Hepatitis B is a contagious communicable disease that cause liver infection. It is caused by Hepatitis B virus (HBV). In past days it was known as serum Hepatitis as it is transmitted through infectious blood.
Risk Factors:The chance of this disease is higher in people who undergoes tattooing, acupuncture, unscreened blood (blood that is not tested) before transfusion, dialysis ( exchange of pure blood with impure one), sharing razors, tooth brushes, use of infected syringes and needles.
Transmission: Hepatitis B is transmitted through the contact with the infected blood or body fluids like semen, saliva. Vertical transmission is common.The baby born from the infected mother get Hepatitis B due to the transfer of the blood from mother to baby during childbirth. Intravenous use of drugs and sex with infected partners is the rapid transmission of infection.
Hepatitis B does not spread by holding hands, sneezing, coughing, breastfeeding, sharing eating utensils, common latrines, hugging and kissing.
Incubation Period: Its incubation period is 75 days on average. It varies from 30-180 days. It can be detected 30-60 days after infection and persists for variable period of time.
Signs and Symptoms: It is based on types:
- Acute Hepatitis B infection:- It is asymptomatic. It persists less than 6months and appears with general illness such as decrease in food intake, joint pain, vomiting, nausea, mild fever, dark urine and yellowing of urine.
- Chronic Hepatitis B infection: It persists more than 6 months. It may be asymptomatic or may be associated with chronic inflammation of the liver. It leads to cirrhosis of liver an increases the incidence of liver cancer.
Diagnosis: The detection of Hepatitis B virus infection includes serum or blood tests that detect either viral antigens or antibodies produced by the host through the Assays test. To screen the Hepatitis B infection Hepatitis B surface Antigen (HBsAg) is commonly used. This viral antigen was first detected when it appear during infection. Individuals with HBsAg positive for the period of at least 6 months are consider to be Hepatitis B carrier. Carrier of virus have increased in serum alaline aminotransferase (ALT) levels and inflammation of liver in chronic case. Polymer Chain Reaction (PCR) is also used to detect the Hepatitis B virus.
Prevention: For the prevention of Hepatitis B, vaccines are being used. Most vaccines are given in three doses over a course of months.
Adult vaccine dose-
- Engerix B- 1ml (20 mcg) IM for 3 doses at birth, 1 month and 6 month.
- Recombivax HB- 1ml (10mcg) IM for 3 doses at birth, 1 month and 6 month.
Post exposure prophylaxis:
- Hepatitis B immune globulin should be given as soon as possible after exposure within 24 hours along with a dose of Hepatitis B vaccine at separate site within 7 days of exposure at 1 month and 6 month.
- Screening the blood before transfusion.
- Use of contraceptives for sexual contact.
- Proper precautions taken when handling the infected person.
- Adequate sterilization of materials used by infected person.
- Avoidance of HBV pregnancy.
- Proper disposal of sharp waste.
Treatment: In acute condition, Hepatitis B does not require treatment whereas in chronic infection treatment is essential to reduce the risk of cirrhosis of liver and liver cancer. Hepatitis B cannot be clear by the use of drugs but it can stop the virus from replication and thus minimize the liver damage. There is elevated level of serum alaline aminotransferase in chronic infected individual. Treatment of Hepatitis B last for six month to a year and it depends on the type of the drugs used. Antiviral drugs used are lamivudine (Epivir), Adefovir (Hepsera) , Tenofovir (Viread), Telbivudine
(Tyzeka) and Entecavir (Baraclude) and the two immune modulators interferon alpha 2a and Pegylated interferon alpha 2a (Pegasys).
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