Watchman Medical Professionals Forum

If you’ve been saying "I have heard of hepatitis B but I don't know what it is all about", then this piece is for you. In this blog post, we’ll discuss what Hepatitis B is, how one can get infected, and then, we’ll wrap up with treatment and prevention information. Take a seat as you read through.

What Is Hepatitis B And How Does It Affect The Liver?

Hepatitis B is the most common liver infection in the world [1]. It is caused by hepatitis B virus. This virus attacks the cells of the liver, leading to inflammation [2]. Someone may ask how the virus gets to the liver. Hepatitis B virus is transmitted through infected blood and bodily fluids via the following routes:

Direct blood to blood contact (like blood transfusion)
Unprotected sex with an infested person
Illegal drug use (with needles)
From an infected mother to her newborn due to blood exchange during pregnancy or child birth.
Tattoos or piercings
Sharing sharps (Needles, syringes etc)

The Global Impact Of HBV (Why it remains a public health priority even now)

Hepatitis B and C have led to chronic (longstanding) disease in hundreds of millions of people and together are the most common causes of death from liver disease and cancer. An estimated 304million people worldwide live with hepatitis B or C, and in fact, there are projections that by 2030, 2.1 million people will die from hepatitis B [2].

What’s interesting is that these terrible outcomes can be largely preventable through hepatitis B vaccination, testing and treatment for hepatitis B and C, and targeted public education campaigns to raise awareness and reduce transmission.

Forms of Hepatitis B Infection: Acute vs. Chronic

Hepatitis B infection can result in either an acute infection or a chronic infection. Acute hepatitis B is a short term illness that occurs within the first 6 months after exposure to hepatitis B virus. Some people with acute hepatitis B have mild to no symptoms while for others, acute hepatitis B can cause a more severe illness that requires hospitalization.

Acute Hepatitis B can lead to a lifelong infection known as chronic hepatitis B and if left untreated chronic hepatitis can cause serious health problems, including liver damage, cirrhosis, liver cancer and even death [3].

What Are The Symptoms Of Hepatitis B?

Most people with Hepatitis B infection have no symptoms. However, if you do get symptoms, it could range anywhere from [4]:

Fever
Weakness
Vomiting
Fever, fatigue, muscle or joint pain
Yellowish discolouration of skin and eyes
Darker than normal urine
Pale-looking faeces
Abdominal pain

Prevention With Hepatitis B vaccination

How Hepatitis B vaccine works and its efficacy rate.

Hepatitis B vaccine protects you from the hepatitis B virus by causing your body to produce its own protection (antibodies) against the disease.

WHO recommends that all infants receive the complete series of hepatitis B vaccines. This includes: one dose at birth (preferably within 24 hours) and 2 or 3 doses to complete the primary series, depending on different vaccine schedules. The Hepatitis B vaccine effectively prevents mother-to-child transmission. The complete vaccine induces immunity (protection) that lasts at least 20 years and possibly for life [5]. In addition, all children aged less than 18 years who have not previously received the hepatitis B vaccine should receive it if available so as to prevent liver cancer [6].

2. Who should get the hepatitis B vaccine?

The following groups are more likely to be exposed to the hepatitis B virus and require vaccination [6,7]:

a) Healthcare and public safety workers at risk for exposure to blood

b) Infants born to mothers who are living with hepatitis B

c) Susceptible sexual partners of people with hepatitis B infection

d) Sexually active persons who are not in a long-term, mutually monogamous relationship

e) Susceptible household contacts of people with hepatitis B infection

f) Persons with end-stage renal disease, including pre-dialysis and home dialysis patients

g) Persons with chronic liver disease

h) People with current drug use

i) People with HIV, hepatitis C

j) People with Diabetes

3. Common myths vs facts about the hepatitis B vaccine

Myth: Hepatitis B can spread by sharing food

Fact: Hepatitis B is not spread by sharing food, sharing utensils, hugging, holding hands, coughing or sneezing but rather through contact with infected blood or bodily fluids. You’re at risk of getting the virus if you share sharps or personal items, such as needles, syringes, toothbrushes, razors or sex toys [8].

Myth: I don't have any symptoms, so I don't need to get tested for hepatitis B vaccine

Fact: Hepatitis B often has no symptoms and can slowly cause health problems. The only way to know if you have hepatitis B is to get tested.

Myth: I have chronic hepatitis B, I won't live a long and healthy life

Fact: Whilst being diagnosed with chronic hepatitis B can feel scary, it's important to remember that people with chronic hepatitis B live long and healthy lives. Hepatitis B is an easily managed condition if you have regular check ups with your doctor.

Myth: I have chronic hepatitis B but I'm a " healthy carrier", so my liver can't be damaged.

Fact: There’s no such thing as a "healthy carrier". Sometimes, hepatitis B won't cause damage to the liver for a long time, but this can change quickly. So even if you feel healthy, the virus could be damaging your liver.

Myth: I have chronic hepatitis B so I can't safely have sex.

Fact: People living with chronic hepatitis B can have safe sex if their sexual partners are vaccinated for hepatitis B. This way, their partners will be protected from getting hepatitis B.

Beyond The Needle: Other Safe Practices To Prevent Hepatitis B Infection

Practice safe sex
Effectively and safely discard sharps after use
Wash your hands thoroughly after contact with blood and bodily fluids
Don’t share sharps; get yours.
Cover any open wounds or sores to prevent infection

What To Expect During A Hepatitis B Blood Test

Here's an easy interpretation guide for the result you might receive after a screening test:

a) Positive HBsAg (Hepatitis B surface antigen): Indicates that a person is infected with hepatitis B

b) Positive anti-HBs or HBsAb (Hepatitis B surface antibody): Indicates that a person is protected against the hepatitis B virus.

c) Positive anti-HBc or HBcAb (Hepatitis B core antibody): Indicates that a person has been exposed to the hepatitis B virus at some point during their life.

Wrapping It All Up

The best way to prevent getting infected with hepatitis B virus is by vaccination. Prior to receiving the vaccine, you should get screened to know your status even if you don’t feel ill. Early screening/ early diagnosis means that you can begin treatment, if needed, sooner and prevent liver cirrhosis or cancer from occurring.

FAQs

1.How long does the hepatitis B vaccine last?

Hepatitis B vaccine when taken appropriately (complete dose) protects one against hepatitis B for a lifetime.

2.How can I protect myself from hepatitis B?

Hepatitis B vaccination is a safe and effective way to protect yourself from hepatitis B in addition to practicing safe sex and avoiding sharps sharing.

3.Can hepatitis B be cured if detected early?

There is no cure or medication that totally eliminates the virus or makes HBsAg negative but there are drugs that control and manage the virus to reduce potential liver damage. As the virus is suppressed, the liver is better able to healing and in rare cases they may even get rid of the virus.

4.What should I do if I have been exposed to hepatitis B?

For unvaccinated individuals who think they have been exposed to hepatitis B, it is recommended that they speak to their doctor about "post exposure prophylaxis" as soon as possible, especially if the source of exposure is known to be positive for hepatitis B.

References

Hepatitis B Foundation - What is Hepatitis B
WHO - Hepatitis B
Hepatitis B Foundation - Acute Vs. Chronic Hepatitis B
NHS - Hepatitis B
WHO - Vaccines for Hepatitis A, B and E
Hepatitis B Foundation - Vaccine for Hepatitis B
NHS - Hepatitis B Vaccine
British Liver Trust - How is Hepatitis B passed on and who is at risk?