Hepatitis B Overview
Hepatitis is a general term that means inflammation of the liver. The liver can become inflamed because of infection, a disorder of the immune system, or exposure to alcohol, certain medications, toxins, or poisons. The most common serious liver infection in the world, Hepatitis B is caused by infection with the hepatitis B virus (HBV). HBV is transmitted when blood, semen, or another body fluid from a person infected with the virus enters the body of someone who is uninfected.
About 90-95 percent of people who are infected can fight off the virus, so their infection never becomes chronic. People with chronic HBV infection are called chronic carriers. About two-thirds of these people do not get sick, but they can transmit it to other people. The remaining one third develop chronic hepatitis B, a disease of the liver that can be very serious.
HBV is a significant public health issue for veterans, with higher prevalence rates than the general population. (Chronic HBV is present in up to 1% of veterans.) More research is needed on potential military contributors to HBV, especially those related to combat exposure, blood transfusions, or travel to regions where the hepatitis B virus occurs at a high rate.
Hepatitis B Phases
- Acute (new, short-term) hepatitis B occurs shortly after exposure to the virus. A small number of people develop a very severe, life-threatening form of acute hepatitis called fulminant hepatitis.
- Chronic (ongoing, long-term) hepatitis B is an infection with HBV that lasts longer than 6 months. Once the infection becomes chronic, it may never go away completely.
Hepatitis B Signs and Symptoms
- Dark urine or clay-colored stools
- Feeling tired
- Fever
- Joint pain
- Loss of appetite
- Nausea, stomach pain, throwing up
- Yellow skin or eyes (jaundice)
Hepatitis B Risk Factors
HBV can be transmitted through:
- Birth from a person infected with HBV.
- Sex with a person infected with HBV.
- Sharing equipment that has been contaminated with blood from a person infected with HBV, such as needles, syringes, and even medical equipment, such as glucose monitors.
- Sharing personal items, such as toothbrushes or razors, though less common.
- Direct contact with the blood or open sores of a person who has hepatitis B.
- Poor infection control in health care facilities.
Hepatitis B Long-Term Risks
About 15-25 percent of people with chronic hepatitis B die of some type of liver disease. Possible long-term effects of chronic hepatitis B include:
- Cirrhosis — condition traditionally associated with alcoholism; liver becomes hardened with scar tissue
- Hepatocellular carcinoma — type of liver cancer
- Liver Failure — the liver can no longer carry out its normal functions; only treatment is liver transplant.
Hepatitis B Treatment
Once a person has developed chronic hepatitis B, few treatment options exist. In some cases–especially if one doesn’t have signs and symptoms or liver damage–a doctor may suggest monitoring, rather than treating the condition. In other cases, the doctor may recommend treatment with antiviral medications. When liver damage is severe, liver transplantation may be the only option. The encouraging news is transplants are increasingly successful. Unfortunately, not enough donor organs are available for every person who needs a transplant.
Current drug treatments for chronic HBV infection:
- Interferon — body naturally produces interferon to help protect against invading organisms such as viruses. Taking additional interferon that has been made in a laboratory may stimulate the body’s immune response to HBV; side effects include depression, fatigue, muscle pains, body aches, fever, and nausea.
- Telbivudine (Tyzeka) — antiviral medication that helps prevent HBV from replicating in the cells.
- Entecavir (Baraclude) — antiviral medication; studies comparing Baraclude with lamivudine found Baraclude more effective; Baraclude may cause worsening of symptoms when drug is stopped.
- Lamivudine (Epivir-HBV) — older antiviral medication like telbivudine, though slightly less strong; minimal side effects during treatment, but may experience severe worsening of symptoms when stops taking the drug; can also cause a drug-resistant form of HBV.
- Adefovir dipivoxil (Hepsera) — helps prevent HBV from replicating in the cells. Hepsera may cause kidney problems.
Hepatitis B Vaccines
The best way to prevent hepatitis B is by getting vaccinated. You need to get all shots in the series to be fully protected.
Other Resources And Support
https://www.cdc.gov/hepatitis-b/about/
https://www.cdc.gov/hepatitis-b/vaccination/index.html
https://www.cdc.gov/hepatitis-b/testing/index.html
https://www.cdc.gov/hepatitis-b/public-resources/index.html
https://www.research.va.gov/currents/1119-Combat-a-possible-risk-factor-for-hepatitis-B.cfm