Hepatitis B

Hepatitis refers to inflammation of the liver which can lead to serious conditions. Hepatitis A, B and C are most common. However, Hepatitis B is of significant importance here due to high rate of prevalence and greater risk of transmission through sexual activity. Hepatitis B Virus (HBV) can be short lived and acute or it can be chronic and potentially fatal.

About 50 million people in India are infected with hepatitis B,even though the infection is highly preventable.

Moreover, men who have sex with men (MSM) are at a greater risk of contracting HBV due to risk behavior patterns. In fact 20% of new Hepatitis B cases occur in MSM as per Centre for disease control and prevention

How is HBV spread?

Hepatitis B is transmitted when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. HBV is transmitted through

·         Sex with an infected partner

·         Injection drug use that involves sharing needles, syringes, or drug-preparation equipment

·         Contact with blood or open sores of an infected person

·         Sharing items such as razors or toothbrushes with an infected person

·         From a mother to her child at the time of pregnancy or childbirth

HBV is not spread through food or water, sharing utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing

What are the signs and symptoms of HBV infection?

HBV generally develops in two stages:

Acute HBV infection: This stage may last up to 6 months after acquiring the infection. Newly acquired (acute) HBV infections only cause symptoms some of the time. Young children usually do not show any symptoms even when they are infected. When present, signs and symptoms of acute HBV infections can include

·         Fever

·         Fatigue

·         Loss of appetite

·         Nausea

·         Vomiting

·         Abdominal pain

·         Dark urine

·         Clay-colored bowel movements

·         Joint pain

·         Jaundice

Chronic HBV: Some acute infections resolve on their own, but some may develop into a chronic infection. This happens when the immune system fails to fight the infection in its acute stage. Chronic hepatitis may be asymptomatic. However, it can also result in fatal conditions discussed below.

What are the complications of HBV?

Acute HBV may result in mild illnesses as mentioned above. However, if it remains unresolved it may turn into Chronic HBV. Chronic HBV infection is not curable, although it’s manageable. Chronic infection can take the form of cirrhosis or liver cancer and can be potentially fatal. A majority of infected people remain asymptomatic until the onset of cirrhosis or end stage liver cancer. Chronic HBV is the 2nd largest cause of liver cancer worldwide

How likely is HBV infection to become chronic?

The risk for chronic infection varies according to the age at infection and is greatest among young children. Approximately 90% of infants and 25%–50% of children aged 1–5 years will remain chronically infected with HBV. By contrast, approximately 95% of adults recover completely from HBV infection and do not become chronically infected

Who is at risk for HBV infection?

The following populations are at increased risk of becoming infected with HBV:

·         Infants born to infected mothers

·         Sex partners of infected persons

·         Men who have sex with men

·         Injection drug users

·         Household contacts or sexual partners of known persons with chronic HBV infection

·         Health care and public safety workers at risk for occupational exposure to blood or blood-contaminated body fluids, and

·         Hemodialysis patients

How is HBV treated?

HBV cannot be cured through medication. In its acute stage it may resolve on its own. Unresolved HBV can, however, be controlled through use of approved drugs.

Current treatments for hepatitis B fall into two general categories:  

·         Immune modulator Drugs – These are interferon-type drugs that boost the immune system to help get rid of the hepatitis B virus. They are given as a shot (similar to how insulin is given to people with diabetes) over 6 months to 1 year.

·         Antiviral Drugs – These are drugs that stop or slow down the hepatitis B virus from reproducing, which reduces the inflammation and damage of your liver. These are taken as a pill once a day for at least 1 year and usually longer.

It is important to know that not everyone with chronic hepatitis B infection needs to be treated. So one must talk to the health care provider about whether you are a good candidate for any of the approved drugs. 

How can HBV be prevented?

HBV can be prevented through vaccination.

The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. The hepatitis B vaccine is also recommended for adults living with diabetes and those at high risk for infection due to their jobs, lifestyle, living situations, or country of birth. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease.

The hepatitis B vaccine is also known as the first “anti-cancer” vaccine because it prevents hepatitis B, the leading cause of liver cancer worldwide.

References:

https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm

https://www.cdc.gov/hepatitis/populations/msm.htm

http://www.hepb.org/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606974/

https://www.mayoclinic.org/diseases-conditions/hepatitis-b/symptoms-causes/syc-20366802

https://www.stdcheck.com/hepatitis-b.php