Hepatitis B: What you need to know about the silent killer

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV).

For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months, which increases your risk of developing liver failure, liver cancer or cirrhosis (a condition that causes permanent scarring of the liver), and even kidney disease, inflammation of blood vessels and anaemia.

Usually in adults the disease can be fully overcome. However, children they are more likely to develop a chronic hepatitis B infection.

You can get a vaccine to prevent hepatitis B, but once you have it there’s no cure. The disease can easily be spread, so if you are infected, taking certain precautions can help prevent spreading HBV to others.

If you know you have been exposed to hepatitis B, contact your doctor immediately. A preventive treatment may reduce your risk of infection if you receive the treatment within 24 hours of exposure to the virus.

If you have been diagnosed, the following suggestions might help: Learn about the disease; take care of yourself by eating a healthy diet full of fruits and vegetables; exercise regularly; and get enough sleep.

Take care of your liver. Don’t drink alcohol. Don’t take prescription or over-the-counter drugs without consulting your doctor.

Get tested for hepatitis A and C. Get vaccinated for hepatitis A if you haven’t been exposed.

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Signs and symptoms

The signs and symptoms of hepatitis B can be mild to severe, and usually appear one to four months after infection:

• Abdominal pain
• Dark urine
• Fever
• Joint pain
• Loss of appetite
• Nausea and vomiting
• Weakness and fatigue
• Yellowing of your skin and the whites of your eyes (jaundice)

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Causes

The hepatitis B virus is passed from person to person through blood, semen or other body fluids. Common ways HBV is transmitted include:

• Sexual contact. You may become infected if you have unprotected sex with an infected partner whose blood, saliva, semen or vaginal secretions enter your body.

• Sharing of needles. HBV is easily transmitted through needles and syringes contaminated with infected blood.

• Accidental needle pricks. Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.

• Mother to child transmission. Pregnant women infected with HBV can pass the virus to their babies during childbirth.

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Acute vs chronic hepatitis B

• Acute hepatitis B infection lasts less than six months. Your immune system is likely to clear it from your body, and you should recover completely within a few months. Most people who get it as adults have an acute infection, but it can lead to chronic infection.

• Chronic hepatitis B infection lasts six months or longer. When your immune system can’t fight off the acute infection, it may last a lifetime – possibly leading to serious illnesses such as cirrhosis and liver cancer.

The younger you are when you get hepatitis B, particularly newborns or children younger than 5, the higher your risk of it becoming chronic. Chronic infection may go undetected for decades until a person becomes seriously ill from liver disease.

Risk factors

Your risk of infection increases if you:

• Have unprotected sex with multiple sex partners or with someone who’s infected with HBV
• Share needles during intravenous (IV) drug use
• Are a man who has sex with other men without protection
• Live with someone who has chronic HBV infection
• Are an infant born to an infected mother
• Have a job that exposes you to human blood
• Travel to regions with high infection rates

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Treatment to prevent hepatitis B infection after exposure

If you know you’ve been exposed to the hepatitis B virus, call your doctor immediately.

If you haven’t been vaccinated or aren’t sure whether you’ve been vaccinated or whether you responded to the vaccination, receiving an injection of hepatitis B immune globulin within 12 hours of coming in contact with the virus may help protect you. You should then be vaccinated at the same time.

Treatment for acute HBV

If your doctor determines your hepatitis B infection is acute – meaning it is short-lived and will go away on its own – you may not need treatment. Instead, your doctor might recommend rest and adequate nutrition and fluids while your body fights infection.

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Treatment for chronic infection

If you’ve been diagnosed with chronic hepatitis B infection, you may have treatment to reduce the risk of liver disease and prevent you from passing the infection to others. Treatments include:

• Antiviral medications. Several antiviral medications can help fight the virus and slow its ability to damage your liver. Talk to your doctor about which medication might be right for you.

• Interferon alfa-2b (Intron A). This is a synthetic version of a substance produced by the body to fight infection and is used mainly for young people with hepatitis B who don’t want to undergo long-term treatment or who might want to get pregnant within a few years.

It’s given by injection. Side effects may include depression, difficulty breathing and chest tightness.

• Liver transplant. If your liver has been severely damaged, a transplant may be an option. During a liver transplant, your damaged liver is replaced with a healthy one.

Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.

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