HEPATITIS B

What’s it?

It’s a liver inflammation caused by the hepatitis B virus (HBV).

How is it acquired?

Blood transfusions used to be the main way of transmission, a circumstance that has become rare with the mandatory laboratory testing of donors.

Currently, the sharing of syringes, needles and other instruments amid drug users, as well as sexual intercourse without condom, is the most worrisome form of contamination in the population.

The accidental contact between blood or body secretions contaminated by the virus and mucosa or skin lesions also transmits the virus.

Contaminated pregnant women may transmit the virus to their babies, normal or Cesarean delivery being the main moment of risk, which can be minimized by the doctor.

What does one experience and how does it develop?

Symptoms are similar to those of hepatitis in general, starting with:
 

general discomfort
headache and pains in the body
tiredness on minimum effort
lack of appetite
fever
Later, usually appear:
yellowish color in the mucosae and skin (jaundice)
body itching
dark urine
light-colored feces

At 10 to 15 days, the general symptoms highly decrease, even during jaundice, which tends to disappear in 6 to 8 weeks on average, indicating cure in more than 95% of cases.

The clinical form, called fulminating hepatitis, with a mortality rate up to 60%, occurs in less than 1% of the patients that acquire the virus.

After the acute phase, which goes on unnoticed, 1-5% fail to have the infection cured, remaining with chronic hepatitis. Of these, 25-40% may develop cirrhosis and liver cancer over the decades.

The risk of chronic disease with ominous development is higher for those who drink alcoholic beverage, babies that acquire the disease at the delivery, and people with low immunity (AIDS patients or patients undergoing chemo or radiotherapy, e.g.).

How does the doctor diagnose it?

The symptoms don’t allow the identification of the hepatitis cause.

Hepatitis in adults, especially in drug injectors, homosexuals or individuals with several sexual partners, raises suspicion of hepatitis B.

The diagnostic confirmation is made by blood tests, in which antibodies or particles from the hepatitis B virus are detected.

Certain cases are only found in the chronic phase or in the investigation into the cause of cirrhosis or liver cancer in an individual that was unaware of suffering from hepatitis.

How is it treated?

Acute hepatitis B doesn’t require specific drug treatment.

Medications for nausea, vomiting and itching, as well as the intravenous administration of fluids, can be used occasionally.

Rest in bed isn’t required since it doesn’t affect the course of chronic or fulminating hepatitis.

Alcohol intake in any amount is forbidden.

The use of any drug must be evaluated by the doctor, as many need a good functioning of the liver for their action.

The fulminating form of acute hepatitis demands intensive hospital care, and may entail urgent liver transplantation.

Some cases of chronic hepatitis can be treated with 2 different types of drugs, interferon and lamivudine. Treatment results aren’t optimal yet, as the cure is achieved in only 30% of patients, despite a greater number responding favorably initially.

How to prevent it?

The hepatitis B vaccine must be applied to all newborns, the vaccination regimen beginning as early as the age of 1 month.

Non-vaccinated adults and those that haven’t had the disease can also take the vaccine, which is especially recommended for people that are taking care of patients, health care providers, virus C carriers, alcoholics, and individuals with other liver diseases.

One must wear protective gloves, mask and goggles whenever there’s possibility of contact with blood or body secretions.

People known to have been exposed to the virus (sexual relationship with contaminated individual, accident with needle) must receive a sort of whey (gamma globulin) in the first days following contact, which may decrease the chance for developing the disease or, at least, the intensity thereof.

Newborns from mothers with hepatitis B must receive specific gamma globulin and take shots right after the birth in order to reduce the risk of developing the disease.

Attention: During sexual relations, the use of condom is crucial. The chance for getting hepatitis B in an unprotected relationship is well higher than that for getting AIDS. Any kind of sexual relation can transmit hepatitis B.

Questions you can ask your doctor about:

What type of hepatitis do I have?

How is it acquired? Is there any risk for the people who live near me?

How long will it take me to get better?

Is drug treatment necessary?

Does this disease have a cure or will I get chronic hepatitis?

Does the medicine work for everyone?

What are the side effects from treatment?

Is there risk for cirrhosis? And what about cancer?

Is there a vaccine for hepatitis? Would it work if the people living near me and I had shots now?

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