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 Treated
Treatment of hepatitis B infection depends on how active the virus is. It also depends on whether you are at risk for liver damage such as cirrhosis.
Treatment of short-term hepatitis B
Treatment depends on whether you:
- Have been recently infected with the virus.
- Have the symptoms of an acute infection.
- Have a chronic infection.
If you haven’t had a hepatitis B vaccine and think you may have been exposed to the virus, you should get a shot of hepatitis B immunoglobulin . You should also get the first of three shots of the hepatitis B vaccine. Make sure to get this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus. The sooner you get treatment after exposure, the better it works.
If you have the symptoms of an acute infection, treatment with antiviral medicine usually isn’t needed. Home treatment usually will relieve your symptoms. It includes eating well, drinking plenty of fluids, and avoiding alcohol and drugs.
In some cases, you may get medicine to treat an acute infection. But this usually isn’t done unless you are very sick.
Treatment of long-term hepatitis B
Treatment depends on how active the virus is in your body and your chance of liver damage. The goal of treatment is to stop liver damage by keeping the virus from multiplying.
Antiviral medicine is used if the virus is active and you are at risk for liver damage. Medicine slows how well the virus can multiply.
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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What Are The Symptoms
- Symptoms can take 2 to 6 months to appear.
- Many people who are infected with hepatitis B have either no symptoms or only mild symptoms.
- Symptoms of acute hepatitis B can include fatigue, loss of appetite, joint pain, abdominal pain, nausea, vomiting, fever, and dark urine. A small number of people will develop jaundice .
- Some people develop chronic hepatitis B and most remain contagious for the rest of their lives. Chronic infection may lead to cirrhosis and/or liver cancer. Most people with chronic hepatitis B are unaware of their infection.
Hiv And Hepatitis B And Hepatitis C Coinfection
Hepatitis B and hepatitis C are liver infections caused by a virus. Because these infections can be spread in the same ways as HIV, people with HIV in the United States are often also affected by chronic viral hepatitis.
Viral hepatitis progresses faster and causes more liver-related health problems among people with HIV than among those who do not have HIV. Liver disease, much of which is related to HBV or HCV, is a major cause of non-AIDS-related deaths among people with HIV.
Given the risks of hepatitis B or hepatitis C coinfection to the health of people living with HIV, it is important to understand these risks, take steps to prevent infection, know your status, and, if necessary, get medical care from someone who is experienced in treating people who are coinfected with HIV and HBV, or HIV and HCV.
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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.
Is Hepatitis B Contagious
Hepatitis B is highly contagious. Its transmitted through contact with blood and certain other bodily fluids. Although the virus can be found in saliva, its not transmitted through sharing utensils or kissing. Its also not transmitted through sneezing, coughing, or breastfeeding.
Symptoms of hepatitis B may not appear for 3 months after exposure. Symptoms can last for several weeks.
But even without symptoms, you can still transmit the infection to others. The virus can live outside the body and remains infectious for at least
Hepatitis B is a highly contagious condition. Its associated with many serious complications, some of which can be life threatening.
But there are many treatment options available and multiple ways you can prevent infection, including getting vaccinated.
If you suspect you may have been exposed to hepatitis B, its important to talk with a doctor to prevent infection and determine the best course of treatment for you.
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What Are The Different Types Of Contraception
Condoms are good because theyre the only contraception that prevents HIV and STIs as well as pregnancy. But for them to work, you have to use them correctly every time you have sex.
This is very effective at preventing pregnancy, but it has to be taken every day or it stops working.
This prevents pregnancy for 8-13 weeks, so there is no need to remember to take anything. But you do need to remember when your next injection is due.
This is a small plastic rod that is fitted in a females arm. It will prevent pregnancy for three, four or five years depending on the type you get, so there is no need to remember to take anything. But it must be removed or replaced when the time period is up.
An intra-uterine device also known as the copper coil, the coil or the coil IUD is a small, T-shaped device that goes in the womb to prevent pregnancy for five to ten years.
If you have unprotected sex, the condom brakes or you forget to take your pill, emergency contraception can prevent pregnancy.
American Association For The Study Of Liver Diseases Recommendations
The 2016 AASLD guidelines for the treatment of chronic hepatitis B as well as select recommendations from the 2018 AASLD guidance update on the prevention, diagnosis, and treatment of chronic hepatitis B are outlined below and in the Guidelines section.
Adults with immune-active chronic hepatitis B infection
Administer antiviral therapy to lower the risk of morbidity and mortality associated with chronic hepatitis B infection.
The recommended initial agent for adults is PEG-IFN, entecavir, or tenofovir.
Adults with immune-tolerant chronic hepatitis B infection
Antiviral therapy is not recommended.
The AASLD suggests obtaining ALT levels at least every 6 months to monitor for potential transition to immune-active or -inactive chronic hepatitis B.
For select patients older than 40 years, the AASLD suggests antiviral therapy in the setting of normal ALT levels, elevated HBV DNA , and significant necroinflammation or fibrosis on liver biopsy specimens.
Adults with HBeAg-positive immune-active chronic hepatitis B who seroconvert to anti-HBe on nucleoside analog therapy
After a period of treatment consolidation , consider discontinuing NA therapy in noncirrhotic HBeAg-positive adults who seroconvert to anti-HBe while on NA treatment. If antiviral therapy is stopped, monitor the patient every 3 months for a minimum of 1 year for recurrent viremia, ALT flares, seroreversion, and clinical decompensation.
Adults with HBeAg-negative immune-active chronic HBV infection
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What Makes Yale Medicines Approach To Treating Hepatitis B And C Unique
The Viral Hepatitis Program at Yale Medicine represents one of the leading viral hepatitis treatment programs in the country and is engaged in innovative research focused on advancing the care of patients with chronic hepatitis B, C and D infections.
A multidisciplinary team of faculty physicians and mid-level providers offer a coordinated approach to preparing patients for success. Services include structured hepatitis patient education classes, mindfulness-based stress reduction techniques , a formal physician-guided weight-loss program and access to clinical trials evaluating current and new therapies that are not available in routine clinical practice.
Our program is a core member of several national and international observational cohort studies which contributes to the advancement of science of hepatitis treatment around the world.
âOur team at Yale Medicine is uniquely equipped to serve patients with viral hepatitis from Connecticut and beyond and aims to offer outstanding, individualized, patient-centered care to help educate and guide patients through their treatment,â says Dr. Lim. We have specialists who have nationally recognized expertise in the management of viral hepatitis in special populations, including HCV-HIV coinfection, end-stage renal disease, cirrhosis/liver failure, post-liver transplant, and prior failure to respond to all-oral direct acting antivirals .
What Are The Alternatives To The Treatment
Vaccination is the best and the only alternative for the hepatitis B virus. Also, the other best option is to be safe from your end and always have protected sex and do not abuse drugs. Do not share needles and if possible get the vaccination when you are young. Also, lead a healthy lifestyle with a proper diet intake.
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New And Current Treatment Options For Hepatitis B
The search for new treatments for hepatitis B has been ongoing for decades. While effective at suppressing the virus, current treatments, which include antivirals, cannot eliminate it from the liver.
Hepatitis B is a liver infection that results from the hepatitis B virus. People acquire it through contact with the bodily fluids of someone with the virus. The liver cleanses the body of waste, and the disruption to its processes can make a person seriously ill.
This article will outline the current treatment options for HBV. It will also discuss new treatments in development that may lead to a cure for HBV.
Initial infection with HBV is an acute infection. Most healthy people with infection with this virus will not have symptoms and can shed the virus easily. If tests show that a person still has the virus 6 months after contracting it, they have a chronic, long-term infection. Doctors use blood tests to diagnose and monitor the condition.
Treatment whether a person has acute or chronic hepatitis B.
What Is The Best Treatment For Hepatitis B
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.
Why hepatitis B is not curable?
Chronic hepatitis B hasnt been cured so far in part because current therapies have failed to destroy the viral reservoir, where the virus hides in the cell. This is in contrast to hepatitis C virus, which has no such viral reservoir and can now be cured with as little as 12 weeks of treatment.
What is the life span of hepatitis B patient?
The estimated 5-year survival rates were 97% for patients with chronic persistent hepatitis, 86% for those with chronic active hepatitis, and 55% for those with chronic active hepatitis with cirrhosis. The usual cause of death was liver failure and its sequelae.
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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.
Virion Structure And Genome
HBV particles, also known as Dane particles , were firstly identified by Dane and colleagues in 1970 . Their shape is spherical, with a diameter of â¼42 nm. They consist of an outer envelope, which is a host-derived lipid bilayer containing three different-sized HBV surface antigens âlarge , middle and small âsurrounding the viral nucleocapsid. The nucleocapsid is icosahedral and comprises the HBV core protein , as well as the viral DNA genome and the viral DNA polymerase . The virus also secretes a wide range of defective particles , including enveloped nucleocapsids that are empty or contain defective immature genomes and subviral lipid particles containing the viral surface antigens. The subviral particles are secreted along with the infectious virions at levels that are thousands of times higher, and they play an important role in suppressing antibody responses to the virus .
Hepatitis B Virus particles. Infectious HBV virion . The lipid envelope, bearing three types of surface proteinsâsmall , middle and large âsurrounds the nucleocapsid, consisting of HBV relaxed circular DNA , the viral DNA polymerase , and the core protein . Non-infectious HBV particles enveloped nucleocapsids containing immature or defective DNA/RNA, subviral particles, and naked nucleocapsids.
Hepatitis B Virus genome. Partially double-stranded, relaxed circular DNA with four overlapping open reading frames .
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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.
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.
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Hiv And Hbv Coinfection
About 2% of people with HIV in the United States are coinfected with HBV both infections have similar routes of transmission. People with HIV are at greater risk for complications and death from HBV infection. All people with HIV are recommended to be tested for HBV, and if susceptible, are further recommended to receive the hepatitis B vaccination or, if chronically infected, evaluated for treatment to prevent liver disease and liver cancer. For more information about HIV and HBV coinfection, visit HIV.govâs pages about hepatitis B and HIV coinfection.