Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV) that can potentially be fatal. It poses a significant global health concern, leading to chronic infections and increasing the risk of death from cirrhosis and liver cancer.
Fortunately, there is a safe and effective vaccine available that provides 90% to 100% protection against hepatitis B. By preventing hepatitis B infection, we can avoid the development of complications such as chronic disease and liver cancer.
Children who contract the infection are more likely to develop chronic hepatitis B. Chronic infection can progress to cirrhosis or liver failure.
TRANSMISSION
Transmission of hepatitis B occurs through needlestick injuries, tattooing, piercing, and exposure to infected blood and body fluids like saliva, menstrual fluid, vaginal fluid, and semen. The virus can also spread through the reuse of contaminated needles, syringes, or sharp objects in healthcare settings, the community, or among individuals who inject drugs. Sexual transmission is more common in unvaccinated individuals with multiple partners. Additionally, hepatitis B can be transmitted from an infected mother to her child at birth (perinatal transmission) or through horizontal transmission (exposure to infected blood), particularly from an infected child to an uninfected child during the first five years of life.
SYMPTOMS
Symptoms of acute hepatitis B may not be apparent in most newly infected individuals. It can take 30 to 180 days for symptoms to manifest. However, some people experience acute illness with symptoms lasting several weeks, including jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, vomiting, abdominal pain, loss of appetite, fever, weakness, fatigue, and joint pain. Acute hepatitis can progress to acute liver failure, which can be fatal. In the long term, certain individuals with HBV infections develop advanced liver diseases like cirrhosis and hepatocellular carcinoma, which have high morbidity and mortality rates.
DIAGNOSIS
Diagnosing hepatitis B based solely on clinical grounds is not possible, so laboratory confirmation of the diagnosis is essential. Several blood tests are available to diagnose and monitor hepatitis B, distinguishing between acute and chronic infections. Screening tests such as HBSag, HBV panel, LFT, PT, and associated tests can be conducted, but a definitive test to determine the extent of liver damage is a costly liver biopsy.
TREATMENT
There is no specific treatment for acute hepatitis B, so care focuses on providing comfort and restoring fluid balance, including replacing fluids lost from vomiting and diarrhea. It is crucial to avoid unnecessary medications, such as acetaminophen, paracetamol, and anti-vomiting drugs.
Chronic hepatitis B infection can be managed with medications, including oral antiviral agents. Treatment aims to slow the progression of cirrhosis, reduce the incidence of liver cancer, and improve long-term survival. The World Health Organization (WHO) recommends the use of oral treatments like tenofovir or entecavir as potent drugs to suppress the hepatitis B virus. Most individuals who begin hepatitis B treatment need to continue it for life.
PREVENTION
Prevention is key in combating hepatitis B. WHO recommends that all infants receive the hepatitis B vaccine within 24 hours of birth, followed by 2 or 3 additional doses at least 4 weeks apart to complete the vaccination series. The protection from the vaccine lasts for at least 20 years and is likely lifelong. WHO does not recommend booster vaccinations for individuals who have completed the 3-dose vaccination schedule. Implementing blood safety strategies and practicing safer sex, such as reducing the number of sexual partners and using barrier protective measures like condoms, also help prevent transmission of the viruses.
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