Hepatitis B Infection

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic. HBV infection is considered chronic when it persists longer than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis (permanent scarring of the liver).

Common ways HBV is transmitted include:

• Sexual contact. You may become infected if you have unprotected sex with an infected partner whose blood, saliva, semen or vaginal secretions enter your body.
• Sharing of needles. HBV is easily transmitted through needles and syringes contaminated with infected blood.
• Accidental needle sticks. Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.
• Mother to child. Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated immediately after labor to avoid getting infected in almost all cases.

Complications

• Scarring of the liver (cirrhosis). The inflammation associated with a hepatitis B infection can lead to extensive liver scarring (cirrhosis), which may impair the liver’s ability to function.
• Liver cancer. People with chronic hepatitis B infection have an increased risk of liver cancer.
• Liver failure. Acute liver failure is a condition in which the vital functions of the liver shut down. When that occurs, a liver transplant is necessary to sustain life.

Treatment for acute hepatitis B infection

If your doctor determines your hepatitis B infection is acute, you may not need treatment. Instead, your doctor might recommend rest and adequate nutrition and fluids while your body fights the infection. You need to recheck your blood regularly to monitor the progress of the infection. Adults tends to fight off the infection much better than children.

If the body is unable to fight off the infection within 6monhts, then you would be treated as a chronic hepatitis B infection.

Treatment for chronic hepatitis B infection

Treatment is usually not needed also as most cases of chronic hepatitis are inactive and does not cause complication but your doctor would need to monitor your liver function every 6-12 months as chronic hepatitis B can be reactivated and increases your risk of developing liver failure, liver cancer or cirrhosis.

If the chronic hepatitis is reactivated (evidence by persistent abnormally liver function test) your doctor may need to refer you to a liver specialist for treatment to suppress the activity of the Hepatitis B virus to reduce the risk of liver complication.  

Vaccination prevent hepatitis B infection

Theirs is no cure for hepatitis B, but vaccination can prevent hepatitis B.  

Therefore check with your family doctor about hepatitis B vaccination.

For those who has not been vaccinated before a three dose vaccination regime is recommended.  

For individuals previously vaccinated for hepatitis B but with antiHBs levels < 10 IU/L, to consider repeat booster of hepatitis B vaccination or give a second course of hepatitis B vaccination before rechecking the anti-HBs antibody titre.

Treatment to prevent hepatitis B infection after exposure

If you know you’ve been exposed to the hepatitis B virus, call your doctor immediately. If you haven’t been vaccinated or aren’t sure whether you’ve been vaccinated, receiving an injection of hepatitis B immune globulin within 12 hours of coming in contact with the virus may help protect you from developing hepatitis B. You should be vaccinated at the same time.

Dr Lee Chong Han (soruce: Mayo Clinic and American Family Physician)