Hepatitis B is a viral liver disorder caused by the Hepatitis B virus.

20-30% of hepatitis B cases develop an acute infection after an incubation period of 1-6 months, and the rest recover without symptoms. For acute hepatitis, 1-2% may develop to serious liver disorder called fulminant hepatitis. Hepatitis B virus may still remain in the liver even after being treated, but most of those who still have Hepatitis B virus in their system do not experience any health problems.

On the other hand, in about 5-10% of people who become infected as an adult the virus will continue to remain in the liver (more than 6 months). In many of these cases there will be no symptom or complications for a long time. However, it can progress to chronic hepatitis and to cirrhosis. Cirrhosis can greatly increase the risk of developing liver cancer.

Hepatitis B virus is divided into several types. People infected by sexual activity are recently found to be progressive and develop to chronic hepatitis.

Route of infection and prevention

Hepatitis B virus are in the blood, semen, and vaginal secretions and you can get infected through direct contact to the mucous membranes and wounds.

The leading causes of infection are used to be mother-to-child infection, blood transfusion, accidental needle sticks by medical staff, and sharing of syringes, but these risks are decreased and is almost eliminated with appropriate measures done in entire Japan. For current route of infection that are seen are through sexual activity. Another route is when piercings or tattoos device is being repeatedly used without sterilization.

Hepatitis is unlikely to be transmitted in a normal setting. Do not share everyday items such as toothbrushes and shavings with blood, wash them or wrap and discard them. Do not perform medical procedures in facilities with poor sanitation. Lastly, but not the least, if you are going to receive any non-medical procedure that uses needles, such as tattooing or piercing, please choose a provider with proper infection control and sterilization.

Hepatitis B vaccination is available and it is given three times with specific time frame. Hepatitis B vaccination is recommended if your partner is not infected and also to prevent transmission to sexual partners. Condoms help reduce the risk of sexual transmission, but they are not 100% preventable. Vaccination is also recommended when traveling in areas of poor sanitation and hygiene.

Sometimes vaccination may not give a sufficient response for prevention. You may want to test your antibody titers before and after vaccination to see if you have had a sufficient increase in antibody titers.

Pregnant woman with hepatitis B virus will need to take measures to prevent transmission to their child.

Testting

There are various tests for hepatitis B.

The most common test is the HBs antigen test. Immunity to hepatitis B can be checked by the HBs antibody test.

Laboratory results for acute hepatitis shows higher than average levels of serum liver transaminase (ALT or GPT, AST or GOT). When jaundice appears, the value of bilirubin also rises. In addition, blood tests and imaging tests may be performed to check whether organs other than the liver have been damaged.

For chronic hepatitis or cirrhosis, you should see your doctor regularly. In addition to regular imaging tests for liver cancer, tests will be done to determine the need for antiviral treatment and check its effectiveness.

Treatment

Treatment of symptoms is the main focus for Hepatits B infection.

Hospitalization might be necessary for patients with severe symptoms or if a blood test shows liver damage. During the acute phase liver function may be impaired, and so, a low-protein, low-fat diet is believed to improve gastrointestinal symptoms.

For 1-2% of those who have hepatits B, a serious condition called fulminant hepatitis occurs and organs other than the liver may be damaged. Please see a doctor immediately.

Antiviral therapy may be given for chronic hepatitis. In addition to interferon therapy, antiviral agents called nucleic acid analogs that were originally developed as therapeutic agents for HIV infection are also used for Hepatitis B treatment. It is necessary to assess whether the Hepatitis B infection is associated with HIV infection when nucleic acid analogs are considered for treatment. Use of nucleic acid analogs alone against HIV infection may lead to resistance to HIV medications, so a more complex treatment approach is needed for people living with HIV who also have hepatitis B.