Hepatitis B

What is Hepatitis B?
Hepatitis B is one of several viruses that causes the liver to become infected. Most people fight off the infection themselves. However, approximately 5-10% of those people who are infected with the virus will become carriers, an estimated 5-10 % of those people infected each year will progress to chronic liver disease, cirrhosis and possibly liver cancer. There are over a million carriers of the hepatitis B virus in the United States and an estimated 200,000 people contract this serious liver disease each year.

How is Hepatitis B transmitted?
This disease is more infectious than AIDS and is transmitted through infected blood and other body fluids (seminal fluid, vaginal secretions, breast milk, tears, saliva and open sores). However, in approximately 30-40% of cases the method of transmission is unknown.

Who is at risk for Hepatitis B?
People exposed to blood or body fluids of an infected person are at risk. The following is list of risk factors:
¨working on the medical or dental professions, first aid or emergency worker, funeral director, police personnel, dental personnel
¨living in the same household with an infected person
¨having sex with carrier or chronically infected person
¨using intravenous drugs
¨having more than one sex partner
¨receiving blood transfusion prior to 1975 (test to screen blood was developed)
¨having hemophilia
¨ working or residing in a health or long term facility
¨working or being incarcerated in a prison
¨traveling to countries with a high incidence of hepatitis B

Ethnic or racial groups with a high rate of infection are: Blacks, Asians, Pacific Islanders, Hispanics, American Indians, and Alaskan Natives.

What are the symptoms of Hepatitis B?
Most people who get Hepatitis B have no recognizable signs or symptoms. The only way the disease can be positively identified is through a blood test. Many people are surprised to learn when they have donated blood that they test positive for the virus. In those that do have symptoms, they resemble the flu: loss of appetite, nausea and vomiting, fever, weakness and fatigue lasting weeks or even months, abdominal pain, dark urine, and jaundice.

Can Hepatitis B result in serious complications?
About 90% of adults recover from hepatitis B in few months, clearing the virus from their system and developing an immunity. However about 10% of adults, 25-50% of children under age 5 and 70-90% of infants infected with hepatitis B will become carriers or are chronically infected with hepatitis B.

What is a carrier?
A carrier is someone who has had hepatitis B in their blood for more than six months. A carrier usually has no signs or symptoms of the virus but remains infected with the virus for years or for a lifetime and is capable of passing the disease to others. Some carriers will spontaneously clear the infection from their bodies, most will not. Although carriers have no serious problems with hepatitis B and lead normal healthy lives, some carriers do become sick because they are at significantly higher risk than the general population for liver failure or liver cancer. If you are carrying the virus you should not donate blood, plasma, body organs, tissue or sperm.

A carrier is infectious even though there are no signs or symptoms and should never have unprotected sex unless the other person is immune to hepatitis B. Annual liver function tests and a test for liver cancer are recommended. Alcohol can harm the liver and should be avoided. Drugs, even over-the -counter ones, should be used under a doctor’s supervision as they too may cause liver damage. A well balanced diet and regular exercise are important.

Up to 90% of pregnant women who are carriers can pass the virus to their newborns at delivery. All pregnant women should be tested for hepatitis B.

What does it mean to be chronically infected?
Anyone who has not cleared the virus after six months and has elevated liver enzymes is considered to have chronic hepatitis. This means the virus is infecting living liver cells and damaging them. Scar tissue, called cirrhosis, replaces the damaged cells. The build up of cirrhosis causes the liver to become hard and bumpy and distorts the blood flow through this vital organ. This cause back pressure in the veins bringing nutrients from the stomach and intestines. Varicose veins form in the stomach and esophagus that can burst causing hemorrhage. This results in vomiting blood or passing black stools.

Can Hepatitis B be cured?
Currently there is only one approved treatment for hepatitis B called interferon alpha 2-b. About 15-20% of those treated will have a lasting response.

Can Hepatitis B be prevented?
You can protect yourself from Hepatitis B with a safe and effective vaccine. To be fully protected three injections are required--an initial dose followed by a second dose one month after the first injection and the third dose six months later. Hepatitis B vaccinations are recommended for all newborns, infants and teenagers. Most cases of hepatitis B occur among sexually active young adults. Therefore, teenagers are an important group to be vaccinated. This is a targeted population but the vaccine may be given at any age. This vaccine provides immunity for most people for at least five years and possibly longer.

Many physicians have the vaccine available. Public health departments may also have vaccine available for a nominal fee.

Hepatitis vaccine is only for people who are not infected chronically. Once infected, the vaccine is of no use. This does not apply to people acutely exposed, infected newborns or those infected by needle sticks.

Please contact your physician or other health care professional if you have any questions.