Hepatitis B is a serious public health issue affecting millions of people worldwide. This viral infection can cause acute and chronic liver disease, leading to severe complications if left untreated. Therefore, it is essential to thoroughly understand the disease, its causes, and how it can be prevented.

What is Hepatitis B?

Hepatitis B is a viral infection that attacks the liver and can cause acute or chronic disease. The Hepatitis B virus (HBV) is spread through contact with infected bodily fluids such as blood, semen, and vaginal secretions. HBV can also be transmitted from mother to child during childbirth.

Symptoms

The symptoms of Hepatitis B can vary from person to person. Some people may not experience any symptoms, while others may develop symptoms such as 

• Fatigue
• Abdominal pain
• Nausea
• Vomiting
• Joint pain
• Dark urine

Some people may also develop jaundice, a yellowing of the skin and eyes.

Risk Factors and Causes

Risk factors for Hepatitis B include:

• Being born to a mother who is infected with Hepatitis B
• Being sexually active with an infected partner
• Sharing needles or other drug-injecting equipment
• Having a job that involves contact with human blood
• Living in or travelling to regions with high rates of Hepatitis B, such as Asia, Africa, or the Pacific Islands

The virus is spread through contact with infected blood or bodily fluids, such as during unprotected sex, sharing needles, or from mother to baby during childbirth.

Types of Hepatitis

There are several types of hepatitis, each caused by a different virus. The most common types of hepatitis are:

• Hepatitis A: This type of hepatitis is caused by the Hepatitis A virus and is usually spread through contaminated food or water or close contact with an infected person. Hepatitis A typically causes acute (short-term) infection, and most people recover fully without treatment.
• Hepatitis B: This type of hepatitis is caused by the Hepatitis B virus and is usually spread through contact with infected blood or other bodily fluids, such as semen or vaginal secretions. Hepatitis B can cause acute or chronic (long-term) infection, leading to liver damage, cirrhosis, and liver cancer.
• Hepatitis C: This type of hepatitis is caused by the Hepatitis C virus and is usually spread through contact with infected blood. Hepatitis C can cause acute or chronic infection, leading to liver damage, cirrhosis, and liver cancer.
• Hepatitis D: This type of hepatitis is caused by the Hepatitis D virus and can only occur in people already infected with Hepatitis B. Hepatitis D can cause acute or chronic infection, leading to more severe liver damage than Hepatitis B alone.
• Hepatitis E: This type of hepatitis is caused by the Hepatitis E virus and is usually spread through contaminated food or water. Hepatitis E typically causes acute infection; most people recover fully without treatment.

Diagnosis

Hepatitis B is diagnosed through blood tests, imaging methods such as elastography to check for cirrhosis, or a liver biopsy if your doctor requires more detailed information than blood tests and imaging can provide.

Treatment

Acute hepatitis B infection does not have a specific treatment. Any treatment aims to maintain good health but cannot cure the illness. 

Treatment for chronic hepatitis B depends on your symptoms and overall health. Treatment options are: 

• Surveillance – This means that your healthcare provider will keep an eye on your overall health. You will have to meet them at regular intervals. Your doctor may do blood and imaging tests to look for signs of the virus.
• Medication – Your doctor may prescribe antiviral drugs or immunomodulators. These drugs reduce the risk of you spreading hepatitis B to anyone else. You will have to take these drugs for the rest of your life.
• Surgery – If hepatitis B results in liver cancer, your healthcare provider might recommend partial liver removal surgery, and a liver transplant may be necessary if the entire liver must be removed.

Complications

Any complications arising from hepatitis B infection will depend on the age of the infected person. 

Infected infants are likely to develop long-term (chronic) infection and can get complications, such as scarring of the liver (cirrhosis), liver cancer, or liver failure (when the liver stops working). About 9 in 10 infants and 3 in 10 children have a chance of developing a chronic, lifelong infection.

Teenagers or adults are likely to become unwell with symptoms (acute hepatitis), but they have a smaller chance of developing a chronic infection. 

Almost all adults (approximately 95 in 100) clear the virus from the body within 6 months. They develop immunity to future hepatitis B infections and do not develop long-term liver damage. 

However, about 1 in 20 adults cannot eliminate the virus and go on to develop chronic hepatitis B. They are at risk of developing complications such as cirrhosis and liver cancer in the long term. 

Hepatitis B and Pregnancy

Pregnant women infected with Hepatitis B can pass the virus on to their babies during childbirth. However, steps can be taken to reduce the risk of transmission, including a vaccine for the newborn and administering hepatitis B immune globulin (HBIG) to the infant.

Prevention

• Get vaccinated against Hepatitis B.
• Practice safe sex by using condoms.
• Avoid sharing needles or other drug-injecting equipment.
• Ensure that all medical equipment is properly sterilised.
• Use only sterile instruments for tattoos, piercings, and other body modifications.
• Wash your hands thoroughly with soap and water before eating or preparing food.
• Avoid contact with the bodily fluids of someone infected with Hepatitis B.
• Do not share personal items such as toothbrushes, razors, or nail clippers with someone infected with Hepatitis B.
• Be cautious when travelling to countries with high rates of Hepatitis B, and avoid consuming food or beverages that may have been contaminated with the virus.
• If you are pregnant and have Hepatitis B, talk to your doctor about steps to reduce the risk of transmission to your baby during childbirth.

Who to consult for HBV?

If you suspect that you may have Hepatitis B or have been diagnosed, you should consult a healthcare professional. A primary care physician or a specialist in infectious diseases or gastroenterology can help diagnose and manage Hepatitis B. In addition, a hepatologist, a physician specialising in liver diseases, may also be involved in caring for people with Hepatitis B. It’s crucial to find a healthcare professional who has experience and expertise in managing Hepatitis B to ensure that you receive the appropriate care and treatment.

Frequently Asked Questions