Hepatitis B virus (HBV) infection causes both acute and chronic illnesses. Acute infections last for less than six months. They may resolve on their own, while chronic infection lasts for more than six months and is associated with an increased risk of hepatocellular carcinoma, which is a type of liver cancer. The WHO estimates that about 254 million people were living with the Hepatitis B virus in 2022, with approximately 1.2 million new infections yearly.
HOW IS THE HEPATITIS B VIRUS TRANSMITTED?
Hepatitis B virus is bloodborne and can also be transmitted from person to person through body fluids. The virus can survive outside the body for up to seven days, and it can cause an active infection if entered into the body. It has an incubation period of about 30 to 180 days.
Ways Hepatitis B can be transmitted include;
Mother to Child: Hepatitis B virus can be transmitted from a mother to her child during childbirth or through any means that exposes the child to the infected mother's blood.
Sexual Activities: The virus can spread through contact with an infected person's body fluids during unprotected sexual activity, which includes seminal fluid and vaginal fluid.
Transfusion of Infected Blood and Blood Products: The virus can also spread through transfusion of unscreened blood with hepatitis B virus or through infected sharps and needles.
In modern days, screening tests are carried out before a blood transfusion is done or donor blood is used. This is done as part of regular clinical practices; the most common means of transmission now lies in mother to child transmission, unsafe sexual practices and the use of contaminated needles and sharps. This shows that only a tiny amount of blood carrying the virus is needed to cause an infection.
STAGES OF HEPATITIS B INFECTION
Infections with Hepatitis B generally lasting for less than six months are classified as Acute, while an infection lasting for greater than six months is classified as Chronic. Chronic infection is more likely to occur in a newborn than in an adult, probably due to a newborn's immune system being less competent than an adult. About 90% of infected neonates progress to chronic carriers and are associated with liver damage. This is not to say adults do not come down with chronic diseases; untreated infections can also progress to chronic illness.
WHAT ARE THE SYMPTOMS?
Some carriers of the hepatitis B virus may show no symptoms and may only be identified as an incidental finding during routine tests. Others may have an active infection and may present to the doctor with some of the following;
Yellowing of the eyes and Yellowing of the skin
Dark-coloured urine
Nausea
Lack of appetite
Pale feces
Abdominal pain
Liver cirrhosis
Hepatocellular carcinoma and, ultimately, death.
HOW IS HEPATITIS B INFECTION DIAGNOSED?
Diagnosis of HBV infection is made by detecting either Hepatitis B antigen (a substance found only in the virus) in the blood or antibodies directed at this virus in serum. Usually, in an acute infection, the Hepatitis B viral antigen is detected first. In asymptomatic patients, when this is prolonged, it indicates that the individual is at risk of a chronic infection.
TREATMENT
Treatment usually commences for individuals who show symptoms. These individuals are placed on anti-viral therapies such as Entecavir and Tenofovir. They act as enzyme inhibitors to the HBV reverse transcriptase enzyme, preventing its function.
Other medications used include lamivudine and adefovir. Combination therapies such as tenofovir and emtricitabine are also used.
PREVENTION
Hepatitis B virus is preventable, and vaccines such as Recombivax HB are available.
It is highly effective with a few side effects. It is indicated for individuals exposed to blood and bloodborne products.
Prevention of Hepatitis B also cuts across healthy lifestyle practices, such as avoiding risk factors that involve
Not sharing needles and other forms of sharps
Carrying out safe sexual practices and using barrier methods to prevent sexually transmitted infections.
Screening all blood and blood products before transfusion
Ensuring Standard Safety procedures are observed in hospitals and all health centers.
CONCLUSION
Hepatitis B virus infection is a highly preventable infection that still accounts for a high percentage of mortality and morbidity in infectious diseases. Awareness of the causes, symptoms, and treatment will go a long way in preventing this disease and provide infected individuals with information for early presentation.
References
Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/hepatitis-b/symptoms-causes/syc-20366802
Assessed and Endorsed by the MedReport Medical Review Board