World Hepatitis Day: Our Spotlight on Hepatitis B

In honor of World Hepatitis Day, we’d like to share some facts about Hepatitis B with you.

Hepatitis B is a liver (hepato-) infection (-itis) caused by the Hepatitis B virus (HBV). Hepatitis B is transmitted when blood, semen, or another body fluid from a person infected with the HBV gets into the body of an uninfected human being.

It is estimated by CDC that 700,000–1.4 million persons in the United States have chronic hepatitis B.

Transmission:

• Sexual intercourse with a person infected with HBV
• Injection drug use that involves sharing needles, syringes, or drug-preparation equipment
• Birth from an infected mother
• Contact with blood or open sores of an infected person
• Needlestick injury or sharp instrument exposures
• Sharing potentially sharp items such as razors with an infected person

Signs and symptoms:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice

Persons with chronic HBV infection might be asymptomatic, have no evidence of liver disease, or have a spectrum of disease ranging from chronic hepatitis to cirrhosis or hepatocellular carcinoma (a type of liver cancer).

Treatment:

• Acute: treatment is usually supportive
• Chronic: several antiviral drugs (adefovir dipivoxil, interferon alfa-2b, pegylated interferon alfa-2a, lamivudine, entecavir, and telbivudine) are prescribed followed by regular checkups.
• Vaccination: Although it is not a treatment, vaccination is worth following. Injection schedule comprises of 3 intramuscular injections, the second and third doses administered 1 and 6 months, respectively, after the first dose.

The Advisory Committee on Immunization Practices recommends that the following persons be vaccinated against Hepatitis B:

• All infants, beginning at birth
• All children aged <19 years who have not been vaccinated previously
• Susceptible sex partners of Hepatitis B surface antigen (HBsAg)-positive persons
• Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., >1 sex partner during the previous 6 months)
• Persons seeking evaluation or treatment for a sexually transmitted disease
• Men who have sex with men
• Injection drug users
• Susceptible household contacts of HBsAg-positive persons
• Health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids
• Persons with end-stage renal disease, including predialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
• Residents and staff of facilities for developmentally disabled persons
• Travelers to regions with intermediate or high rates of endemic HBV infection
• Persons with chronic liver disease
• Persons with HIV infection
• Unvaccinated adults with diabetes mellitus who are aged 19 through 59 years (discretion of clinicians for unvaccinated adults with diabetes mellitus who are aged ≥60 years)
• All other persons seeking protection from HBV infection — acknowledgment of a specific risk factor is not a requirement for vaccination

Some important facts to remember:

• HBV can survive outside the body for at least 7 days and still be capable of causing infection.
• Any blood spills — including dried blood, which can still be infectious — should be cleaned using 1:10 dilution of one part household bleach to 10 parts of water for disinfecting the area. Gloves should be used when cleaning up any blood spills.
• Symptoms begin an average of 90 days (range: 60–150 days) after exposure to HBV.
• HBV is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing.

The simple formula of 1,2,3 (three shots of immunization) on 0,1,6 months is the best way in which we can prevent this infection apart from direct contact with the already infected source. After all, it is better to “prevent and prepare than repent and repair.”
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