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
Whats The Difference Between Acute And Chronic Hepatitis B
Hepatitis B can be either acute or chronic:
- Acute hepatitis B lasts for a short period of time. If you have acute hepatitis B, you may be asymptomatic or have symptoms and develop icteric hepatitis. It can transition into chronic hepatitis B if the virus doesnt naturally go away after 6 months.
- Chronic hepatitis B lasts for at least 6 months. If you have this type of hepatitis, you may carry the hepatitis B virus for the rest of your life. Its possible to have chronic hepatitis B that started as acute, but many people dont have acute hepatitis B first.
Most people with acute hepatitis B make a full recovery. Some may never even show any symptoms. But those with chronic hepatitis B often need treatment to help manage the infection. Chronic hepatitis B also increases your risk of developing cirrhosis and certain types of liver cancer.
Your risk of developing chronic hepatitis B depends on when you first received your diagnosis of the virus. Children who receive a diagnosis of hepatitis B, especially those under the age of 5 years old, have a higher risk of the infection becoming chronic. Adults are less likely to develop chronic hepatitis B. Around 90 percent of adults who develop it will fully recover.
Keep in mind that hepatitis B can be present for years before you start to show any symptoms.
Hepatitis B And Pregnancy
If youâre pregnant, you might pass the virus to your baby at birth.
If your baby gets the virus and isnât treated, they could have long-term liver problems. All newborns with infected mothers should get hepatitis B immune globulin and the vaccine for hepatitis at birth and during their first year of life.
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Does The Hepatitis B Vaccine Have Side Effects
Some children will develop pain or soreness in the local area of the shot, and low-grade fever.
There is one extremely rare, but serious, side effect. About 1 out of every 600,000 doses of the hepatitis B vaccine will cause a severe allergic reaction, called anaphylaxis, with symptoms including swelling of the mouth, difficulty breathing, low blood pressure or shock. Anaphylaxis usually occurs within 15 minutes of receiving the vaccine. Although anaphylaxis can be treated, it is quite frightening. People should remain at the doctors office for about 15 minutes after getting the vaccine.
Although the hepatitis B vaccine is made in yeast cells, no one has ever been shown to be allergic to the yeast proteins contained in the hepatitis B vaccine .
How Do You Get The Hepatitis B Virus
There are several ways that the hepatitis B virus can be transmitted:
Contact with blood or body fluids:
HBV can be transmitted from an infected mother to her baby during childbirth.
Sharing personal items:
HBV can be transmitted through contact with personal items that have been contaminated with infected blood, such as razors or toothbrushes.
It is important to practice safe sex, avoid sharing needles or personal items, and get vaccinated to prevent the spread of HBV. If you think you may have been exposed to the virus, it is important to see a doctor as soon as possible.
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A Note About Sex And Gender
Sex and gender exist on spectrums. This article will use the terms male, female, or both to refer to sex assigned at birth. .
It is important that infants who are born to females with hepatitis B receive accurate doses of the hepatitis B vaccine. They may also be required to receive hepatitis B immunoglobulin if it is available.
The WHO also recommends using antiviral prophylaxis to help prevent hepatitis B transmission.
The table below outlines the two recommended hepatitis B vaccine schedules for infants born to those who have hepatitis B:
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 a partner who has HBV infection
- injection drug use that involves sharing needles, syringes, or drug-preparation equipment
- birth to a person who has HBV infection
- contact with blood from or open sores on a person who has HBV infection
- exposures to needle sticks or sharp instruments and
- sharing certain items with a person who has HBV infection 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 9 parts 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 people with HBV infection
- Sex partners of people with HBV infection
- 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
- Patients on hemodialysis
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Approved Drugs For Adults
There are currently 7 approved drugs in the United States for adults living with chronic hepatitis B infection. These include 5 types of antiviral drugs that are taken as a pill once a day for 1 year or longer. And there are 2 types of immune modulator drugs called interferon that are given as an injection for 6 months to 1 year.
It is important to know that not everyone needs to be treated. A liver specialist should evaluate your health through a physical exam, blood tests, and an imaging study of your liver . Then you can discuss together whether you are a good candidate for treatment since the approved drugs are most effective when there are signs of active liver disease. In addition, talk to your provider about HBV Clinical Trials since there are several new drugs being tested that are available for infected adults.
All adults, however, should be seen regularly by a liver specialist whether they are on treatment or not.
What Kind Of Hepatitis Is The Most Dangerous
All forms of hepatitis can be serious and can lead to complications, such as liver damage, cirrhosis, and liver cancer. However, hepatitis C is generally considered to be the most dangerous type of hepatitis because it can cause chronic infection and is the leading cause of liver cancer and liver transplantation.
Hepatitis C is a viral infection that is transmitted through contaminated needles, syringes, or other drug-injection equipment. It can also be transmitted through sexual contact, but this is less common.
Symptoms of hepatitis C may include fatigue, loss of appetite, nausea, muscle and joint pain, and yellowing of the skin and whites of the eyes . In some cases, the infection may not cause any symptoms until it has caused significant liver damage.
There is a vaccine available to prevent hepatitis A and B, but there is no vaccine for hepatitis C. If you think you may have been exposed to the hepatitis C virus, it is important to see a doctor as soon as possible. The infection can be treated with antiviral medications, and early treatment can help prevent complications.
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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.
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.
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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 .
How Many People Die From Hepatitis
It is estimated that worldwide, around 780,000 people die each year from hepatitis B-related liver disease. This includes deaths from cirrhosis and liver cancer, as well as other complications of HBV.
Hepatitis B is a serious and potentially life-threatening infection that can lead to chronic liver disease and liver cancer if left untreated. However, the infection can be prevented with the HBV vaccine and can be treated with antiviral medications. It is important to get vaccinated and to seek medical attention if you think you may have been exposed to the virus.
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Enhancing Healthcare Team Outcomes
The interprofessional health care team faces many challenges when vaccinating patients for hepatitis B. While few medical interventions have as significant an impact on health as vaccinations, and the hepatitis B vaccination is generally safe, lack of knowledge about the vaccine by healthcare team members and patient concern about adverse events can decrease coverage. Challenges on knowledge of the vaccine for healthcare team members include staying current on evolving recommendations for whom the vaccine is indicated. All team members can increase the vaccination rate of their patients by encouraging all staff to become trained in the assessment of vaccination histories and any pertinent staff in the administration of the vaccine. Protecting the time available for the team to do this is an essential component of this strategy. All patients should receive education on the benefits of vaccination, including its herd immunity effect, the generally safe side effect profile, and the relatively few contraindications. A presumption of acceptance may be effective with most patients. The hesitant parent and patient who does not respond to this can pose a challenge in vaccination. Motivational interviewing techniques have shown to be effective with these hesitant patients.
Hepatitis B Vaccination Schedule For Children And Infants
The Centers for Disease Control and Prevention recommends that babies and children receive three 0.5 milliliter doses of either Engerix-B or Recombivax HB, starting just after birth.
The current recommended hepatitis B vaccine schedule for children and infants is as follows:
|Hepatitis B Vaccination Schedule for Infants and Children
|Hepatitis B Vaccine Dose
|618 months old
If your child is undergoing hemodialysis, your healthcare provider may recommend that they receive additional doses of the HBV vaccine.
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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.
Toll Like Receptor Ligands
TLRs are key mediators of innate immune system. TLRs recognize viruses based upon their structural specificity and activate phagocytes and DCs to trigger an immune response. Induction of cytokines via this immune activation has been shown to suppress HBV replication . Therefore, TLRs may be useful in the treatment of CHB in future.
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How Is Hepatitis B Diagnosed
There are three main ways to diagnose HBV infection. They include:
- Blood tests: Tests of the blood serum shows how your bodys immune system is responding to the virus. A blood test can also tell you if you are immune to HBV.
- Abdominal ultrasound: An ultrasound uses sound waves to show the size and shape of your liver and how well the blood flows through it.
- Liver biopsy: A small sample of your liver tissue is removed though a tiny incision and sent to a lab for analysis.
The blood test that is used to diagnose hepatitis B is not a test that you get routinely during a medical visit. Often, people whove become infected first learn they have hepatitis B when they go to donate blood. Blood donations are routinely scanned for the infection.
The virus can be detected within 30 to 60 days of infection. About 70% of adults with hepatitis B develop symptoms, which tend to appear an average of 90 days after initial exposure to the virus.