Hepatitis B

Hepatitis B is a liver disease caused by the hepatitis B virus. Most hepatitis B infections clear up within 1-2 months without treatment. When the infection lasts more than six months, it can develop into chronic hepatitis B, which can lead to:
Chronic inflammation of the liver
Cirrhosis (scarring of the liver)
Liver cancer
Liver failure
Death

CAUSES

Hepatitis B is caused by the hepatitis B virus. This virus is spread through contact with body fluids of an infected person, such as blood, semen, vaginal fluids, and saliva. A woman infected with hepatitis can pass the virus on to her baby during childbirth.

RISK FACTORS

A risk factor is something that increases your chance of getting a disease or condition. Coming in contact with the blood or other body fluids of someone infected with hepatitis B increases your risk for infection. Unlike the hepatitis A virus, hepatitis B virus is not spread through contaminated food or water.

The following situations may increase your risk of getting hepatitis B:
Having sex with someone infected with hepatitis B or who is a carrier of hepatitis B
Injecting illicit drugs, especially with shared needles
Having more than one sexual partner
Being a man who has sex with men
Living in the same house with someone who is infected with hepatitis B
Having a job that involves contact with body fluids, such as:

  • First aid or emergency workers
  • Funeral directors
  • Medical personnel
  • Dentists
  • Dental assistants
  • Firefighters
  • Police personnel
  • Having a sexually transmitted disease at the time you come in contact with hepatitis B
  • Traveling to areas where hepatitis B is common, such as China, southeast Asia, and sub-Saharan Africa
  • Receiving a blood transfusion prior to 1975 (the year a test to screen blood was developed)
  • Receiving multiple transfusions of blood or blood products, as hemophiliacs do (risk is greatly reduced with careful blood screening)
  • Working or being a patient in a hospital or long-term care facility
  • Working or being incarcerated in a prison
  • Being bitten so that the skin is broken by someone whose saliva contains the virus
  • Being a hemodialysis patient

SYMPTOMS

Symptoms usually appear within 25 to 180 days following exposure to the virus. The most common symptoms are:

  • Yellowing skin and eyes (jaundice)
  • Fatigue that lasts for weeks or even months
  • Abdominal pain in the area of the liver (upper right side)
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain
  • Low-grade fever
  • Dark urine and light-colored stool
  • Widespread itching
  • Rash

DIAGNOSIS

The doctor will ask about your symptoms and medical history, and perform a physical exam. Hepatitis B is diagnosed with blood tests, which are also used to monitor its effects on the liver. For chronic cases, a liver biopsy may be needed. A biopsy is the removal of a sample of liver tissue for testing.

TREATMENT

The symptoms of hepatitis B can be treated with medication. Patients with uncomplicated cases can expect to recover completely. Patients with chronic hepatitis B are treated with medication to reduce the activity of the virus and prevent liver failure.

Medications include:

  • Interferon alfa-2b (Intron A) injection
  • Lamivudine (Epivir-HBV) oral medication
  • Chronic hepatitis B patients should avoid anything that can further injure the liver. These include:
  • Alcohol
  • Certain medications, dietary supplements, and herbs (Discuss these substances with your doctor before taking them.)
  • Chronic hepatitis B patients should prevent the spread of their infection by:
  • Telling their doctors, dentists, and sexual partner(s) that they have hepatitis B
  • Never donating blood, organs, or tissue
  • Discussing their hepatitis B status with their doctor during pregnancy or before becoming pregnant to insure the baby receives treatment

PREVENTION

Hepatitis B can be prevented through vaccination, which consists of three injections over a six-month period. Protection is not complete without all three injections. Anyone at increased risk for hepatitis B should be vaccinated.

In addition, to prevent the transmission of hepatitis B:

  • Use condoms or abstain from sex
  • Limit your number of sexual partners.
  • Do not inject drugs. If you use IV drugs, get treatment to help you stop. Never share needles or syringes.
  • Do not share personal items that might have blood on them, such as:
  • Razors
  • Toothbrushes
  • Manicuring tools
  • Pierced earrings
  • If you get a tattoo or body piercing, make sure the artist or piercer properly sterilizes the equipment. You might get infected if the tools have someone else's blood on them.
  • If you are a health care or public safety worker:
  • Get vaccinated against hepatitis B.
  • Always follow routine barrier precautions and safely handle needles and other sharp instruments.
  • Wear gloves when touching or cleaning up body fluids on personal items, such as:
  • Bandages
  • Band-aids
  • Tampons
  • Linens

Cover open cuts or wounds.
Use only sterilized needles for drug injections, blood testing, ear piercing, and tattooing.
If you are pregnant, have a blood test for hepatitis B. Infants born to mothers with hepatitis B should be treated within 12 hours after birth.

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