Hepatitis B is an infection of the liver caused by the Hepatitis B virus (HBV). HBV is a Deoxyribonucleic Acid (DNA) virus meaning its genetic material in made from DNA. This virus can cause both acute and chronic liver infection. Chronic Hepatitis is associated with carriage of the virus in the blood stream with long term damage to the liver. An estimated 257 million individuals are chronically infected with HBV world over.
The virus is transmitted in the following ways
The infection most commonly presents as an acute viral hepatitis (90%) which resolves completely with no carrier state. In some infected patients (1-10%), chronic HBV infection develops and they carry the virus in their blood. When infected as a neonate (in first month of life), the risk of chronic infection rises to 90%. Immunocompromised states are also associated with an increased risk.
Acute Hepatitis
The symptoms appear around 2 to 3 months after infection. Some patients may even remain asymptomatic.
Chronic Hepatitis
This involves continued or recurrent flares of acute infection for a duration longer than 6 months. Some individuals may have progressed to a chronic state even without any acute symptoms. Later they develop symptoms of chronic liver failure. Apart from liver involvement, they may have involvement of other organs such as the musculoskeletal system and the kidneys
Symptoms experienced are as follows
The following tests are done to evaluate for HBV infection and to confirm the diagnosis.
The treatment is supportive in acute infection, with the goal of stabilising the patient. Adequate hydration, high calorie nutrition and rest is recommended for recovery. There is no specific medication during this period
Chronic HBV infection now has many different options medications for treatment. It is best to consult with a specialist to decide of the right treatment regimen. The following options are available
The HBV vaccine contains the HBsAG subunit of the virus and it is recommended that everyone gets vaccinated. The WHO recommends vaccinating all new-borns within 24 hours of birth as this would control the mother to child transmission of the virus. Other individuals at high risk of HBV such as health care workers, immunocompromised individuals, patients who receive multiple blood transfusion, IV drug abusers and household contacts of chronic HBV carriers ought to be vaccinated with the thee dose series.
If a person is exposed to HBV either through contact with blood or through sexual contact with an infected person, they must be tested immediately for immunity by checking antibody titres to HBsAG. If they are not immune, they should receive Hepatitis B Immune globulins and be given vaccination. Immune individuals should receive a booster dose of the vaccine.
This post was last modified on July 24, 2023 10:43 am
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