Chronic hepatitis B

Overview – Chronic hepatitis B is when infection with the hepatitis B virus lasts more than 6 months.

Most people with hepatitis B infection recover completely in a few months clearing hepatitis B from the body. In some, the infection lingers because the body’s immune system can’t fight off the infection. Chronic hepatitis B infection may last a lifetime, possibly leading to serious diseases such as cirrhosis and liver cancer.

Hepatitis B infection spreads through contact with body fluids (blood, semen, breast milk). The modes of transmission are having unprotected sex with someone who’s infected with HBV, sharing needles, infant born to an infected mother, accidental needlestick injuries in health care workers.

A vaccine can prevent infection with the hepatitis B virus, but there’s no cure if you have the condition.

Symptoms and signs

  • Some people usually young children may not have any symptoms. In those who have symptoms, the symptoms may vary from mild to severe.
  • Hepatitis B signs and symptoms include
  • Yellowing of your skin and the whites of your eyes (jaundice)
  • Dark urine
  • Joint pain
  • Loss of appetite
  • Fever
  • Weakness
  • Abdominal pain
  • Nausea and vomiting

Complications

  • Scarring of the liver tissue leading to cirrhosis of the liver.
  • There is an increased risk of liver cancer.
  • The vital functions of the liver are impaired leading to liver failure.
  • Inflammation of blood vessels and kidney disease are conditions that may develop in people with chronic hepatitis B infection.

Diagnosis

  • Blood tests can detect hepatitis B infection, acute infection versus chronic infection.
  • Liver ultrasound to find out the amount of damage to the liver.
  • Liver biopsy to analyze the tissue sample.

Screening

  • Screening is done in asymptomatic people who are at high risk of having been exposed to the hepatitis B virus. Those who are at high risk are –
  • Persons born in countries with a high prevalence of hepatitis B infection
  • Pregnant women
  • In people who require immunosuppressive therapy
  • Organ, plasma, semen, blood, tissue donors
  • Infants born to hepatitis B virus-infected mothers
  • Persons born in the United States but whose parents were born in regions with a high prevalence of hepatitis B infection
  • Persons with HIV or hepatitis C virus
  • Persons who have a history of injecting drugs
  • Men who have sex with men
  • People with multiple sexual partners and/or a history of sexually transmitted diseases
  • People with end-stage kidney disease
  • Household and sexual contacts of hepatitis B virus-infected persons
  • Inmates of correctional facilities
  • People with chronic liver disease (eg, cirrhosis, fatty liver disease, autoimmune liver disease)

Lifestyle management

  • Follow a healthy diet and exercise program recommended by your doctor.
  • Do not have unprotected sex. Use barrier methods of contraception to reduce the risk of transmission. You should tell your partner if you have an infection with the hepatitis B virus. Your partner also needs to be tested for the infection.
  • Do not share needles, syringes, razor blades, or toothbrushes with anyone.
  • If you are pregnant and have an infection with the hepatitis B virus than talk to your doctor about the best preventive treatment to reduce the risk of newborn infection in utero, at the time of birth, or after birth.
  • If you have been exposed to infection and are not sure if you have been vaccinated, call your doctor immediately. Hepatitis B vaccine and/or HBIG (hepatitis B immune globulin), given within 12 hours of exposure to the virus may help protect you from getting sick with hepatitis B.

Medical management

  • People with chronic hepatitis B need treatment for the rest of their lives to reduce the risk of complications and to prevent passing the infection to others.
  • Antiviral medications are given to fight the virus. The antiviral medications that are used are entecavir, tenofovir, lamivudine, adefovir, and telbivudine.
  • Interferon alfa-2b is generally given to young people who wish to avoid long-term treatment. Interferon should not be used during pregnancy.
  • A liver transplant is an option if the liver is severely damaged.

 

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