What Is Hepatitis B?
Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). There are other hepatitis viruses (A, C, D, E) that may behave and be transmitted differently. HBV causes swelling and inflammation of the liver that prevents its normal function. HBV can cause a short-term, acute illness that lasts up to a few months. It can also cause a lifelong illness, which more commonly develops in children.
Since many people may not have symptoms or do not realize they are infected, their illness is often not diagnosed. Presenting symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, and dark urine among others.
Treatment is much like that for a regular infection, with plenty of rest, fluids, and adequate nutrition provided at home or from a medical team in more severe cases. Hepatitis B can be prevented by a variety of measures.
You should visit your primary care physician. Hepatitis B infection, if confirmed by a blood test, is treated with prescription antiviral medication.
How common is Hepatitis B?
Hepatitis B Symptoms
According to the Centers for Disease Control and Prevention (CDC), in 2016, more than 3000 cases of acute hepatitis B were reported in the USA. Just 30 to 50 percent of adults who contract hepatitis B experience symptoms, and many people infected with hepatitis B virus do not realize they are infected, and therefore commonly not reported. The CDC estimates the actual number of acute hepatitis B cases was almost 21,000 in 2016 [1,2].
These symptoms can appear from eight weeks to five months after initial exposure to the virus. The average time from exposure to onset is three months. It is important visit your healthcare professional immediately if there is any suspicion of infection. This is also important because the virus can still be unknowingly transmitted to others. Symptoms of acute hepatitis B include:
- Loss of appetite
- Abdominal pain
- Dark urine
- Clay-colored bowel movements
- Joint pain
- Jaundice: This is yellow coloring of the skin or eyes.
Developing the lifelong form
In the acute form of HBV, symptoms usually last several weeks, but can last as long as six months. About 95 percent of adults exposed to HBV have the acute form, while the remaining 5 percent develop the lifelong form. In children, the statistics are reversed; 95 percent of children will develop the lifelong form of hepatitis B, while just 5 percent will have the acute form of the infection .
Hepatitis B Causes
Hepatitis B is caused by a variety of factors that contribute to its spread. However, it is important to also understand how HBV is not spread. Certain individuals do have characteristics that place them at a higher risk of developing HBV.
How HBV is spread
Hepatitis B results when the hepatitis B virus enters the bloodstream. The only way to become infected is to be exposed to blood, semen or other body fluid that is infected. People can become infected from the virus via:
- Birth: Spread can occur an infected mother to her baby during birth
- Sex with an infected partner
- Sharing needles or syringes with an infected person
- Sharing items: This includes toothbrushes, razors or other medical equipment that accesses the bloodstream (a glucose stick, for example) with an infected person
- Direct contact: Spread can occur from touching blood or open sores of an infected person
- Exposure to blood: Spread can occur from needlesticks or other sharp instruments of an infected person
How HBV is not spread
The common thread among the causes above is that they involve contact/transmission of body fluids. Hepatitis B virus is not spread via airborne transmission or contact transmission if there is no blood contact involved. For example, hepatitis B virus is not spread via:
- Food or water
- Sharing eating utensils
- Hand holding
Who is most likely to be affected
Given the ways that HBV is spread from person-to-person, there are specific populations that are at a greater risk for contracting the disease even though anyone can get HBV. These populations include:
- Infants born to infected mothers
- People who inject drugs or share needles, syringes, or other drug equipment
- Sex partners of people with HBV
- Men who have sexual contact with men
- People who live with a person who has HBV
- Healthcare and public safety workers exposed to blood
- Hemodialysis patients
Treatment Options and Prevention for Hepatitis B
Treatment options include methods of testing and methods to restore fluid and nutrition levels as well as hospitalization, if necessary. There are also important preventative methods that are highly effective [3-5].
The first step to treating or preventing HBV infection is to see a doctor for testing. A blood test can help to tell whether you have immunity, or an acute or chronic hepatitis B infection.
Restoring fluids and nutrition
There is no curative medication for HBV, and most infections in adults resolve on their own. Rest, fluids, and adequate nutrition will help this process. More severe cases of acute hepatitis B will require hospitalization to provide appropriate fluid and nutrition supplementation while the infection resolves.
Fortunately, HBV is a preventable disease, and an effective vaccine has been available since 1981. The hepatitis B vaccine is safe and effective in all age groups. It is a series of shots given over several months. You can also do the following in to reduce your risk of HBV:
- Safer sex: Condoms act as a protective barrier against bodily fluids such as blood and semen that could be infected with the virus. Condoms can reduce your risk of contracting HBV, they do not eliminate the risk completely.
- Know the HBV status of sexual partners: Don't engage in unprotected sex (sex without a condom) unless you're absolutely certain your partner isn't infected with HBV or any other sexually transmitted infections.
- Be cautious about body piercing and tattooing: If you get a piercing or tattoo, look for a reputable shop. Ask about how the equipment is cleaned. Make sure the employees use sterile needles. If you can't get answers, look for another shop.
- Avoid shared, re-used, or dirty needles: Use a sterile needle each time you inject anything and never share needles.
If a HBV infection does resolve on its own, the affected individual becomes immune and cannot become infected with HBV again.
Individuals with chronic HBV infection are at an increased risk for liver damage, cirrhosis, liver failure, liver cancer, and death. Chronically infected individuals will need to follow up closely with a liver doctor. Some antiviral medications are available that can help to suppress the infection .
When to Seek Further Consultation for Hepatitis B
If you think that you have been exposed to HBV but are unsure of your vaccination status, call your physician immediately. They may be able to perform tests that will indicate your vaccination and exposure status.
You may be eligible for an injection of an antibody that may help protect you from HBV if it is given to you within 12 hours of exposure. Because this treatment only provides short-term protection, you also should get the hepatitis B vaccine at the same time, if you never received it.
Questions Your Doctor May Ask to Determine Hepatitis B
To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.
- Have you lost your appetite recently?
- Have you experienced any nausea?
- Are you sick enough to consider going to the emergency room right now?
- Any fever today or during the last week?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
The above questions are also covered by our A.I. Health Assistant.
- Surveillance for Viral Hepatitis - United States, 2016. Centers for Disease Control and Prevention. Published October 1, 2018. CDC Link
- Trpo C, Chan HLY, Lok A. Hepatitis B Virus Infection. The Lancet. Published June 18, 2014. The Lancet Link
- Elgouhari HM, Abu-Rajab Tamimi TI, Carey WD. Hepatitis B Virus Infection: Understanding Its Epidemiology, Course, and Diagnosis. Cleveland Clinic Journal of Medicine. 2008;75(12):881-889. NCBI Link
- Komatsu H, Inui A. Hepatitis B Virus Infection in Children. Expert Review of Anti-Infective Therapy. 2015;13(4):427-450. NCBI Link
- Wilkins T, Zimmerman D, Schade RR. Hepatitis B: Diagnosis and Treatment. American Family Physician. 2010;81(8):965-972. AAFP Link
- Tang LSY, Covert E, Wilson E, Kottilil S. Chronic Hepatitis B Infection: A Review. JAMA Network. 2018;319(17):1802-1813. JAMA Link