What is Hepatitis B from a Medical Perspective?
- Acute Hepatitis B: Short-term infection that may resolve spontaneously, especially in adults.
- Chronic Hepatitis B: Lifelong infection (if persists beyond 6 months), increasing risk of cirrhosis, liver cancer, and liver failure.
- Asymptomatic Carriers: Individuals with detectable HBV but no liver damage (e.g., HBsAg positive but no inflammation).
HBV has a high global prevalence, with 2.4 billion infections recorded. It is a leading cause of liver-related deaths worldwide.
Symptoms of Hepatitis B
Acute Hepatitis B:
- Yellowing of skin/eyes (jaundice).
- Fatigue, nausea, vomiting, and abdominal pain.
- Dark urine and pale stools.
- Loss of appetite and muscle aches.
Chronic Hepatitis B:
- May be asymptomatic for decades.
- Progressive liver damage leading to:
- Cirrhosis: Scarring of the liver, causing portal hypertension and ascites.
- Hepatocellular Carcinoma (HCC): Liver cancer with poor prognosis if undetected.
- Chronic fatigue, spider angiomas, and hepatic encephalopathy in advanced stages.
Hepatitis B Diagnostic Methods
Testing involves serological and molecular assays:
- Initial Screening:
- HBsAg (hepatitis B surface antigen): Detects current infection.
- Anti-HBc IgM: Indicates acute infection.
- Confirmatory Tests:
- Anti-HBs: Confirms immunity (from vaccination or recovery).
- HBeAg/HBeAb: Assesses viral replication and infectivity.
- Viral Load Testing:
- Quantitative HBV DNA for chronic cases to guide treatment.
- Liver Function Tests (LFTs):
- ALT/AST elevations indicate liver inflammation.
Medical Management of Hepatitis B
Acute Hepatitis B:
- Supportive care: Rest, hydration, and symptom management.
- No specific antiviral therapy unless severe liver failure occurs.
Chronic Hepatitis B:
- Antiviral Therapy:
- Entecavir, Tenofovir, or Pegylated Interferon for suppressing viral replication.
- Long-term use required to prevent progression.
- Liver Monitoring:
- Biannual LFTs and ultrasound for early HCC detection.
- Liver Transplant: For end-stage cirrhosis or decompensation.
Frequently Asked Questions (FAQ)
Can Hepatitis B be cured?
Acute HBV often resolves spontaneously. Chronic cases are manageable but not curable. Antivirals suppress viral replication but do not eliminate the virus completely.
What is the “window period” for testing?
Antibodies may take 1-6 months to appear. Testing should occur 1-3 months post-exposure. Repeat testing at 6 months for conclusive results.
Is Hepatitis B transmitted through saliva?
Low risk unless blood/saliva mixes with open wounds. Transmission via kissing is rare but possible during bleeding gums.
Can pregnant women transmit HBV?
Yes. 90% of infants born to untreated mothers acquire HBV. Prophylaxis with HBV vaccine + immunoglobulin within 12 hours of birth prevents transmission.
Does Hepatitis B affect life expectancy?
Untreated chronic HBV reduces life expectancy by 10-20 years. Early treatment and monitoring can normalize prognosis.
Preventing Hepatitis B Transmission
- Vaccination:
- Universal infant vaccination (3-dose series) provides 95% protection.
- Recommended for healthcare workers, travelers, and high-risk groups.
- Safe Practices:
- Avoid sharing needles, razors, or toothbrushes.
- Use condoms during sex with untested partners.
- Blood Safety:
- Screen all donated blood for HBV.
- Perinatal Care:
- Screen all pregnant women and provide prophylaxis to infants at risk.
