Hepatitis B: Symptoms, Causes, Treatment

What are the symptoms of hepatitis B?

Hepatitis B can vary widely in its presentation, ranging from mild symptoms to severe illness. Common symptoms include:

1. Fatigue: Feeling unusually tired or exhausted.
2. Jaundice: Yellowing of the skin and eyes.
3. Abdominal pain: Discomfort or pain in the upper right side of the abdomen.
4. Loss of appetite: Reduced desire to eat.
5. Nausea and vomiting: Feeling sick to your stomach and possibly vomiting.
6. Joint pain: Pain or stiffness in the joints.
7. Dark urine: Urine that is darker than usual.
8. Clay-colored stools: Pale or clay-colored stools.
9. Fever: Low-grade fever.
10. Symptoms of chronic infection: In some cases, hepatitis B can become chronic without showing symptoms initially but may lead to liver damage over time.

It’s important to note that not everyone with hepatitis B will experience symptoms, especially in the early stages of infection. If you suspect you’ve been exposed to hepatitis B or are experiencing symptoms, it’s crucial to seek medical evaluation and testing promptly.

What are the causes of hepatitis B?

Hepatitis B is caused by the hepatitis B virus (HBV), which is transmitted through exposure to infectious body fluids. Common modes of transmission include:

1. Mother-to-Child Transmission: During childbirth, an infected mother can pass the virus to her baby.
2. Sexual Transmission: Unprotected sex with an infected person can spread the virus.
3. Blood-to-Blood Contact: Sharing needles, syringes, or other drug-injection equipment with someone who has hepatitis B.
4. Occupational Exposure: Healthcare workers and others who are exposed to blood may acquire the virus through needle-stick injuries or other exposures.
5. Household Transmission: Sharing items such as razors or toothbrushes that might be contaminated with infectious blood.
6. Blood Transfusions and Organ Transplants: Receiving blood, blood products, or organs from an infected donor (although this is rare in countries with rigorous screening processes).

The hepatitis B virus is highly contagious and can survive outside the body for at least 7 days, making it relatively easy to spread through these routes. Vaccination is the most effective way to prevent hepatitis B infection.

How is the diagnosis of hepatitis B made?

The diagnosis of hepatitis B is made through a combination of clinical evaluation, medical history, and laboratory tests. The key tests used to diagnose hepatitis B include:

1. Hepatitis B Surface Antigen (HBsAg): The presence of HBsAg in the blood indicates an active hepatitis B infection. If HBsAg is present for more than six months, it typically indicates a chronic infection.
2. Hepatitis B Surface Antibody (anti-HBs): This antibody indicates recovery and immunity from hepatitis B infection or a successful response to the hepatitis B vaccine.
3. Hepatitis B Core Antibody (anti-HBc): This antibody appears at the onset of acute hepatitis B and persists for life. The presence of anti-HBc indicates a previous or ongoing infection with hepatitis B.
4. Hepatitis B e Antigen (HBeAg): The presence of HBeAg suggests that the virus is actively replicating, and the infected person has a higher level of the virus in their blood and is more infectious.
5. Hepatitis B Virus DNA (HBV DNA): This test measures the amount of hepatitis B virus DNA in the blood, indicating how actively the virus is replicating.
6. Liver Function Tests (LFTs): These tests measure the levels of liver enzymes and other substances in the blood to assess liver function and damage.
7. Liver Biopsy: In some cases, a liver biopsy may be performed to evaluate the extent of liver damage caused by the virus.

The combination of these tests helps to determine the presence of the hepatitis B virus, the stage of the infection (acute or chronic), and the level of liver involvement or damage. If you suspect you have been exposed to hepatitis B or are experiencing symptoms, it is crucial to seek medical evaluation and testing.

What is the treatment for hepatitis B?

The treatment for hepatitis B depends on the stage of the infection and the individual’s overall health. Here are some common treatments for hepatitis B:

Acute Hepatitis B:

• Rest and good nutrition to help the body fight the infection
• Antiviral medications, such as lamivudine (Epivir) or tenofovir (Viread), may be prescribed to shorten the duration of the illness and reduce the risk of chronic infection
• Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be used to manage symptoms such as fever, headache, and fatigue

Chronic Hepatitis B:

• Antiviral medications, such as:
  • Nucleoside analogues (e.g., lamivudine, emtricitabine, telbivudine)
  • Nucleotide analogues (e.g., tenofovir, adefovir)
  • Pegylated interferon alfa (PegIntron) or peginterferon alpha-2a (PegIntron)
• Combination therapy with multiple antiviral medications may be used to reduce the risk of drug resistance and improve treatment outcomes
• Lamivudine or telbivudine may be used to treat pregnant women with chronic hepatitis B

Chronic Hepatitis B with Liver Damage:

• Antiviral medications as above
• Liver transplantation may be necessary in severe cases of liver damage

Other Treatments:

• Immune globulin therapy may be used to prevent hepatitis B infection in newborns born to mothers with hepatitis B
• Hepatitis B vaccine is recommended for people who have not been previously infected or vaccinated against hepatitis B
• Lamivudine or telbivudine may be used as prophylaxis in individuals who have had a previous episode of acute hepatitis B

It’s important to note that there is no cure for hepatitis B, but antiviral medications can help manage the infection and reduce the risk of complications. Treatment is typically individualized based on the severity of the infection, liver damage, and other factors. It’s essential to work closely with a healthcare provider to determine the best course of treatment.