Hepatitis B is a viral infection that targets the liver, causing inflammation and potentially severe damage. It is a significant global public health concern, affecting millions. The virus can cause both short-term, acute illness and long-term, chronic disease, which can have serious health consequences.
How Hepatitis B is Contracted and Its Signs
The hepatitis B virus (HBV) primarily spreads through contact with infected blood, semen, or other bodily fluids. Common transmission routes include perinatal transmission from an infected mother to her newborn. Transmission can also occur through sexual contact, sharing contaminated needles or unsterile medical equipment, tattoos, or piercings. Hepatitis B is not transmitted casually through coughing, sneezing, hugging, or sharing food.
Symptoms of acute hepatitis B, a short-term illness, can vary widely. Some individuals experience no symptoms, especially young children. When symptoms do appear, they can include fatigue, nausea, vomiting, dark urine, abdominal pain, and jaundice (yellowing of the skin and eyes).
For many adults, the immune system clears the virus within six months, leading to full recovery and lifelong immunity. However, infection in infancy or early childhood can become chronic, lasting longer than six months. Chronic hepatitis B often presents with no symptoms for long periods, making it difficult to know one is infected. When symptoms do manifest, they can indicate more advanced liver disease.
Identifying and Treating Hepatitis B
Diagnosing hepatitis B infection involves blood tests that detect viral antigens and antibodies. The Hepatitis B surface antigen (HBsAg) indicates a current HBV infection; if positive for more than six months, it signifies a chronic infection. The Hepatitis B surface antibody (anti-HBs) indicates protection against the virus, either from vaccination or recovery from a past infection. The Hepatitis B e-antigen (HBeAg) signifies active viral replication and a high level of contagiousness.
Additional tests like the Hepatitis B core antibody (anti-HBc) and HBV DNA quantification measure the amount of virus in the blood. These markers help determine if the infection is acute or chronic, assess viral activity, and monitor liver damage. Regular blood tests for liver function also provide insights into liver health.
Treatment approaches vary depending on whether the infection is acute or chronic. For acute hepatitis B, there is no specific antiviral medication; treatment focuses on supportive care to manage symptoms. Most adults with acute infection recover spontaneously.
Chronic hepatitis B often requires long-term management with antiviral medications. These medications suppress the virus, reducing viral replication and minimizing liver damage. While antivirals can reduce the risk of complications like cirrhosis and liver cancer, they typically do not cure the infection, meaning many individuals need to take them for life. Regular monitoring through blood tests and liver imaging is important to assess treatment effectiveness and detect any progression of liver disease.
Strategies for Prevention and Chronic Hepatitis B
Prevention of hepatitis B is primarily achieved through vaccination, a safe and highly effective measure. The hepatitis B vaccine provides substantial protection against the virus. Vaccination is recommended for all infants, children, adolescents, and adults at higher risk of exposure.
Beyond vaccination, other preventive measures limit the spread of HBV. These include practicing safe sex, avoiding sharing needles or drug injection equipment, and ensuring sterile equipment for tattoos, piercings, and in healthcare settings. Pregnant individuals are routinely screened for hepatitis B to prevent mother-to-child transmission.
For individuals living with chronic hepatitis B, proper management improves long-term health outcomes. While chronic infection can lead to serious liver conditions like cirrhosis and liver cancer, consistent medical care mitigates these risks. Regular follow-up with a liver specialist monitors liver health, assesses the need for antiviral therapy, and manages complications. Adopting a healthy lifestyle, including avoiding alcohol and maintaining a balanced diet, also supports liver health.