Hepatitis B is a viral infection that is spread through the blood and other bodily fluids (eg. semen and vaginal fluid) of an infected person. It is 100 times more infectious than HIV. The hepatitis B virus (HBV) circulates in the blood and may causes inflammation of the liver (hepatitis) and may also cause long term liver damage. Hepatitis B is found all over the world. It is estimated that in the UK about 1 in every 200 people carry the virus.
Hepatitis B can cause an acute or chronic illness.
Acute hepatitis B:- An acute illiness is one that gets better quickly, usually within weeks or at most a few months. About 90-95% of adults who acquire acute hepatitis B will clear the virus from their bodies, usually within 6 months from exposure, and become immune. Many people have no symptoms while others experience a flu-like illness including a sore throat, tiredness, joint pains, and a loss of appetite. Acute hepatitis B is fatal in less than 1% of cases.
Chronic hepatitis B:- The failure to clear hepatitis B infection after six months leads to the chronic carrier state. About 5% of adults and 90% of babies exposed to the hepatitis B virus cannot get rid of the infection as their immune systems are not strong enough to repel the infection. Approximately two thirds of chronic carriers do not themselves become ill or die of the infection (although they can still transmit the virus to others) and some do go onto clear the virus. Other chronically infected patients (especially babies and children) will have periodic symptoms and may go on to develop irreversible scarring of the liver (cirrhosis). 25% of those with chronic hepatitis B will develop serious liver disease, including cirrhosis and over time some will develop liver cancer.
Control not cure
There is no cure for chronic hepatitis B – in most people some genetic material from the virus (viral DNA) persists in the nucleus of liver cells so they never clear it completely from their body. However, in most cases antiviral treatments can keep levels of the virus very low (ideally below the lower limit of detection using sensitive testing techniques). If the virus is suppressed to very low levels, tests of liver function (such as liver enzyme tests including ALT) will return towards normal, the condition of the liver will improve and the risk of complications reduced.
Occasionally the virus becomes undetectable in the blood and the person may become negative on testing for hepatitis B surface antigen (HBsAg negative).
Although these people usually feel very well, they remain at increased risk of complications, probably because the virus remains in the liver cells. For this reason, people who have had chronic hepatitis B will need monitoring for the rest of their lives.
Summary of hepatitis B
- It is a blood borne virus
- It affects the liver
- Hepatitis B is the most common carcinogen after tobacco
- It is the cause of 80% of all cases of liver cancer worldwide
- 100 times more infectious than HIV
- Hepatitis B affects twice as many people as hepatitis C
- 1 in every 200 people in the UK are infected
- High risk of sexually transmission
- Infected mothers can pass virus to their babies
- It can be spread through sharing injecting equipment
- Never share toothbrushes, razors or other personal items
- Remains highly potent in dried blood or other body secretions outside the body at room temperature for several days
- Hepatitis B is a vaccine-preventable disease
- There is very effective treatment available to keep hepatitis B virus under control
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