When To Contact A Doctor
Anyone who suspects that they have come into contact with HBV should consult a doctor as soon as possible.
A doctor can provide postexposure prophylaxis through the vaccines and a drug called hepatitis B immune globulin. PEP can prevent infection and liver damage.
A person should also contact a doctor if they notice any of the symptoms of hepatitis B or if they know they have hepatitis B, and their symptoms worsen.
Hepatitis B is a viral infection that impacts the liver.
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.
Is There A Cure For Hepatitis B
There is no cure or medication that totally eliminates the virus or makes HBsAg negative, but there is hope. There are approved therapies for hepatitis B and many in development. First-line therapies in the U.S. and globally are entecavir, tenofovir and tenofovir , which are antivirals. Sometimes, pegylated interferon is used. These drugs control and manage the virus and reduce potential liver damage. The virus is suppressed, liver enzymes and liver function tests may normalize and the liver is better able to heal. In rare cases, they may even get rid of the virus .
You might be interested in the recent by Dr. Timothy Block, president of the Hepatitis B Foundation Dr. Chari Cohen, our senior vice president and Maureen Kamischke, the Foundation’s patient engagement and consult specialist.
You might also listen to this podcast by HBFs Dr. Tim Block, the co-founder of the Hepatitis B Foundation about efforts to find a cure, and how the time is right for these great medical discoveries to be achieved sometime soon.
For a complete list of FDA-approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch page.
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Diagnosis Of Hepatitis B
Blood tests are available to determine if you are or have been infected with hepatitis B. It may take 6 months from the time of infection before a blood test can detect antibodies to hepatitis B, so follow-up testing may be required. During this 6-month period, until you know whether you are infected or not, take action to prevent potential infection of other people.
There are also tests that can assess liver damage from hepatitis B. The interpretation of these tests can be complicated and specialist advice is needed, so talk to your doctor.
All pregnant women are tested for hepatitis B. If you are found to have chronic hepatitis B, your doctor can help reduce the risk of transferring the infection to your newborn child.
Prevent Infection After Contact With The Virus
If you think you have been in contact with the hepatitis B virus, see your doctor right away. Doctors typically recommend a dose of the hepatitis B vaccine to prevent infection. In some cases, doctors may also recommend a medicine called hepatitis B immune globulin to help prevent infection. You must get the vaccine dose and, if needed, HBIG shortly after coming into contact with the virus, preferably within 24 hours.
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What Is Chronic Hepatitis B
Doctors refer to hepatitis B infections as either acute or chronic:
- An acute HBV infection is a short-term illness that clears within 6 months of when a person is exposed to the virus.
- A person who still has HBV after 6 months is said to have a chronic hepatitis B infection. This is a long-term illness, meaning the virus stays in the body and causes lifelong illness. An estimated 850,000 to more than 2 million people in the U.S. have chronic HBV.
The younger someone is when infected, the greater the chances for chronic hepatitis B.
How Do Doctors Treat The Complications Of Hepatitis B
If chronic hepatitis B leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, minor medical procedures, and surgery. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order blood tests and an ultrasound or another type of imaging test to check for liver cancer.
If chronic hepatitis B leads to liver failure or liver cancer, you may need a liver transplant.
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Reduce Your Chance Of Infection
You can reduce your chance of hepatitis B infection by
- not sharing drug needles or other drug materials
- wearing gloves if you have to touch another persons blood or open sores
- making sure your tattoo artist or body piercer uses sterile tools
- not sharing personal items, such as toothbrushes, razors, or nail clippers
- using a latex or polyurethane condom during sex
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, semen, 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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Prevent Hepatitis B Infections In Newborns
If you are pregnant and have hepatitis B, talk with your doctor about lowering the risk that the infection will spread to your baby. Your doctor will check your virus levels during pregnancy. If virus levels are high, your doctor may recommend treatment during pregnancy to lower virus levels and reduce the chance that hepatitis B will spread to your baby. Your doctor may refer you to a liver specialist to find out if you need hepatitis B treatment and to check for liver damage.
When it is time to give birth, tell the doctor and staff who deliver your baby that you have hepatitis B. A health care professional should give your baby the hepatitis B vaccine and HBIG right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.
What Are The Symptoms Of Hepatitis B
After the virus enters the body, there is an incubation period lasting 1.5 to 6 months until illness begins. During the acute phase most persons have no symptoms or might experience a mild illness. Symptoms of acute HBV infection, when present, may include:
- Dark-colored urine, light-colored stools
During the chronic phase hepatitis B usually progresses silently, with no symptoms at all during the first 10-20 years. Signs of severe liver scarring may include:
- Star-shaped vein pattern developing on the swollen belly
- Easy bruising and bleeding
Chronic HBV infection can lead to serious liver disease, liver scarring , and hepatocellular cancer.
Because symptoms of hepatitis B are usually absent, persons with risk for HBV infection should be tested. If you think you have hepatitis B, or are at risk for hepatitis B, you should contact your doctor.
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Hbsag Clearance After Na Treatment
There are few large or conclusive studies on the clearance of HBsAg after NA treatment, and some of these studies are single-centre retrospective studies. Kim et al. reported a clearance rate of 1% or less in 110 CHB patients who were treated with ETV/LAM for approximately 1 year. A retrospective study by Yip et al. reported an HBsAg clearance rate of 2.1% after an average follow-up of 4.8 years in 20,263 CHB patients treated with ETV/TDF for longer than 6 months. Wong et al. retrospectively evaluated 1072 CHB patients on antiviral therapy for approximately 6 years and found an HBsAg clearance rate of 4.58%. This study found no significant difference in the clearance rate between HBeAg-positive and HBeAg-negative patients, but the rate in patients with cirrhosis was significantly lower than patients without cirrhosis . These results suggested that the clearance rate of non-cirrhosis patients was higher after NA treatment, which is not consistent with the results of patients who experienced spontaneous clearance. Compared to patients with normal baseline ALT, patients with higher ALT levels had significantly higher rates of achieving HBsAg clearance. In general, the clearance rate may increase with the extension of treatment in CHB patients, but the overall rate with currently available NA treatment is low. The HBsAg clearance rates were 1.45.1% after an average follow-up of 27 years after NA treatment .
What Is The Outlook For People With Hepatitis B
The outlook for people with HBV is better now than ever before. You are certainly able to live a full life and help yourself stay healthy. You should make sure to have regular check-ups with a healthcare provider who is qualified to treat hepatitis B, possibly a liver doctor.
Make sure you are vaccinated against hepatitis A. Check with your healthcare provider or pharmacist before taking other medications or over-the-counter products, including supplements and natural products. These could interfere with your medication or damage your liver. For instance, taking acetaminophen in large doses may harm your liver.
Follow the usual guidelines for living a healthy life:
- Eat nutritious foods, choosing from a variety of vegetables, fruits and healthy proteins. It is said that cruciferous vegetables are especially good at protecting the liver.
- Exercise regularly.
- Dont smoke and dont drink. Both tobacco and alcohol are bad for your liver.
- Do things that help you cope with stress, like journaling, talking with others, meditating and doing yoga.
- Avoid inhaling toxic fumes.
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Should All Patients With Chronic Hepatitis B Be On Treatment
Not all patients with chronic hepatitis B need to be on treatment. The decision to treat HBV is based on several factors including blood tests results, the patient’s age, and the risk of developing cirrhosis or liver cancer. Sometimes a liver biopsy is needed to see if there is significant liver damage to make a decision.
Hepatitis B medications are recommended for patients with detected HBV virus on a blood test and evidence of liver damage. Liver damage can be detected with a liver enzyme known as ALT. People with cirrhosis should be considered for treatment even if the liver enzymes appear normal.
Chronic hepatitis B may change over time. Patients can go through different phases with low amounts of virus and normal level of ALT followed by high viral loads and ALT levels. These bursts of virus activity usually don’t cause any symptoms but may cause liver damage overtime. It is important that people with chronic hepatitis B have blood tests on a regular basis to see if treatment is needed.
There are some medications which can cause hepatitis B “reactivation” which can lead to life threatening liver failure. These medications are used to treat some cancers, inflammatory conditions and hepatitis C. Reactivation reactions can be prevented and it is important to let your provider know you have HBV before you start any new medications.
How Common Is Hepatitis B
The number of people who get this disease is down, the CDC says. Rates have dropped from an average of 200,000 per year in the 1980s to around 20,000 in 2016. People between the ages of 20 and 49 are most likely to get it.
About 90% of infants and 25-50% of children between the ages of 1-5 will become chronically infected. In adults, approximately 95% will recover completely and will not go on to have a chronic infection.
As many as 1.2 million people in the U.S. are carriers of the virus.
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Preparing For An Appointment
You’re likely to start by seeing your family doctor or a general practitioner. However, in some cases, you may be referred immediately to a specialist. Doctors who specialize in treating hepatitis B include:
- Doctors who treat digestive diseases
- Doctors who treat liver diseases
- Doctors who treat infectious diseases
Treatment For Chronic Hepatitis B Infection
Most people diagnosed with chronic hepatitis B infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others. Treatment for chronic hepatitis B may include:
- Antiviral medications. Several antiviral medications including entecavir , tenofovir , lamivudine , adefovir and telbivudine can help fight the virus and slow its ability to damage your liver. These drugs are taken by mouth. Talk to your doctor about which medication might be right for you.
- Interferon injections. Interferon alfa-2b is a man-made version of a substance produced by the body to fight infection. It’s used mainly for young people with hepatitis B who wish to avoid long-term treatment or women who might want to get pregnant within a few years, after completing a finite course of therapy. Interferon should not be used during pregnancy. Side effects may include nausea, vomiting, difficulty breathing and depression.
- Liver transplant. If your liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.
Other drugs to treat hepatitis B are being developed.
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What Is Hepatitis B
Hepatitis B is an infection of your liver. Itâs caused by a virus. There is a vaccine that protects against it. For some people, hepatitis B is mild and lasts a short time. These âacuteâ cases donât always need treatment. But it can become chronic. If that happens, it can cause scarring of the organ, liver failure, and cancer, and it even can be life-threatening.
Itâs spread when people come in contact with the blood, open sores, or body fluids of someone who has the hepatitis B virus.
It’s serious, but if you get the disease as an adult, it shouldnât last a long time. Your body fights it off within a few months, and youâre immune for the rest of your life. That means you can’t get it again. But if you get it at birth, itâ unlikely to go away.
Treatment For Acute Hepatitis B
If you’re diagnosed with hepatitis B, your GP will usually refer you to a specialist, such as a hepatologist .
Many people do not have any troublesome symptoms, but if you do feel unwell, it can help to:
- get plenty of rest
- take over-the-counter painkillers, such as paracetamol or ibuprofen, for tummy pain
- maintain a cool, well-ventilated environment, wear loose clothing, and avoid hot baths or showers if itching is a problem
- take medication, such as metoclopramide, to stop you feeling sick, and chlorphenamine to reduce itching your doctor can give you a prescription for these if necessary
Most people recover completely in a couple of months, but you’ll be advised to have regular blood tests to check that you’re free of the virus and have not developed chronic hepatitis B.
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If I Have Hepatitis B And Feel Healthy Do I Need To Keep Going To My Doctor
Chronic hepatitis B is a silent disease because often no symptoms appear until your liver is severely damaged. Although many people with chronic hepatitis B have an inactive disease and will remain healthy, about one in four will have an active disease that may lead to cirrhosis, liver failure, and liver cancer.
Because hepatitis B has no symptoms until your liver is badly damaged, a blood test is the only way for your doctor to find out if your hepatitis B is active or inactive, and to offer treatment, if needed. To help your doctor monitor how your disease behaves over time, you will need lifelong repeat blood tests every six to 12 months. Some tests, such as HBV DNA may need to be done more frequently . No treatment is required while the virus is inactive, but you should continue to get regular blood tests from your doctor to monitor your liver disease.
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
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