Hepatitis B

Overview

Hepatitis B is one of a family of viruses that can cause inflammation of the liver. The hepatitis B virus (HBV) usually spreads through blood, semen or other bodily fluids.

For most people, hepatitis B is a short-term (or “acute”) infection that may produce mild symptoms for a few months, or no symptoms at all. Once those with an acute HBV infection recover, they are immune for the rest of their lives and usually cannot spread the virus to others.

For some, however, hepatitis B can become a chronic, long-term illness that can lead to serious complications like cirrhosis, liver cancer and liver failure. While those with a chronic hepatitis B infection may experience no symptoms and feel fine for decades, the virus remains in their body and can be spread to others without the carrier’s knowledge.

Generally, the younger a person is when they contract hepatitis B, the more likely they are to develop chronic HBV and serious complications. According to the CDC, about 90% of infants who contract HBV from their mother during pregnancy develop lifelong symptoms from the disease. On the other hand, almost all of those over 6 years old who contract hepatitis B, including most teens and adults, have acute infections and recover completely without long-term symptoms or ongoing contagiousness.

Most often, hepatitis B is contracted due to unprotected sex, from sharing needles while using injectable street drugs, or passes from mother to child during pregnancy or delivery. There is a hepatitis B vaccine that can prevent the disease if taken prior to infection. The CDC recommends HBV vaccination for all healthy infants, children and adults up to age 59.

Why Hoag for Hepatitis B Treatment in Orange County?

Hoag’s comprehensive Liver Program offers the most advanced care in Orange County for conditions involving the liver, including acute and chronic Hepatitis B. Through groundbreaking treatments and clinical trials, we’re leading the way to a future where hepatitis B is a disease of the past.

If you’ve received a hepatitis B diagnosis, are at risk due to your sexual history or drug activity, or worry you may have been exposed, don’t wait. Contact Hoag and get the diagnosis and treatment you and your family can depend on.

Symptoms & Causes of Hepatitis B

The symptoms of hepatitis B are different for every patient and may mimic those of other conditions. Some people with hepatitis B may have no symptoms at all. Most of those infected with hepatitis B as an adolescent, teen or adults fully recover, even without seeking medical treatment.

For those who do develop noticeable issues due to an acute HBV infection, symptoms usually begin an average of 90 days after exposure. Symptoms usually last several weeks, but can last for up to 6 months.

Common Symptoms of Acute HBV Infection:

• Unexplained fever
• Fatigue
• Loss of appetite
• Unexplained nausea and vomiting
• Abdominal pain
• Pale bowel movements and/or dark urine
• Joint pain
• An enlarged liver or spleen
• Jaundice, which is a yellowing of the eyes and skin

Symptoms of Long-Term or Chronic HBV Infection

Many of those with chronic HBV infection can be symptom free for decades, even though they can still pass on the virus to others. By the time those with a chronic HBV infection develop symptoms, they often have advanced liver disease.

Long-term symptoms of chronic hepatitis B may include:

• Cirrhosis, which is permanent scarring of the liver due to tissue damage
• Developing liver cancer
• Liver failure

Risk Factors & Screening

Because both chronic and acute HBV can cause no symptoms, the CDC recommends HBV testing for:

• All adults over 18 years old at least once in their lifetime
• All pregnant women early in each pregnancy
• All healthy infants born to women with an HBV infection

Those at Elevated Risk

For those with an elevated risk of contracting hepatitis B, the CDC recommends periodic testing. Those at elevated risk for HBV include:

• Men who engage in sex with men
• People who use or have used injectable street drugs
• People who are or have been incarcerated
• Those living with HIV
• Those who live in a household with someone who has hepatitis B
• People who engage in unprotected sex, have multiple sexual partners, or have had sexual contact with someone known to be infected with or at elevated risk of HBV
• Those on dialysis or suffering from end-stage kidney disease
• Those with chronic conditions that may cause them to be immunocompromised
• People born in parts of the world where hepatitis B is common, or whose parents were born where HBV is common. According to the CDC, places where HBV is common include:
  • Asia
  • Pacific Island nations
  • Africa
  • Eastern Europe

Activities That Don’t Put You at Risk for Contracting Hepatitis B

Hepatitis B is not an airborne virus and cannot be spread through casual contact with an infected person. Activities that don’t put you at risk of contracting HBV include:

• Sharing dishes or utensils with a person who has HBV
• Drinking from the same water fountain as a person with HBV
• Using the same bathroom facilities as a person with HBV
• Kissing or hugging a person with HBV
• Being nearby when a person with HBV coughs or sneezes
• Sitting or standing close to someone with HBV

Diagnosis & Tests for Hepatitis B

Hepatitis B is usually diagnosed through a blood test, which can also help your doctor determine whether the infection is acute or chronic and whether you are infectious to others. If it is determined you have chronic HBV, your doctor may order more testing, potentially including imaging tests to look for any liver damage.

Management & Treatment for Hepatitis B

Around 95% of adults who contract hepatitis B recover within a few weeks or months without the need for treatment, though a doctor may recommend fluids and rest to aid in recovery. In certain cases, a doctor may also recommend that you take immune globulin, a substance made from blood plasma that contains antibodies, which can help your immune system fight the hepatitis B infection.

For those who develop a chronic hepatitis B infection, there is currently no way to completely purge the body of the virus or reverse any liver damage it may have caused. However, there are treatments that can help control the disease, protect remaining liver function and prevent many of the worst long-term side effects.

Drug treatments for chronic HBV generally fall in two categories:

• Immune modulators, which are injectable drugs that fortify the immune system and help your body fight the virus
• Antiviral Drugs, usually taken in a daily pill, which slow replication of HBV inside the body, preventing or slowing inflammation of the liver

Because those with chronic hepatitis B can pass on the virus to others through bodily fluids, they should be sure to inform all current and future sexual partners, those providing medical care and others who might be at risk of contracting the disease of their status so those they come in contact with can protect themselves from infection and make informed decisions.

Prevention of Hepatitis B

One of the best ways to prevent yourself from contracting hepatitis B is by taking the hepatitis B vaccine. The CDC recommends HBV vaccination for:

• All medically-stable infants within 24 hours of birth
• All children and teens younger than 19 years of age who have not been vaccinated
• All adults 19 to 59 years old
• Adults more than 60 years old who engage in behaviors that may put them at risk for contracting hepatitis B

Other ways to potentially protect yourself from hepatitis B infection include:

• Don’t share toothbrushes, razors or other personal care items with others
• Avoid using injectable street drugs
• Wear a condom if you engage in male/male sex, particularly if you have multiple partners
• Seek regular screening if you engage in behaviors that might put you at risk of HBV infection, or if you live with someone who has a chronic HBV infection