Where Does Hepatitis B Come From

Eating Diet And Nutrition For Hepatitis B

If you have hepatitis B, you should eat a balanced, healthy diet. Obesity can increase the chance of nonalcoholic fatty liver disease , and NAFLD can increase liver damage in people who have hepatitis B. Talk with your doctor about healthy eating and maintaining a healthy weight.

You should also avoid alcohol because it can cause more liver damage.

How Do Doctors Treat Hepatitis B

Doctors typically dont treat hepatitis B unless it becomes chronic. Doctors may treat chronic hepatitis B with antiviral medicines that attack the virus.

Not everyone with chronic hepatitis B needs treatment. If blood tests show that hepatitis B could be damaging a persons liver, a doctor may prescribe antiviral medicines to lower the chances of liver damage and complications.

Medicines that you take by mouth include

• tenofovir disoproxil fumarate

A medicine that doctors can give as a shot is peginterferon alfa-2a .

The length of treatment varies. Hepatitis B medicines may cause side effects. Talk with your doctor about the side effects of treatment. Tell your doctor before taking any other prescription or over-the-counter medicines.

For safety reasons, you also should talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.

How Many People Have Hepatitis A

Since the release of the first vaccine in 1995, the rate of new HAV infections in the United States declined by more than 95% from 1996 to 2011. From 2012 through 2016, the number of hepatitis A cases fluctuated because large foodborne outbreaks occurred. From August 2016 through August 2020, 33 states reported hepatitis A outbreaks spread through person-to-person contact resulting in over 33,000 infections with high numbers of hospitalizations and deaths.

Globally, HAV infection is most common in countries with poor sanitary conditions and hygienic practices and transitional economies according to the World Health Organization .

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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.

Where Did Hepatitis B Virus Come From

New insight on the geographical origins and the global spread of two classes of the hepatitis B virus has been found in this study. The findings of this study are published in the journal of eLife. The findings identify the HBV genotypes D and A as having originated in the Middle East and North Africa. They also reveal considerable differences in the global dissemination patterns of these genotypes, adding to our understanding of both the historical and prehistoric spread of one of the world’s largest viral pandemics.

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Relation To Hepatitis B

At first, Blumberg believed that AuAg was indeed a polymorphic serum protein like the lipoprotein antigen which he had discovered before. But soon the evidence accumulated that it might have something to do with hepatitis, which Blumberg first revealed in a publication in 1967 , page 100. Parallel to that, Alfred Prince was specifically looking for a serum hepatitis antigen in the blood of hepatitis B patients and reported on it in 1968, but soon he realized that it was identical to AuAg . Subsequently, various groups confirmed that Au/SH-Ag was actually a marker for acute or chronic hepatitis B and that there were apparently healthy Au/SHAg carriers.

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

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What Is The Outlook

Most people with hepatitis A recover without any complications. Once youve had hepatitis A, you cant get it again. Antibodies to the virus will protect you for life.

Some people may be at an increased risk for serious illness from hepatitis A. These include:

• older adults

acute hepatitis B infections in the United States in 2018.

Identification Of The Hbv Receptors

In 1987, Mary Ann Sells and George Acs succeeded in generating the stably HBV-transfected hepatoma cell line HepG2.2.15 which was permissive for replication of infectious HBV and has been crucial for many studies on HBV, in particular for development of antiviral drugs . But this and similar cell lines did not facilitate the search for the factors mediating efficient attachment and entry of HBV. Many publications claimed to have detected functional receptors for HBV, but the search for them remained unsuccessful for decades. Only recently, Camille Sureau could prove by a meticulous mutational analysis that the previously by J. P. Allain identified heparansulfate proteoglycan binding capacity of the small HBsAg protein is essential for infectivity and that the binding sites coincide with neutralizing epitopes of HBsAg . However, this receptor cannot explain the peculiar species specificity of HBV because it is present in livers of all mammalians.

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Hbeag Positive Hbv Carriers

HBeAg is not essential for virus replication. HBeAg negative variants of HBV with a mutated, non-functional preC sequence were first described in 1989 by William Carman and can even cause fulminant hepatitis B. As shown by David Milich, HBeAg acts as an immune modulator and suppresses the recognition of HBcAg expressing cells by T-lymphocytes which is the main mechanism of HBV immune control. The long term lack of effective immune defenses allows production and secretion of the virus with up to 1010 infectious particles per mL blood, without the infected person showing clinical symptoms. HBsAg is usually present at very high levels of between 30,000 and 200,000ng/mL serum .

The three phases of chronic HBV infections.

How Common Is Hepatitis A

In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked.1 However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness.1 Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.2

Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.

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Pathogenesis Of Acute Hepatitis B

Highly replicative HBV infection is the normal course for several weeks or months before immune recognition begins, after considerable delay. A vigorous cellular immune response suppresses viral replication and eliminates most of the HBV expressing hepatocytes resulting in acute hepatitis. This model of immunopathogenesis has been well supported by studies from Frank Chisari and others in transgenic mice or chimpanzees and by careful analysis of human T cell responses . If the infectious dose is low the immune response may start early enough before many hepatocytes are infected and in this case the symptoms are so mild that they are usually not noticed . Appearance of neutralizing anti-HBs antibodies in the late acute phase prevents the infection of new hepatocytes.

Hepatitis B Vs Hepatitis C

Hepatitis has many different types. HBV and the hepatitis C virus have both acute and chronic forms.

The main difference between HBV and HCV is how they spread from person to person. Although HCV is transmissible via sexual activity, this is rare. HCV usually spreads when blood that carries the virus comes into contact with blood that does not.

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Hbv Dna In Hepatoma Cells

While the immunopathogenesis of HBV is relatively well understood, the mechanisms of oncogenicity are not. Early hopes that explantation and cultivation of hepatoma cells from HBV carriers would lead to a culture system for HBV were not fulfilled because the cells usually did not express HBV antigens or HBV DNA. However, in 1976 South-African researcher Jennifer Alexander was able to establish the hepatoma cell line PLC PRF 5 which secreted HBsAg . Shortly thereafter the team of William Rutter identified several fragments of HBV DNA integrated at several chromosomal sites in that cell line .

Other Body Fluids And Tissues

Hepatitis B is found in semen and vaginal secretions. The virus can be transmitted during unprotected sexual intercourse, and from mother to infant during birth.

Synovial fluid , amniotic fluid, cerebrospinal fluid, and peritoneal fluid can contain the hepatitis B virus, but the risk of transmission to workers is not known.

Feces, nasal secretions, sputum, sweat, tears, urine, and vomit have not been implicated in the spread of hepatitis B. Unless they are visibly contaminated with blood, the risk of contracting hepatitis B from these fluids in the workplace is very low.

Hepatitis B is not transmitted by casual contact. For example, hospital employees who have no contact with blood, blood products, or blood-contaminated fluids are at no greater risk than the general public. However, the virus can spread through intimate contact with carriers in a household setting, possibly because of frequent physical contact with small cuts or skin rashes. The virus can also spread through biting and possibly by the sharing of toothbrushes or razors. It is not spread through sneezing, coughing, hand holding, hugging, kissing, breastfeeding, sharing eating utensils, water or food.

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How Long Does It Last

According to the World Health Organization , the complete vaccine series induces protective antibody levels in of the infants, children, and adolescents who receive it.

Immune memory induced by the HBV vaccine can last for in healthy people. That said, studies into the duration of the protection that the vaccine offers are ongoing.

How Can I Pay For My Medication

Private health insurance or drug plansIf you have private health insurance or a drug plan at work, you may be able to have the medication paid through your plan. Please consult your private health insurance or drug plan provider to see if your drug is covered.

Publicly funded drug plansEach province and territory has their own rules. Some provincial drug plans provide coverage for individuals 65 and older, or those on social assistance. Some provinces provide special support to low-income individuals. Please call your Provincial Ministry or Department of Health to get more information about the terms of the publicly funded drug plan in your province.

Quebec public drug programIn Quebec, everyone must be covered by prescription drug insurance either through private or publicly funded plans.

Each provincial and territorial government offers a drug benefit plan for eligible groups. Some are income-based universal programs. Most have specific programs for population groups that may require more enhanced coverage for high drug costs. These groups include seniors, recipients of social assistance, and individuals with diseases or conditions that are associated with high drug costs. For more details, please contact your provincial or territorial health care ministry, or click on the appropriate link below.

Yukon

Available Patient Assistance Program for Hepatitis B treatment VEMLIDY

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Medical Impact Of The Vaccine

Taiwan was the first country to begin with universal childhood vaccination in 1984. At that time, the rate of perinatal transmission was extremely high leading to a nation-wide HBsAg carrier rate of ca. 10%. Twenty years later only 1.2% of those borne after beginning of the vaccination campaign were HBsAg carriers. Although HCC is mainly a disease of advancing years, the impact of the vaccination quickly became apparent in children and adolescents because its incidence dropped significantly from 0.57 to 0.17 in 100,000 person years in that age group after the beginning of mass vaccination. Thus, the hepatitis B vaccine was the first successful vaccine against a specific form of cancer . Similar observations were reported from other parts in the world. In low prevalence countries like Italy the vaccination has probably contributed to a very strong decrease of hepatitis B incidence.

Observations in Taiwan and Thailand or in high risk groups of other countries suggest that the protection becomes weaker within 20 years but the immune memory is good enough to mitigate the infection in the ca. 23% of those infected. Those with no or with low anti-HBs are still protected against HBV disease but they get a clinically silent infection with transient HBs antigenemia, or anti-HBc seroconversion or increase of the anti-HBs titer. The necessity or timing of later booster injections is a matter of debate.

If I Have No Symptoms How Would I Know If I Have Hepatitis B

To confirm whether or not you have hepatitis B, you will need blood tests.

If you have at least one risk factor , you should ask your health care provider to be tested for hepatitis B. Also, you should be tested for hepatitis B if:

• you were born in a region where hepatitis B is more common, including Asia, Africa, southern and eastern Europe, the Pacific Islands, the Middle East, and the Arctic
• one or both of your parents immigrated from a region where hepatitis B is more common
• you live or travel to regions where hepatitis B is more common
• you have a family history of liver disease or liver cancer
• you have been in prison
• you are pregnant
• you have ever used injection drugs, even just once
• you have unexplained abnormal liver enzymes or if
• you receive medicines that suppress the immune system.

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Scientists Shed New Light On Hepatitis B Virus Origins

• Open annotations. The current annotation count on this page is being calculated.

Researchers have provided new insight on the geographical origins and global spread of two classes of the hepatitis B virus , according to a study in eLife.

The findings identify the HBV genotypes D and A as having originated in the Middle East and North Africa. They also reveal considerable differences in the global dissemination patterns of these genotypes, adding to our understanding of both the historic and prehistoric spread of one of the worlds largest viral pandemics.

HBV, the main cause of liver disease, is a global public health concern with an estimated 257 million people living with the infection, according to figures from the World Health Organization*. The virus is classified into nine genotypes . HBV-A and HBV-D are present around the globe, with A prevailing in Europe and Africa and D in Europe and the Middle East.

The epidemiological history of HBV-D and HBV-A remains unclear due to a lack of relevant studies, says lead author Evangelia-Georgia Kostaki, PhD Candidate in Molecular Epidemiology at the National and Kapodistrian University of Athens, Greece. In order to uncover more of this detail, we wanted to establish how HBV was disseminated across different geographic regions.

Good Nutrition And Rest

• All family members should eat a well-balanced diet that includes foods shown in the graphic MyPlate . You can find more information about balanced nutrition on the website ChooseMyPlate.gov .
• All family members should get at least 8 hours of sleep each night.
• Young children who are ill should rest during the day when possible.

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How Is Hepatitis B Spread

You can become infected with hepatitis B through exposure to blood, semen and other bodily fluids of an infected person. You can get the infection by:

• Having unprotected sex.
• Sharing or using dirty needles for drug use, tattoos or piercing.
• Sharing everyday items that may contain body fluids, including razors, toothbrushes, jewelry for piercings and nail clippers.
• Being treated medically by someone who does not use sterile instruments.
• Being bitten by someone with the infection.
• Being born to a pregnant woman with the infection.

Hepatitis B is not spread by:

• Kissing on the cheek or lips.
• Coughing or sneezing.
• Hugging, shaking hands or holding hands.
• Eating food that someone with the infection has prepared.
• Breastfeeding.

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.

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