Hepatitis B
What Is Hepatitis B?
Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). It can lead to both acute (short-term) and chronic (long-term) illness. Acute hepatitis B occurs within the first 6 months after exposure to the virus, while chronic hepatitis B is a lifelong condition for some people.
In the United States, an estimated 880,000 people are living with chronic hepatitis B. Globally, hepatitis B affects around 296 million people, including over 6 million children under 5 years old. Acute hepatitis B cases are often underreported, but the CDC estimates there were around 14,000 new acute infections in the U.S. in 2020.
Know Your Status
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Hepatitis B is a serious liver infection that is manageable when caught in the first six months. It can be contracted through sexual activities, infected blood or sharing needles. Approximately 70% of cases are symptomless, so get tested if you may have been exposed.
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Acute and Chronic Hepatitis B
When a person is first infected with the hepatitis B virus, it's called an acute hepatitis B infection. Most healthy adults are able to clear the virus on their own within 6 months and recover completely. However, for some people, the virus remains in the body and causes a chronic hepatitis B infection.
The risk of developing chronic hepatitis B is directly related to the age at which a person is first infected. Over 90% of infants and up to 50% of young children (ages 1-5) who are infected will develop chronic hepatitis B. In contrast, only 5-10% of healthy adults develop chronic infection after an acute case. This is because younger individuals have less developed immune systems to fight off the virus.
Symptoms
Many people with acute hepatitis B don't experience any symptoms. When symptoms do occur, they may include fatigue, poor appetite, abdominal pain, nausea, vomiting, dark urine, joint pain, and jaundice (yellowing of the skin and eyes). These symptoms typically appear 60-150 days after exposure to the virus.
Chronic hepatitis B often has no symptoms in the early stages, so many people don't know they are infected. As the disease progresses, symptoms like fatigue, poor appetite, and abdominal discomfort may develop.
How is Hepatitis B Spread?
Hepatitis B is primarily spread through contact with the blood, semen, or other body fluids of an infected person. Common routes of transmission include:
- Mother-to-child during childbirth
- Unprotected sexual contact with an infected partner
- Sharing needles, syringes, or other drug injection equipment
- Needlestick injuries in healthcare settings
- Contact with open sores or blood of an infected person
The hepatitis B virus can survive outside the body for at least 7 days and still be capable of causing infection during that time.
Risks and Complications
Those at highest risk for hepatitis B include infants born to infected mothers, people with multiple sex partners, men who have sex with men, injection drug users, healthcare and public safety workers, and people with HIV.
Chronic hepatitis B can lead to serious complications like cirrhosis (severe liver scarring), liver failure, and liver cancer. People with chronic HBV infection have a 15-25% lifetime risk of dying prematurely from these complications.
Testing and Treatment
A simple blood test can diagnose both acute and chronic hepatitis B infections. There is no cure for hepatitis B, but treatments are available that can control the virus and prevent complications in those with chronic infections.
For those with acute hepatitis B, the goal is to manage symptoms and allow the body to clear the virus naturally. In rare, severe cases, hospitalization and medication may be necessary.
People diagnosed with chronic hepatitis B should receive regular monitoring and evaluation by a liver specialist. Antiviral medications can help suppress the virus and reduce the risk of liver disease progression. Screening for liver cancer is also crucial for those with chronic infection.
Vaccination
The best way to prevent hepatitis B is through vaccination. The hepatitis B vaccine is safe and effective, and it's recommended for all infants, children, and unvaccinated adults. Full vaccination requires a series of 3-4 doses.
References:
- CDC. "Viral Hepatitis - Hepatitis B Information." https://www.cdc.gov/hepatitis/hbv/index.htm
- WHO. "Hepatitis B." https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
- AASLD. "Hepatitis B Guidance." https://www.aasld.org/practice-guidelines/chronic-hepatitis-b
