Who Should Get The Hepatitis B Vaccine
All newborn babies should get vaccinated. You should also get the shot if you:
- Come in contact with infected blood or body fluids of friends or family members
- Use needles to take recreational drugs
- Have sex with more than one person
- Are a health care worker
- Work in a day-care center, school, or jail
What Occupations Have Increased Risk Of Hepatitis B
In general, occupational groups with increased risk include:
- Health-care workers repeatedly exposed to blood or blood products or those who are at risk of needlestick injury.
- Pathologists, laboratory personnel, or embalmers.
- Dentists, dental assistants, and dental hygienists.
- Certain staff members of institutions for the developmentally handicapped.
- Staff of institutions where workers may be exposed to aggressive, biting residents.
Travellers to regions with intermediate or high rates of endemic HBV infection may also consider being vaccinated.
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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What Is The Significance Of The Hepatitis A Blood Test Result
The Hepatitis A Blood Test may have the following outcomes:
- IgM positive and total antibodies negative: Indicates acute hepatitis A viral infection
- IgM negative and total antibodies positive: Indicates a past infection with HAV, or likely post-vaccination
- IgM negative and total antibodies negative: Neither is there an exposure to HAV, nor is the individual vaccinated hence, there is a susceptibility to infection
The laboratory test results are NOT to be interpreted as results of a “stand-alone” test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.
Serological Markers Of Hepatitis B Virus
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HBsAg – an external component of the hepatitis B virus, appears in the blood of patients with acute hepatitis in the prodromal period of the disease, persists for about 1-4 months, disappears upon recovery. The determination of HBsAg in the blood is a sign of the persistence of the hepatitis B virus. This is observed in the uz of patients with chronic liver diseases. There may be cases of “healthy carrier” HBsAg.
HBeAg – is determined in the blood of patients with positive HbsAg, is detected in the early stages of acute hepatitis B virus soon after the appearance of HBsAg and disappears by the time of the unfolded clinical picture.
When the inflammatory process is chronicized in the liver, HBeAg is preserved together with HBsAg in the blood for a long time.
The presence of HBeAg reflects the phase of replication of the hepatitis B virus and correlates with the high activity of the inflammatory process in the liver and the contagiousness of the patient.
Serologic markers of the integration phase:
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Structure Of The Virus
The hepatitis B virion is a 42-nm particle comprising an electron-dense core 27 nm in diameter surrounded by an outer envelope of the surfaceprotein embedded in membranous lipid derived from the host cell . The surface antigen isproduced in excess by the infected hepatocytes and is secreted in the form of22-nm particles and tubular structures of the same diameter .
Interpretation of Results of Serologic Tests for Hepatitis B.
Hepatitis B surface antigen first appears during the late stages of theincubation period and is easily detectable by radioimmunoassay or enzymeimmunoassay. The antigen persists during the acute phase of the disease andsharply decreases when antibody to the surface antigen becomes detectable.Antibody of the IgM class to the core antigen is found in the serum after theonset of the clinical symptoms and slowly declines after recovery. Itspersistence at high titer suggests continuation of the infection. Core antibodyof the IgG class persists for many years and provides evidence of pastinfection.
Hepatitis C: Answers To The Most Commonly Asked Questions
Is hepatitis C sexually transmitted?
HCV can be spread by sex, but this is rare, accounting for less than 1% of overall cases. Sexual transmission is more common in men having sex with men. If you are having sex with more than one steady sex partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases. More FAQs
How many patients with hepatitis C develop cirrhosis?
It is estimated that nearly 20% of patients with chronic hepatitis C will develop cirrhosis over a period of decades. Factors which influence progression to cirrhosis include co-infection with hepatitis B or the human immunodeficiency virus , alcohol use and obesity. More FAQs
Can patients with hepatitis C drink alcohol?
Regular alcohol intake has been shown to leadto increased liver damage in patients who have hepatitis C. HCV-positive persons should be advised to avoid alcohol because it can accelerate liver damage and progression to complications from cirrhosis.
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Life Expectancy And Prognosis
Can you die from hepatitis? Technically, the complications of chronic hepatitis C are fatal. About 30,000 people in the U.S. die each year from cirrhosis.
How long can you live with untreated hep C? The disease affects everyone differently, so thereâs no rule. But about 70% to 80% of people with will get chronic help C. Within 20 years, about 20% to 30% of those people will get cirrhosis. From there, it depends on what type of cirrhosis you have, your treatment, and if you can get a liver transplant.
Can hepatitis C go away on its own? Yes. From 15% to 20% of people with hep C clear it from their bodies without treatment. Itâs more likely to happen in women and people who have symptoms. But it usually happens between 4 and 18 months after symptoms start.
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Causes Of Hepatitis C
You can become infected with hepatitis C if you come into contact with the blood of an infected person.
Other bodily fluids can also contain the virus, but blood contains the highest level of it. Just a small trace of blood can cause an infection. At room temperature, its thought the virus may be able survive outside the body in patches of dried blood on surfaces for up to several weeks.
The main ways you can become infected with the hepatitis C virus are described below.
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Can Hepatitis B Be Prevented
The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.
The disease has also been more widely prevented thanks to:
- Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
- Safer blood injection practices, using clean needles.
- Safe-sex practices.
You can help prevent hepatitis B infections by:
- Practicing safe sex .
- Never sharing personal care items like toothbrushes or razors.
- Getting tattoos or piercings only at shops that employ safe hygiene practices.
- Not sharing needles to use drugs.
- Asking your healthcare provider for blood tests to determine if you have HBV or if you are immune.
How Are Hepatitis B And C Treated
Hepatitis B: Not all patients with chronic hepatitis B infection require treatment. At Yale Medicine, specialists decide on an individual basis whether a patient is an appropriate candidate for treatment. Generally, patients require treatment when their hepatitis B virus level is high, and when laboratory tests demonstrate significant inflammation or injury to the liver.
There are currently seven approved drugs for hepatitis B, two of which are considered to be first-line treatments. These drugs are oral pills taken once daily, and while they’re very effective at suppressing the virus to very low or undetectable levels over the long term, they are not considered curative.
Therefore, the goal of treatment is to control the virus long-term and decrease the risk of hepatitis B related complications such as cirrhosis and liver cancer.
Hepatitis C: For the greater part of the last 20 years, treatment of hepatitis C required the use of a chemotherapy-like injection drug called interferon, which has been associated with serious side effects and a low cure rate. Fortunately, advances in hepatitis C treatments within the last three years now allow for the use of oral medications that are significant improvements in terms of safety and effectiveness.
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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.
Who Is More Likely To Get Hepatitis C
People more likely to get hepatitis C are those who
- have injected drugs
- have been on kidney dialysis
- have been in contact with blood or infected needles at work
- have had tattoos or body piercings
- have worked or lived in a prison
- were born to a mother with hepatitis C
- are infected with HIV
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have or had sex with men
In the United States, injecting drugs is the most common way that people get hepatitis C.13
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Complications Of Hepatitis B
A small proportion of people who become infected with the hepatitis B virus develop a long-term hepatitis B infection. They may have the virus in their bloodstream for most of their life without realising they are infected.
People with chronic hepatitis B infection may not notice any health problems until they develop liver problems such as liver disease or liver cancer later in life. Treatment for hepatitis B is essential because it is not possible to be a healthy carrier of the hepatitis B virus. Chronic hepatitis B infection occurs more commonly in some communities, including:
- Aboriginal and Torres Strait Islander communities.
- In people from parts of the world where hepatitis B is more common, such as:
- North-East Asia
- Sub-Saharan Africa.
How Are Hepatitis B And C Diagnosed
Hepatitis B is diagnosed by a series of blood tests. The test may show an ongoing infection or antibodies that indicate that the patient is protected against hepatitis B. In patients who have a positive screening test that suggests the possibility of ongoing infection, further testing is done to determine the levels of the virus in the bloodstream.
Hepatitis C is diagnosed via a blood test called a Hepatitis C Antibody Test. A positive result means that hepatitis C antibodies are present in the blood. But a positive antibody test doesnt necessarily mean a person has hepatitis C. A further blood test is needed to confirm the diagnosis. This second blood test quantifies the amount of the virus or the viral load in the liver and the bloodstream.
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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:
Reducing The Risk Of Hepatitis B
Simple steps that everyone can take to protect themselves against hepatitis B include:
- Making sure you and your children are immunised this is the best protection.
- Using condoms every time you have anal or vaginal sex with new partners until you both get a check-up .
- Avoiding oral sex if you or your partner have herpes, ulcers or bleeding gums it is unlikely that you will contract hepatitis through oral sex unless blood is present.
- Choosing to have any body piercing or tattooing done by an experienced practitioner who follows good sterilisation and hygiene practices, and who works at premises registered by the local council.
- Wearing single-use gloves if you give someone first aid or need to clean up blood or body fluids.
- Never sharing needles and syringes or other equipment , if you inject drugs. Always use sterile needles and syringes. These are available from needle and syringe programs and some pharmacists. Always wash your hands before and after injecting.
If you have hepatitis B:
If you think you have been exposed to hepatitis B, see a doctor immediately. Your doctor can give you treatment in some instances, which greatly reduces the risk of you becoming infected with hepatitis B.
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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.
Hepatitis B is primarily spread when blood, semen, or certain other body fluids- even in microscopic amounts from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus can also be transmitted from:
- 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
Diagnosis Of Hcv Infection
Successful cloning of portions of the viral genome permitted the development ofnew diagnostic tests for infection by the virus. Since the original antigen wasdetected by antibodies in the serum of an infected patient it was an obviouscandidate for the basis of an ELISA to detect anti-HCV antibodies. A largerclone, C100, was assembled from a number of overlapping clones and expressed inyeast as a fusion protein using human superoxide dismutase sequences tofacilitate expression, and this fusion protein formed the basis of firstgeneration tests for HCV infection. The 5-1-1 antigen comprises amino acidsequences from the non-structural, NS4, region of the genome and C100 containsboth NS3 and NS4 sequences.
It is now known that antibodies to C100 are detected relatively late following anacute infection. Furthermore, the first generation ELISAs were associated with ahigh rate of false positive reactions when applied to low incidence populations,and there were further problems with some retrospective studies on stored sera.Data based on this test alone should, therefore, be interpreted withcaution.
The availability of the nucleotide sequence of HCV made possible the use of thepolymerase chain reaction as a direct test for the genome of the virus.There is considerable variation in nucleotide sequences among different isolatesof HCV, and the 5 non-coding region, which seems to be highlyconserved, is the preferred target for the PCR.
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