What Should I Do If I Am Exposed To The Hepatitis B Virus
If you know you were recently exposed to the hepatitis B virus, you may get protection from an injection of hepatitis B immunoglobulin , which is different from the hepatitis B vaccine.
HBIG is given only when it is suspected or known that someone has been infected with hepatitis B, and it is given within 24 hours after the exposure.Unlike the vaccine, which is not given after exposure, HBIG is given before a potential exposure. HBIG will protect you for 3 to 6 months, but it is strongly recommended that you also begin the 3-shot hepatitis B vaccination series within 7 days of your exposure.
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.
What Are The Risk Factors For Hepatitis B And C
Hepatitis B: Although most commonly acquired early in life, adults can also contract it. Hepatitis B is largely transmitted through bodily fluids. It can be passed at birth from a hepatitis B-infected mother or through exposure in early childhood to body fluids, blood or contaminated medical instruments. Hepatitis B can also be transmitted through intranasal and injection drug use as well as infected tools used during tattooing and body piercing.
Hepatitis C: The key risk factors are also intranasal and injection drug use, tattoos and body piercings, high-risk sexual contact, blood transfusions before 1992 and organ transplantation.
Another key risk factor for hepatitis C is being born from 1945 to 1965, during the baby-boom years. Eighty percent of all people who currently have hepatitis C in the United States were born in that timeframe.
Although the reasons that baby boomers are more likely to have hepatitis C than others arent entirely understood, its believed that most were infected in the 1970s and 1980s, when rates of hepatitis C were at their peak.
The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend that all U.S. adults born from 1945 to 1965 undergo a one-time screening test for hepatitis C. Connecticut is one of several states that has written this recommendation into law. In Connecticut ,the law requires that primary care clinicians screen all adults born within those years.
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What Is Hepatitis B
Hepatitis B is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness. It results from infection with the hepatitis B virus. Hepatitis B can be either “acute” or “chronic.”
Acute hepatitis B virus infectionis a short-term illness that occurs within the first 6 months after someone is exposed to HBV. Acute infection can – but usually does not – lead to chronic infection.
Chronic hepatitis B virus infectionis a long-term illness that occurs when the virus remains in a person’s body.
The younger a person is when infected with hepatitis B virus, the greater his or her chance of developing chronic hepatitis B.
People can become infected with the virus during activities such as:
- Sex with an infected partner
- Sharing needles, syringes, or other drug-injection equipment
- Sharing items such as razors or toothbrushes with an infected person
- Direct contact with the blood or open sores of an infected person
- Exposure to blood by sticks from needles or other sharp instruments
People can have hepatitis B infection and not know it. People can pass the virus to others and not know it.
Although anyone can get hepatitis B, some people are at greater risk, such as those who:
- Have sex with an infected person
- Have multiple sex partners
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.
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Who Publishes New Guidelines On Hiv Hepatitis And Stis For Key Populations
Today, WHO published new Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations. The guidelines are officially launched at the AIDS 2022 Conference in Montreal, Canada, in a satellite session entitled: Launching new WHO guidelines for key populations: Focus for impact.
The guidelines outline a public health response to HIV, viral hepatitis and sexually transmitted infections for 5 key populations .
WHO promotes an evidence and rights based approach to addressing these health issues which puts key populations at the centre of the response. Key populations must be prioritized, in every setting and this means as outlined in these new guidelines, planning to reach them first with prevention, testing and treatment as well as prioritizing key populations in funding programmes, said Erika Castellanos, Director of programmes at GATE , who was the co-chair of the WHO Guidelines Development Group.
Particularly for key populations, social, legal, structural and other contextual factors both increase vulnerability to HIV, viral hepatitis and STIs and obstruct access to health and other essential services. These guidelines highlight the critical importance of addressing structural barriers in all settings as a priority.
A summary of the guidelines is provided in the policy brief.
Who Is At Risk For Chronic Disease
The likelihood that infection becomes chronic depends upon the age at which a person becomes infected. Children less than 6 years of age who become infected with the hepatitis B virus are the most likely to develop chronic infections.
In infants and children:
- 80â90% of infants infected during the first year of life develop chronic infections and
- 30â50% of children infected before the age of 6 years develop chronic infections.
In adults:
- less than 5% of otherwise healthy persons who are infected as adults will develop chronic infection and
- 20â30% of adults who are chronically infected will develop cirrhosis and/or liver cancer.
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Causes Of Hepatitis B
Hepatitis B is spread through contact with blood that contains the hepatitis B virus. If infected blood or body fluids enter another persons bloodstream, that person may become infected.
The time from exposure to the hepatitis B virus to the appearance of the illness is 45 to 180 days.
Risky activities that can cause infection include:
- Sharing unsterile or unclean equipment for injecting drugs.
- Piercing the skin with equipment that is not properly cleaned, disinfected and sterilised.
- Sharing razor blades or toothbrushes.
- Coming into contact with infected blood through open cuts or the mucous membranes of another person.
- Having unprotected sex , especially if there is blood present.
Mothers who have hepatitis B can pass the virus to their babies or children at the time of birth or after birth. If the newborn baby is quickly immunised with 2 vaccines, they can be protected from getting hepatitis B.
All blood and blood products produced for medical purposes in Australia are carefully screened for hepatitis B and other blood-borne viruses. The risk of getting infected with hepatitis B from a blood transfusion is extremely low .
How Is The Hepatitis B Vaccine Given
The hepatitis B vaccine is a “recombinant vaccine,” which means that it is a fragment of the hepatitis B virus that has been produced in a laboratory. The vaccination for hepatitis B is given as 3 injections over a 6-month period – an initial dose, followed by a second dose 1 month later, and a third dose 5months after the second.
If you need hepatitis A vaccination in addition to hepatitis B, you can do these individually or as a combined vaccine that covers both. The combination vaccine is given as 3 injections over a 6-month period – an initial dose, followed by a second dose 1 month later, and a third dose 5 months after the second.
If you are not able to get the shots on time, it is not necessary to restart the series, but you should continue from the last dose given.
You will NOT get hepatitis B from the vaccine.
You will be protected for about 13 years. If it has been many years since you received your hepatitis B vaccination, or if you do not know when you were vaccinated, ask your doctor to check to see if you have antibodies against hepatitis B.
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How Can Hepatitis B Be Prevented
A safe and effective vaccine to prevent hepatitis B is available. The hepatitis B vaccine is recommended for people in high-risk settings who have not already been infected and for infants who are born to infected mothers. It is recommended that all children and adolescents be vaccinated against hepatitis B along with their routine childhood immunizations beginning at birth. A special hepatitis B immune globulin is also available for people who are exposed to the virus. In the event of exposure to hepatitis B, consult a doctor or the local health department.
Who Gets Hepatitis B
One out of 20 people in the United States will get infected with HBV some time during their lives. Anyone can get hepatitis B, but you are at greater risk if you:
- have sex with someone infected with HBV
- have multiple sex partners
- are a man and have sex with men
- have ever been diagnosed with a sexually transmitted disease
- are an injection drug user
- live in the same house with someone who has lifelong HBV infection
- are a health care or public safety worker who has contact with human blood
- are an infant born to an HBV-infected mother
- are a hemodialysis patient
- are an infant/child or immigrant from areas with high rates of infection
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For How Long Is A Person Able To Spread The Virus
The virus can be found in blood and other body fluids several weeks before symptoms appear and generally persists for several months afterward. Approximately 10 percent of infected adults may become long-term carriers of the virus. Infants infected at birth have a 90 percent chance of becoming chronically infected.
What Are The Symptoms Of Hepatitis B And C
In most patients, hepatitis B develops slowly over the course of several decades, and thus most patients have no symptoms. People who have advanced liver disease such as cirrhosis of the liver may experience complications and symptoms that reflect liver failure. Other symptoms include:
- A buildup of fluid within the abdominal cavity
- Confusion and tremors , which are complications due to the inability of the liver to filter out toxins that are normally cleaned out by a healthy liver
- Vomiting of blood, or blood within the stool . This is a complication in which enlarged veins within the esophagus or stomach bleed as a consequence of increased pressure around the diseased liver.
Most patients with chronic hepatitis C infection report no symptoms. But some patients may have very nonspecific symptoms related to fatigue and discomfort on the right side of the abdomen. Often, symptoms that lead to a diagnosis of hepatitis C are noticeable only at the end stage of liver disease, when the patient has developed liver cirrhosis and liver failure.
Because hepatitis B and C typically have no specific symptoms, many people who have the viruses dont even know it.
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What Is The Treatment For Hepatitis B
There are no special medicines or antibiotics that can be used to treat a person that is acutely infected once the symptoms appear. Generally, bed rest is all that is needed. Interferon is the most effective treatment for chronic HBV infection and is successful in 25 to 50 percent of cases. Chronic carriers of HBV should avoid drinking alcohol or taking medications which are harmful to the liver, as these actions can make the liver disease worse.
Symptoms Of Hepatitis B
Some people who are infected with the hepatitis B virus have mild, flu-like symptoms and some do not become sick at all. Children who are infected are less likely to have an illness or get sick after getting hepatitis B than adults.
In more severe cases, hepatitis B can cause:
- Loss of appetite.
- Pain in the joints.
Normally, these health problems disappear in a few weeks, but even when the person feels much better, they may still be infectious.
Most adults who become infected with the hepatitis B virus recover completely and do not become infected again. A few people become very ill in the time just after infection and need to go to hospital some may even die.
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Are Hepatitis B And C Preventable
Hepatitis B is a vaccine-preventable disease.
There is a three-shot vaccination series that is very effective in protecting people against the virus if theyre exposed. In the United States, all newborns are vaccinated for hepatitis B and all pregnant women are screened for hepatitis B during pregnancy. This way, mothers infected with hepatitis B can take protective steps to decrease the risk of transmission of the virus to the child.
There is no vaccine for hepatitis C.
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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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.
What Makes Yale Medicine’s 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.
“Our 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,” 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 .
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What Precautions Should Hepatitis B Carriers Take
Chronic hepatitis B carriers should follow standard hygienic practices to ensure that close contacts are not directly contaminated by his or her blood or other body fluids. Carriers must not share razors, toothbrushes or any other object that may become contaminated with blood. In addition, susceptible household members, particularly sexual partners, should be immunized with hepatitis B vaccine. It is important for carriers to inform their dentist and health care providers.