VPMD: Hepatitis B
What is Hepatitis B?
Hepatitis B, the virus, causes the infectious disease Hepatitis B; This disease affects the liver primarily. There are two forms of the disease: acute and chronic.
Acute Hepatitis B presents on a spectrum, from no symptoms at all to severe liver failure. Hepatitis is heralded by signs of inflammation of the liver including, but not limited to, jaundice, dark urine, fatigue, abdominal pain, nausea and vomiting. Severe symptoms include bruising, easy bleeding, confusion.
Chronic hepatitis presents with the same symptoms of acute hepatitis but last longer and progresses to cirrhosis (liver scarring) and/ or liver cancer.
How do you get the disease?
The virus is passed from person to person through bodily fluids (e.g. blood, saliva, semen and vaginal fluid.) It is thought that vaginal fluid and blood from infected mothers can spread the virus to their child. Common ways people contract the virus include through use of contaminated needles, sex with infected persons, passage through the birth canal or passage of virus in blood through the umbilical cord.
How is Hepatitis B diagnosed?
There are several infectious and non infectious causes of hepatitis,therefore specific testing is required for the diagnosis of Hepatitis B. To identify the presence of the Hepatitis B virus, antibody based testing is used.
How is Hepatitis B treated?
Acute Hepatitis B is self limited, so no treatment is indicated aside from treating symptoms.
Chronic Hepatitis on the other hand is treated with non-specific antivirals with the goal of slowing the progression of disease to liver fibrosis( cirrhosis) and/or hepatocellular carcinoma.
How is Hepatitis B prevented?
The hepatitis B vaccination is given as a three dose series with the initial dose occurring within 24 hrs of birth in the United States. The rationale for the newborn dose is to provide early protection from unknown exposure to Hepatitis B from peripartum exposure and curb the potential for developing chronic hepatitis B along with its complications.
Other modes of prevention include:
Use safe sex practices.
Avoid needle sharing
Handwashing with soap following contact with bodily fluid.
The case for the newborn dose
This article by Dr. Paul Offit, on the Children Hospital of Philedelphia’s webpage, goes into detail about the rationale for the newborn dose. In summary the number of children with hepatitis B infection born to mother’s whose blood tests were negative was overwhelming and declined considerably following the implementation of the infant dose recommendation in 1991.