July 2008, Hepatitis B by Dr Gonzalez

Hepatitis B is a liver infection caused by the hepatitis B virus. Chronic hepatitis B is a long-term infection of the liver that can sometimes develop after a bout of an acute or short term, hepatitis B.

The virus that causes hepatitis B is spread through contact with infected blood or other body fluids of people who have hepatitis B. For example, you can get hepatitis B by having unprotected sex with an infected person

People who use intravenous drugs can get hepatitis B when they share needles with someone who has the virus. Health care workers, such as nurses, lab technicians and doctors can get these infections if they are accidentally pricked with a needle that was used on an infected patient.

Pregnant women who are infected with hepatitis B can also pass the virus on to their babies. Hepatitis B cannot be transmitted through casual contact. For example, you cannot get hepatitis B by hugging or shaking hands with someone who is infected.

When you are having symptoms for the first time, this is called acute hepatitis. Acute hepatitis lasts 6 weeks or less. Most people recover from the infection and have no long-lasting problems.

Hepatitis B can become an illness that lasts a long time. This is called chronic hepatitis B. It lasts six months or longer. Chronic hepatitis occurs when the liver has been damaged from the acute illness and cannot recover. Chronic hepatitis develops in 10% to 20% of people who have hepatitis B.

People with chronic hepatitis B may not have any symptoms at all. In some people, chronic hepatitis can lead to cirrhosis of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The damaged areas of the liver stop working and cannot cleanse the body of wastes. The early stages of cirrhosis may not have symptoms, but the following symptoms may arise as cirrhosis gets worse and more of the liver is damaged:

Cirrhosis can lead to liver failure and even liver cancer.If you have hepatitis B, you are also susceptible to hepatitis D (also called “Delta agent). Hepatitis D can only develop in people who already have hepatitis B. It can make your symptoms of hepatitis B or liver disease worse. It is spread through contact with infected blood or other body fluids of people who have hepatitis D.

The time between the acute illness and signs of chronic hepatitis B varies. It may take a short time, or it may be years after the acute infection before chronic hepatitis B develops.

If you have chronic hepatitis B, your family physician will probably refer you to a gastroenterologist or other subspecialist that treats people with chronic liver problems. There are a number of medical treatments available that are often successful. These include Interferon alfa-2b and other antiviral medicines. Treatment may take a year or more, depending on the severity of the infection and the response to treatment.

The best way to prevent hepatitis B is to have protected sex (use a condom) and to avoid sharing needles.A vaccine is available to prevent hepatitis B. It is now routinely given in the first year of life to all newborn infants. It is safe and requires 3 shots over a 6-month period. This vaccine should be given to people who are at high risk for this illness, such as health care workers, all children, drug users, people who get tattoos or body piercing, and those with multiple sex partners.