- Birth to an infected mother
- Sex with an infected person
- Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
- Sharing personal items such as toothbrushes or razors
- Poor infection control has resulted in outbreaks in health care facilities
Hepatitis C is spread when blood from a person infected with the Hepatitis C virus even in microscopic amounts enters the body of someone who is not infected. The hepatitis C virus can also be transmitted from:
- Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
- Receiving a blood transfusion or organ transplant before 1992
- Poor infection control has resulted in outbreaks in health care facilities
- Birth to an infected mother
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Molecular Mechanisms Of Drug Resistance
Different types of mutations are associated with drug resistance and can emerge during antiviral therapy with nucleoside or nucleotide analogues. Primary mutations typically affect the reverse transcriptase domain of the HBV polymerase, thereby causing steric changes of the polymerase protein that escape the inhibitory effects of the nucleoside analogues . The most relevant hot-spot mutations in the HBV polymerase are displayed in Table 1. However, the polymerase mutants have a dramatically reduced viral replication efficacy in most cases . Secondary compensatory mutations occur in order to restore the viral replication fitness, thereby overcoming deleterious effects of the primary drug-resistant mutations . These mutations are not necessarily located within the enzymatically active sites of the polymerase, but oftentimes stabilize secondary or tertiary viral structures. The eight different HBV genotypes AH partly differ with respect to the position of secondary compensatory mutations and the rate of drug resistance development .
Table 1
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What Treatments Are Available For Chronic Hepatitis B
First line treatments include antiviral therapies such as tenofovir , entecavir and Vemlidy which are taken once daily. These antivirals are not a cure for chronic hepatitis B, but they work to suppress or control the virus while you are taking them. When the virus is suppressed, liver disease progression is slowed or even stopped, and the liver is often able to heal with time. It is important to see a knowledgeable doctor to determine if you are a good candidate for treatment since treatment is a commitment, and is taken for at least a year, usually for many years or even for life – or until there is a cure found for this disease.
U.S. residents seeking help with medication costs can find resources here.