What Is Hepatitis B?

Hepatitis refers to liver inflammation due to viral infection or due to excessive alcohol consumption. There are different types of hepatitis infection and the severity of infection varies. Long-lasting infections, usually for more than six months are termed Chronic Hepatitis. Proper care is needed to treat the infection else it might damage the liver and can even cause liver cancer.

Nowadays, doctors are noticing increasing cases of hepatitis infection in children. Research is going on to find the cause. 

Hepatitis B is caused by the hepatitis B virus (HBV) and is spread through the blood of the infected person. 

According to the World Health Organization, there are approximately 296 million people infected with chronic hepatitis B in 2019. Every year 1.5 million people get infected with hepatitis B. Hepatitis B resulted in around 820,000 deaths in 2019. The Western Pacific and African regions are the regions with the highest hepatitis B infection rates globally. 

Infection in infancy or childhood leads to chronic hepatitis in 95% of patients. Whereas, if infection occurs in adulthood, then only 5% of cases turn into chronic hepatitis. 

Overview 

Hepatitis B infection is caused by the hepatitis B virus or HBV and is spread by blood, semen, or vaginal fluids of the infected person. 

According to the British Liver Trust, hepatitis B is the most prevalent form of all hepatitis infections found worldwide. Hepatitis B infection is not that common in the UK. Some parts of the world such as Africa, Southern Europe, the Middle and Far East, the Indian subcontinent, and South-East Asia have more cases of hepatitis B infections.

Approximately 180,000 people in the UK have chronic hepatitis infections. 

Different types of hepatitis infection are - 

• Hepatitis A: Caused by the hepatitis A virus. It spreads through contaminated food and drinks. Mostly caused due to unhygienic handling of food and drinks by the infected person. It causes pain, nausea, and itching which might subside in some time. It is rarely a life-threatening condition. Vaccinations are given to people from high-risk categories.

• Hepatitis B: Caused by the hepatitis B virus and spread through the blood, semen, or vaginal fluid of an infected person. Unprotected sex and mother-to-child transmissions are usually the cause of the spread. Vaccinations are advised for prevention.

• Hepatitis C: Caused by the hepatitis C virus and spread by blood-to-blood contact with an infected person. The most common cause of spread in the UK is sharing needles for drug use. Mostly flu-like symptoms are seen with this infection. No vaccine is available currently for this infection. 

• Hepatitis D: Caused by the hepatitis D virus and spread through blood-to-blood or sexual contact with an infected person. HBV is needed for the survival of this virus. So, this infection is seen only in people with hepatitis B. Vaccination with hepatitis B can help in preventing hepatitis D infection also. 

• Hepatitis E: Caused by the hepatitis E virus and spread with the consumption of raw or undercooked meat or fish products. It is mostly a short-term acute infection and mostly affects people who have weak immune systems. No vaccine is available for this. Adopting good hygiene measures is the prevention method.

• Alcoholic hepatitis: As the name suggests, it is caused due to excessive consumption of alcohol over a long period. It is common in the UK. As it does not necessarily present any symptoms, people don't realise that they are suffering. Drinking in moderation is the way to prevent this infection. Excessive drinking habits might lead to liver cirrhosis, liver failure, or liver cancer.

• Autoimmune hepatitis: It is a rare form of infection due to the immune system attacking the liver. In extreme cases, the liver stops functioning. The exact cause and prevention are still not known. Treatment involves the use of medicines that suppress the immune system. 

Causes of hepatitis B 

HBV is the cause of hepatitis B infection. Semen, blood, and vaginal fluids are responsible for the spread of the virus. Let's check out the causes of this infection in detail.¹

• Sex: Having unprotected sex with an infected person results in the spread of HBV. The virus passes through the blood, saliva, semen, or vaginal secretions of the infected person.

• Sharing needles: Individuals who used shared needles for drug use are at high risk of getting infected. Contaminated blood from an infected person might spread the disease. Other ways can be tattooing or piercing.

• Needle injury: This mostly happens with healthcare workers. Sometimes, healthcare workers get accidental needle injuries during work. If they come in contact with the blood of an infected person, they might be at risk.

• Mother-to-child transmission: Pregnant women with hepatitis B can pass the virus to their children during childbirth. Vaccines can be given to newborns to prevent infection.

Signs and symptoms of hepatitis B 

Detection of HBV takes around 30-60 days after infection. Some people don't experience any symptoms in the early days of infection. It takes 2-3 months after infection for the symptoms to develop. The following symptoms occur in the infected individuals.¹,²

• Jaundice in which skin and eyes get a yellowish colour
• Nausea 
• Vomiting 
• Abdominal pain 
• Dark coloured urine 
• Fever 
• Loss of appetite 
• Weakness and fatigue 
• Diarrhea

Management and treatment for hepatitis B 

Hepatitis B can be diagnosed by blood tests, radiological scans of the liver, or liver biopsy. If hepatitis B is confirmed, healthcare providers can decide on treatment options.³

Vaccine: If you or your child suspect an infection, you might be given the hepatitis B vaccine within 24 hours of exposure to HBV. Two more doses are given in the next six months to get full immunity against the virus.

Hepatitis B Immune Globulin (HBIG): HBIG is given as a vaccine to prevent infection in people who are recently exposed to the virus. It is made from human blood with naturally produced antibodies developed to fight against hepatitis b infection. 

Immune modulator drugs: Immune modulator drugs, also known as interferons are versions of antibodies that are produced to fight HBV infections. The course of the infection is around 6-12 months.

Antivirals: Antivirals are used to treat viral infections and so these are used in case of hepatitis infection. These oral medications can help treat hepatitis B infection.

Lifestyle modifications: Apart from medications, patients must ensure that they follow healthy lifestyle choices to prevent any further damage to their liver. Excessive alcohol consumption causes liver cirrhosis and ultimately liver damage. So, it is better to control the number of drinks per week.

Surgery: If the infection is not controlled at early stages, chronic hepatitis might cause liver cirrhosis, liver damage, or liver cancer. In severe cases, doctors might prefer surgery to remove the damaged liver part. The Liver can regenerate if healthy tissues are present. 

FAQs

How is hepatitis B diagnosed 

Blood tests, radiological liver scans, or liver biopsy can help in diagnosing hepatitis B infection.³

How can I prevent hepatitis B

Hepatitis B infection can be prevented by practicing safe sex, not sharing needles, avoiding tattoos or anything which can contaminate blood, and vaccinations.³

Who are at risk of hepatitis B

People who have HIV, use intravenous drugs, people who practice unprotected sex, healthcare workers and people of Asian, African, or Pacific Island are prone to get infected with hepatitis B.³,⁴

Is hepatitis B contagious 

Hepatitis B is not contagious by touch. This virus is spread by blood, semen, or vaginal fluids.

How common is hepatitis B

According to 2019 World Health Organisation estimates, there are around 296 million people infected with hepatitis B. Every year around 1.5 million people get infected.

When should I see a doctor 

If you feel you are exposed to the hepatitis B virus, contact your doctor immediately. There are vaccines that can be given in the first 24 hours after exposure to prevent infection. Don't wait for symptoms to show as it might take 1-2 months.

Summary 

Hepatitis refers to liver inflammation due to viral infection or excessive alcohol consumption which causes liver damage. There are 7 types of hepatitis infection. The most prevalent form of infection is hepatitis B caused by the hepatitis B virus, also known as HBV. This virus is spread through blood, semen, or vaginal fluids. 

Acute hepatitis infection refers to short-term infection. Whereas, chronic hepatitis refers to symptoms lasting for more than 6 months. If infection occurs in childhood or infancy, there is a 95% chance of it becoming a chronic hepatitis infection. If infection occurs in adulthood, only 5% of cases turn out to be chronic hepatitis.

This infection is mostly found in people of Asian, African, or Pacific Island descent.

The Hepatitis B virus spreads through unprotected sex, sharing needles, needle stick injury, and mother-to-child transmission during childbirth.

Symptoms occur 1-2 months after exposure to HBV. People might experience jaundice, nausea, vomiting, diarrhea, dark urine, tiredness, abdominal pain, fever, and loss of appetite.

Infants are given scheduled vaccinations for prevention. If someone is not vaccinated and suspects that they were exposed to HBV, they need to contact their healthcare provider immediately. Doctors might give them a vaccine within 24 hours of exposure which will prevent the chances of infection. So, don't wait for symptoms to show and get medical help immediately.

If the infection is not controlled, it can lead to liver damage, liver cirrhosis, or even liver cancer.

Vaccinations, avoiding excessive drinking, practicing safe sex, not sharing needles, and leading a healthy lifestyle can prevent the risk of infections.