Hepatitis B

Why is the liver important?

The largest internal organ in the body, the liver is absolutely vital for survival. It has a lot of vital functions:

• Produces bile, a mixture of chemicals, which aids digestion.
• Helps break down food to turn it into energy.
• Removes harmful substances from the blood, helping fight infection.
• Makes chemicals that are important for blood clotting.
• Stores iron, vitamins and other essential substances

What is Hepatitis B?

A viral infection of the liver, Hepatitis B is caused by HBV (Hepatitis B virus). It causes swelling of the liver and inflammation (acute hepatitis) and prevents the liver from working well. It may persist in the liver causing chronic hepatitis, and over many years can lead to cirrhosis (scarring) of the liver, liver cancer, and liver failure.

How does one get Hepatitis B?

The Hepatitis B virus is spread by contact with blood or other infectious body fluids. Adults get Hepatitis B through infected blood transfusion, contaminated needles and sexual transmission from a Hepatitis B infected partner. Usually, children get Hepatitis B from their mother during childbirth. Hepatitis B virus does not spread by water, air or food.

Who is at risk of having Hepatitis B?

Hepatitis B is very common. About 2 to 3 percent of people in Asia have chronic Hepatitis B infection. Certain practices like reuse of needles and syringes in hospitals and clinics in the past, tattooing using unclean and contaminated needles, unregulated and unsafe blood transfusion have increased the risk of transmission of Hepatitis B. In view of the high prevalence of Hepatitis B, it is recommended that everyone should get tested for Hepatitis B infection by doing a simple blood test.

Infection with HBV can cause both – short-term (acute) disease and long-term (chronic) disease. Patients with acute HBV infections display symptoms including loss of appetite, weakness, nausea, vomiting, abdominal pain, jaundice (yellow skin or eyes), and dark urine. The acute phase usually lasts 2-8 weeks and most patients recover completely. Few individuals develop a severe form of acute infection and can die as a result of liver failure. Some adults and almost all children who get infected during birth go on to develop chronic HBV infection. These people often do not feel sick for many years. With the progression of the disease, cirrhosis and liver failure develop and patients develop swelling of legs (edema), fluid in the abdomen (ascites), vomiting of blood, and mental confusion.

What can be the long-term consequences of Hepatitis B?

Hepatitis B damages the liver gradually over 20-30 years of time. Close to 20 percent of patients with untreated Hepatitis B develop liver cirrhosis (scarring of the liver). Once cirrhosis develops, patients are at risk of developing liver failure.

Do patients with Hepatitis B develop liver cancer?

One in 20 individuals suffering from Hepatitis B will develop liver cancer. The risk depends on the amount of virus in the blood and is more in patients with chronic Hepatitis B and cirrhosis. Patients suffering from chronic Hepatitis B should get ultrasound scans done regularly to detect small liver tumours at an early stage. Detected early, they can be treated effectively.

Hepatitis B is easily diagnosed by a simple blood test. It is also possible to know the amount of Hepatitis B virus in the blood by doing a special blood test called Hepatitis B virus DNA PCR. Knowing the amount of virus in the blood is important to decide the need for treatment and to monitor the effectiveness of treatment. 

What should you do if you are diagnosed with Hepatitis B?

• Talk to your doctor regarding the need for treatment.
• Do a blood test to determine the amount of virus in the blood (Hepatitis B virus DNA PCR).
• Take only the medication recommended by your doctor.
• Do not resort to herbal drugs.
• Avoid alcohol completely.
• Ask all your family members including spouse, siblings and children to get tested for Hepatitis B.

If you are suffering from Hepatitis B virus, it is important to speak to your doctor about the available treatment options. Most patients who develop acute Hepatitis B infection recover on their own. Your doctor will recommend rest, drinking lots of fluids, eating a healthy diet and avoiding alcohol. Patients with chronic Hepatitis B infection and those with Hepatitis B related cirrhosis need specific medicines which act against the Hepatitis B virus in your blood. Some commonly used medicines are Entecavir and Tenofovir. Occasionally weekly injections of Interferon may be required for 6 to 12 months.

What is the most effective way to stop the spread of Hepatitis B?

Vaccination is the most effective way to prevent Hepatitis B infection. The vaccine is given as 3 injections over a period of six months. People of all age groups can take it. After the vaccination course is completed, it is important to do a blood test to check whether it is effective or not. This form of blood test detects the level of protective antibodies in the blood. In India, children are being vaccinated at birth as per the Government’s Universal Immunization Programme.

Conclusion

Facts at a Glance:

• Hepatitis B is a liver disease caused by HBV (Hepatitis B virus).
• Hepatitis B spreads to adults through contaminated needles, infected blood transfusion and sexual transmission from a Hepatitis B infected partner.
• Usually, children get Hepatitis B from their mother during childbirth.
• About 1 in 50 Indians are infected with the virus.
• Most individuals with Hepatitis B show no symptoms.
• Hepatitis B can be easily diagnosed with a simple blood test.
• There are effective medications to treat the disease.
• Untreated Hepatitis B can lead to cirrhosis, liver cancer, and liver failure.
• Vaccination is the best way to prevent HBV.