Hepatitis B

Hepatitis B A serious liver condition caused by the Hepatitis B virus is known as Hepatitis B or Hep B. It is usually seen in the people falling in the age group of 20 to 49 years. Statistics available with the CDC has shown that the number of people contracting Hepatitis B has gone down considerably from 200,000/year in the 1980s to 43,000/year in 2007.

If the condition lasts for more than 6 months, it is known as chronic Hepatitis B infection. It puts the person at risk of developing conditions like liver failure, liver Cancer and cirrhosis, where there is permanent scarring of the liver. Currently there are 1.25 million people who are Hepatitis B virus carriers in the United States alone.

What Are the Symptoms & Complications of Hepatitis B?


Once the Hepatitis B virus infects the body, the person may remain asymptomatic, or feel sick for a period of few days or weeks. In case the person becomes ill rapidly, it is termed as fulminant Hepatitis.

Sometimes the patient may remain asymptomatic for as long as 6 months. The initial symptoms can be as follows:

• Loss of appetite


• Fatigue and low grade fever


• Pain in the muscles and joint aches


• Nausea and vomiting


• Yellowing of the skin and dark urine

When the body fights off the infection, the symptoms can go away. However, if they persist, it is because the person has chronic Hep B. A person with chronic Hepatitis B can remain asymptomatic and need not be aware of the presence of the infection. Even in this scenario they can pass the infection to others. Such people can develop symptoms of liver failure or cirrhosis over a period of time.

Complications
The complications of Hepatitis B are:

• Cirrhosis. In this condition there is extensive scarring of the liver tissue which impairs the normal functioning of the liver.


• Liver Cancer. The risk of getting liver cancer is very high in such patients.


• Liver failure. The liver functions shut down in case of acute liver failure and a transplant will be required.


• The person will be at risk of developing conditions like anemia, kidney disease and inflammation of blood vessels.

When to See a Doctor
The doctor should be contacted in case the following symptoms are noticed:

• Nausea and vomiting for over 2 days


• High fever or fever that lasts for more than 2 days


• Inability to keep liquids, vomiting them as well


• Yellowing of skin and white of the eyes


• Pain in the abdomen


• Dark urine (tea or cola colored)

If the person seems confused or is in Delirium, they should be taken to emergency care. The doctor should also be informed if one have been exposed to the virus. In case an infected person becomes pregnant or a pregnant person is exposed to the virus, they should consult the doctor immediately.

What Are the Causes & Risk Factors of Hepatitis B?
Hepatitis B is caused when the HBV passes from person to person via blood, semen or other body fluids. Its common transferring modes are:

• Sexual contact: unprotected sex with an infected person can cause Hep B via blood, saliva, semen and vaginal secretions.


• Reusing needles: if needles, syringes and IV drug material contaminated by HBV is reused.


• Accidental: health care workers and others who come in contact with infected blood are at risk from accidental pricks and fluid exchange.


• Pregnancy: pregnant infected women can transfer the virus to the baby during childbirth. However, the baby can be vaccinated to prevent infection.

Risk Factors
Since Hepatitis B is transmitted via body fluids, the risk of contracting the infection increases in the following cases:

• Have unprotected sex with multiple partners or person infected with Hep B


• Have homosexual relations


• Use and share needles and IVs


• Born to a Hepatitis B infected mother


• Are living with someone with chronic Hepatitis B


• Work in a field which has exposure to human blood


• Travelling to places like Africa, Central & Southeast Asia, Eastern Europe which have high Hepatitis B infection rates

What Are the Treatments for Hepatitis B?
Within two weeks of exposure to Hepatitis B, you can get yourself vaccinated and also get an injection of Hepatitis immune globulin, which helps in fighting off the infection.

If the symptoms start appearing, it is important to take bed rest and not consume anything which can harm the liver. This includes alcohol, acetaminophen, herbal remedies or supplements which worsen the liver damage.

For chronic active Hepatitis B, the doctor usually prescribes aggressive treatment, if the patient is an inactive carrier, he is kept under observation.

The following medications or treatments are prescribed for people with chronic Hepatitis B:

• Interferon. This is responsible for boosting the immune system and needs to be administered for 6 months. It improves the Liver Inflammation, but does not cure the disease. Some side effects of the drug are malaise, Depression, loss of appetite and it also lowers the WBC count.


• Epivir. This is prescribed to be taken once a day and is well tolerated. Long term use can result in viral mutations.


• Hepsera. When Epivir does not work, this medicine is prescribed. It can causes kidney problems in high doses.

How to Live with Hepatitis B
The first thing to that can be done is to learn about Hepatitis B. Having a short note on Hepatitis B from the CDC can be helpful. Since it does not spread via casual contact, keep in touch with family and friends. Ensure that you have a healthy diet, exercise daily and get adequate sleep. Avoid substances which can harm the liver and get vaccinated and test for Hepatitis A.

How to Prevent Hepatitis B

• Anyone who is at high risk should get the Hepatitis B vaccination


• Babies should get the vaccine at birth and remaining 3 shots within 6 months


• Anyone below 19 years of age and not vaccinated should get a ‘catch-up’ dose


• Healthcare workers and people living with Hep B patients should get vaccinated


• Babies born with Hep B positive mothers should get the vaccine within 12 hours of being born


• Avoid contact with blood and body fluids of person infected with Hep B


• Get vaccinated or shot of HBIG within 24 hours of exposure to avoid infection

Hepatitis B Surface Antigen

Hepatitis B Surface Antigen

Hepatitis B virus (HBV) is responsible for causing an acute as well as chronic infection of liver (also known as hepatitis B). It is transferred via semen, blood and other body fluid of an infected person to non-infected individuals and the initial diagnosis is Hepatitis B Surface Antigen test. The body fluid can be transferred through shared syringes or needles, sexual contact or by using other mutually shared injecting equipment or from a mom to her baby at birth. In some cases, hepatitis B is short term or acute illness but in other cases it may be chronic or long-term infection.

What Is Hepatitis B Surface Antigen (HBsAg)?


It is a protein which is present on the surface of surface of HBV that entice or stimulate the immune system to produce antibodies. This surface antigen can be found in elevated concentration within the serum when checked during chronic or acute HBV infection. The presence of hepatitis B surface antigen serves as an indication that the person has been exposed to the virus. Once infected, it takes about 30-150 days to develop symptoms that are suggestive of hepatitis B infection.

Hepatitis B Surface Antigen Test
This antigen can be detected in the blood of an infected person within 12 weeks after the initiation of the infection; serving as an earliest sign to look for in hepatitis B infection. If the antigen is detectable after the period of 6 months, then it may indicate the progression of short term or acute hepatitis B turns into long term or chronic hepatitis B. Inother words the infected person may spread HBV to other throughout his life.

Hepatitis B Blood Test Panel
The hepatitis virus panel is a series of blood tests used to detect current or past infection by hepatitis B. Your doctor may order a hepatitis panel if you have symptoms of hepatitis. It can screen blood samples for more than one kind of hepatitis virus at the same time.

The blood panel for hepatitis B is dependent upon the following 3 tests:

• Hepatitis B surface antigen test: HbsAg is the earliest marker of HBV infection therefore it is detected before the occurrence of any other symptom. Presence of antigen for a period of greater than 6 months indicates chronic HBV infection.


• Hepatitis B surface antibody test: Antibody is detected usually 4 weeks after the detection of antigen. It indicates the end of the infectious stage i.e. the infected person is no longer contagious. This surface antibody prevents recurrence of HBV infection in the future. This test is done in order to estimate the vaccination need. If the test shows both antigen and the antibody, then the infected person may still be contagious.


• Hepatitis B surface core antibody test: Hepatitis B surface core antibody is an antibody, made 1 month after the initiation of HBV infection, against the core antigen of the Hepatitis B. It is usually detected in people who have chronic HBV infection or people with a history of infection in the past. It is usually present for the lifetime. Therefore, when blood is donated to blood banks; it is screened for hepatitis B.

When Do I Need to Do the Test?
You’ll be recommended to get your test done if:

• Your doctor suspects you have HBV infection.


• You have been diagnosed with Hepatitis B.

Symptoms begin to develop gradually. At times either there are no symptoms or they are too mild. Following symptoms may serve as a red flag:

• Dark colored urine


• Jaundice or pale coloration of skin


• Fever


• Nausea


• Anorexia


• Fatigue


• Muscle ache

If you have been in contact with the individuals carrying the virus, you’ll need a test regardless. Risk factors associated with hepatitis B include:

• Working in an environment where you have frequent exposure to blood or blood products.


• If you are habitual of using shared needles for IV drug administration


• Being born to an infected mother


• Men having sex with men


• Having a close contact with an infected person


• Having sex with an infected person


• An elastic band is wrapped around the arm to diminish the blood flow and to make needle insertion easier


• The site of insertion is cleaned with an alcohol swab


• Needle is inserted into the vein


• A tube is attached with the needle to collect the blood


• Once blood sample is taken, the elastic band is removed


• Cotton ball or gauze pad is placed on the site of insertion; pressure is applied followed by bandage.

How the Test Is Done?

• An elastic band is wrapped around the arm to diminish the blood flow and to make needle insertion easier


• The site of insertion is cleaned with an alcohol swab


• Needle is inserted into the vein


• A tube is attached with the needle to collect the blood


• Once blood sample is taken, the elastic band is removed


• Cotton ball or gauze pad is placed on the site of insertion; pressure is applied followed by bandage.

Are There Any Risks?
Following risks may be associated with blood sampling:

• Development of small bruise at the site of insertion. This may be minimized by applying pressure once the needle is removed.


• Inflammation of vein, also known as Phlebitis, after the removal of needle; however, it’s quite rare. It can be taken care of by warm compress multiple times each day.


• Unstoppable bleeding in people with bleeding disorders. This can be treated by administering blood thinning medications like warfarin and aspirin.

What Are the Results?
Results of the test may be assessed as:

Hepatitis B virus tests:

Hepatitis B surface antigen: Active infection. If the antigen is detected for greater than 6 months, then it indicates chronic hepatitis B.

Hepatitis surface antibody: Indicates the end stage of active infection and may serve as a marker of previously provided vaccine.

Hepatitis B e-antigen: Active infectious and contagious state of the HBV infection.

HBV DNA: Detects HBV DNA and marks the current active infectious state.

Hepatitis B core antibody: Indicates that the person has been infected but doesn’t differentiate between present or past infection.

Hepatitis B core antibody IgM: It indicates occurrence of HBV infection in past 6 months and may mark the beginning of chronic stage.

Hepatitis B e-antibody: It indicates less active HBV infection.

Hepatitis B Vaccine

Hepatitis B Vaccine

Hepatitis B is an infection that targets the liver. The hepatitis virus is considered to be the reason for this deadly infection. Around 38,000 people got infected with hepatitis in the year 2009. Approximately 4,000 people in the US die from liver Cancer and cirrhosis caused by hepatitis B each year.

However, since 1990, there has been a decline in the number of cases of Hepatitis B reported in the US by almost 82%. The reason for this has been the implementation of routine hepatitis B vaccination of the children ever since the year 1990. This has dramatically reduced the rate of this infection in children in the United States. Thus, getting the hepatitis B vaccine is considered the best way to avert hepatitis B.

What Is Hepatitis B Vaccine?


The hepatitis B vaccinecompromises of a sequence of shots that can help in stimulating the immune system of a person so that it can protect him against the hepatitis B virus. As the vaccine enters the body, it starts producing antibodies which fight the virus and protect the person from its affects. Antibodies are basically substances that are present in blood and are produced in response to the virus that has attacked the body. The antibodies produced by the body because of the hepatitis B vaccineget stored in the body and when in the future the person gets exposed to the hepatitis B virus, they are ready to fight it off.

Recombivax HB PediatricAdolescent, Recombivax HB, Engerix-B and Engerix-B Pediatric are the brand names of the hepatitis B vaccine which are commonly available in the market.

Brief Introduction of Hepatitis B
Hepatitis B is part of the hepatitis family as it causes Liver Inflammation. The contagious disease varies in its strength as it sometimes only lasts for a few weeks while it sometimes proves to be a severe and lifelong disease.

The disease spreads through infected semen, blood or body fluid by entering the body of an uninfected person. The major causes for spread of Hepatitis B are:

• Sexual intercourse with a partner who has the virus


• Birth (the infected mother spreads the disease to the newborn)


• Drug-injection equipment like needle and syringe sharing


• Razor and toothbrush sharing with an individual who is already infected by the virus


• Exposition to blood of an infected person through needlesticks or any other sharp equipment

Contrary to popular belief, activities like sharing of utensils used for eating with an infected person or kissing or hugging an infected person, etc. don’t cause the spread of hepatitis B.

The symptoms of acute Hepatitis B are:

• High fever


• Weakness


• Dizziness


• Continuous vomiting


• Pain in the abdomen


• A darkish tinge to the urine


• Pain in the joints


• Appearance of a yellowish tinge in the eyes

Who Should Take Hepatitis B Vaccine?
Hepatitis B vaccination is considered compulsory for:

• All newborn babies


• All adolescents and children who are under 19 years old and still haven’t received the vaccination


• People who have sex with people that suffer from hepatitis B


• People who actively have sex with multiple partners


• People who are either being evaluated or treated for a STD


• Men who take part in sexual activities with other men


• People who are in the habit of sharing syringes and other equipments used for drug injection


• People who remain in close contact at all times with an individual who has the HBV


• All the public safety and healthcare workers as they always remain at risk of being exposed to either blood or body fluids of the contaminated blood while working


• End-stage renal disease patients


• Workers who work at facilities and centers for people with developmental disabilities


• People travelling to regions where the hepatitis B is more common


• Chronic liver disease patients


• Patients harboring the HIV infection


• Everyone who seeks protection from the HBV

The hepatitis B vaccinations are also recommended for all individuals who have either been taking treatment from or have been admitted in the following facilities:

• STD treatment centers


• HIV treatment centers and testing facilities


• Drug abuse prevention and treatment centers


• Health care centers where drug users are treated


• Health care centers for gay men who have sex with other men


• Medical centers where chronic hemodialysis facilities are available


• Centers where facilities and services are provided to developmentally disable people

Who Should Not Take Hepatitis B Vaccine?
There are still some people who shouldn't take hepatitis B vaccine:

• People with yeast Allergy which might be life threatening or allergy to any other constituent of the vaccine should avoid the Hepatitis B vaccine. You should let your health professional know about all your allergies so that he can decide whether you would have any allergic reaction to the vaccine or not.


• People who didn’t respond well to their last hepatitis B vaccineshot (had a strong allergic reaction) should avoid the remaining shots.


• People who are not feeling well or are suffering from a disease at the time when the next vaccine dose is to be given should avoid the vaccine at that time and should only get it after they have recovered.

You can contact your doctor to better know about all of the precautions.

When to Take Hepatitis B Vaccine
Every child should be given their first shot of the Hep B vaccine when they are born and the sequence of shots should be completed within the first 18 months. However, if any child doesn’t get the vaccine at birth then adolescents under the age of 19 are recommended "Catch-up" vaccinations. This vaccination is appropriate for both children who never got any vaccine shot and who got a few but didn’t get the entire series.

If any adult wants the Hepatitis B vaccineas he thinks that he is at risk of contracting the infection then he would have to contact a doctor about how to get the most appropriate hepatitis B vaccine series.

A hepatitis B booster dose especially a hepatitis B 5 year booster dose is often recommended for all vaccinated individuals so as to ensure continued protection from the virus.

What Are the Side Effects of Hepatitis B Vaccine?
The vaccine for hepatitis B is extremely safe and the majority of people face no side-effects. The vaccine itself can never cause the HBV as it consists of non-infectious material only.

However, a few people do feel minor side-effects when injected with the vaccine. These side-effects include:

• A fever of around 100 °F or more (this is the case in around 7% of the vaccinations)


• Soreness in the region where the vaccine shot was administered (this is the case in 25% of the vaccinations)

Apart from these minor issues, the chances of any severe complications are very little with only one case of severe reaction to the vaccine coming out for every 1.1 million vaccines administered.

Over 100 million people in the US have been vaccinated with only a handful of cases where serious complications were developed as a result of the vaccine. Like every other medicine, there remains a chance of a severe allergic reaction to the vaccine but even in those cases, the chances of lasting harm or death are very small.

When to See a Doctor
Increased heart rate, fatigue, breathing problems, wheezing and lightheadedness are all indicators of a strong allergic reaction and if any of these symptoms are observed after the injection of the vaccination, a doctor should be contacted immediately.

Hepatitis B

Hepatitis B

A serious liver condition caused by the Hepatitis B virus is known as Hepatitis B or Hep B. It is usually seen in the people falling in the age group of 20 to 49 years. Statistics available with the CDC has shown that the number of people contracting Hepatitis B has gone down considerably from 200,000/year in the 1980s to 43,000/year in 2007.
If the condition lasts for more than 6 months, it is known as chronic Hepatitis B infection. It puts the person at risk of developing conditions like liver failure, liver Cancer and cirrhosis, where there is permanent scarring of the liver. Currently there are 1.25 million people who are Hepatitis B virus carriers in the United States alone.
What Are the Symptoms & Complications of Hepatitis B?


Once the Hepatitis B virus infects the body, the person may remain asymptomatic, or feel sick for a period of few days or weeks. In case the person becomes ill rapidly, it is termed as fulminant Hepatitis.
Sometimes the patient may remain asymptomatic for as long as 6 months. The initial symptoms can be as follows:

• Loss of appetite


• Fatigue and low grade fever


• Pain in the muscles and joint aches


• Nausea and vomiting


• Yellowing of the skin and dark urine

When the body fights off the infection, the symptoms can go away. However, if they persist, it is because the person has chronic Hep B. A person with chronic Hepatitis B can remain asymptomatic and need not be aware of the presence of the infection. Even in this scenario they can pass the infection to others. Such people can develop symptoms of liver failure or cirrhosis over a period of time.
Complications
The complications of Hepatitis B are:

• Cirrhosis. In this condition there is extensive scarring of the liver tissue which impairs the normal functioning of the liver.


• Liver Cancer. The risk of getting liver cancer is very high in such patients.


• Liver failure. The liver functions shut down in case of acute liver failure and a transplant will be required.


• The person will be at risk of developing conditions like anemia, kidney disease and inflammation of blood vessels.

When to See a Doctor
The doctor should be contacted in case the following symptoms are noticed:

• Nausea and vomiting for over 2 days


• High fever or fever that lasts for more than 2 days


• Inability to keep liquids, vomiting them as well


• Yellowing of skin and white of the eyes


• Pain in the abdomen


• Dark urine (tea or cola colored)

If the person seems confused or is in Delirium, they should be taken to emergency care. The doctor should also be informed if one have been exposed to the virus. In case an infected person becomes pregnant or a pregnant person is exposed to the virus, they should consult the doctor immediately.
What Are the Causes & Risk Factors of Hepatitis B?
Hepatitis B is caused when the HBV passes from person to person via blood, semen or other body fluids. Its common transferring modes are:

• Sexual contact: unprotected sex with an infected person can cause Hep B via blood, saliva, semen and vaginal secretions.


• Reusing needles: if needles, syringes and IV drug material contaminated by HBV is reused.


• Accidental: health care workers and others who come in contact with infected blood are at risk from accidental pricks and fluid exchange.


• Pregnancy: pregnant infected women can transfer the virus to the baby during childbirth. However, the baby can be vaccinated to prevent infection.

Risk Factors
Since Hepatitis B is transmitted via body fluids, the risk of contracting the infection increases in the following cases:

• Have unprotected sex with multiple partners or person infected with Hep B


• Have homosexual relations


• Use and share needles and IVs


• Born to a Hepatitis B infected mother


• Are living with someone with chronic Hepatitis B


• Work in a field which has exposure to human blood


• Travelling to places like Africa, Central & Southeast Asia, Eastern Europe which have high Hepatitis B infection rates

What Are the Treatments for Hepatitis B?
Within two weeks of exposure to Hepatitis B, you can get yourself vaccinated and also get an injection of Hepatitis immune globulin, which helps in fighting off the infection.
If the symptoms start appearing, it is important to take bed rest and not consume anything which can harm the liver. This includes alcohol, acetaminophen, herbal remedies or supplements which worsen the liver damage.
For chronic active Hepatitis B, the doctor usually prescribes aggressive treatment, if the patient is an inactive carrier, he is kept under observation.
The following medications or treatments are prescribed for people with chronic Hepatitis B:

• Interferon. This is responsible for boosting the immune system and needs to be administered for 6 months. It improves the Liver Inflammation, but does not cure the disease. Some side effects of the drug are malaise, Depression, loss of appetite and it also lowers the WBC count.


• Epivir. This is prescribed to be taken once a day and is well tolerated. Long term use can result in viral mutations.


• Hepsera. When Epivir does not work, this medicine is prescribed. It can causes kidney problems in high doses.

How to Live with Hepatitis B
The first thing to that can be done is to learn about Hepatitis B. Having a short note on Hepatitis B from the CDC can be helpful. Since it does not spread via casual contact, keep in touch with family and friends. Ensure that you have a healthy diet, exercise daily and get adequate sleep. Avoid substances which can harm the liver and get vaccinated and test for Hepatitis A.
How to Prevent Hepatitis B

• Anyone who is at high risk should get the Hepatitis B vaccination


• Babies should get the vaccine at birth and remaining 3 shots within 6 months


• Anyone below 19 years of age and not vaccinated should get a ‘catch-up’ dose


• Healthcare workers and people living with Hep B patients should get vaccinated


• Babies born with Hep B positive mothers should get the vaccine within 12 hours of being born


• Avoid contact with blood and body fluids of person infected with Hep B


• Get vaccinated or shot of HBIG within 24 hours of exposure to avoid infection