Hepatitis B Infection

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This week we continue this series of conditions that can cause acute liver failure. The topic of discussion for this week will be about the Hepatitis B infection. This is a viral infection which causes inflammation of the liver. Hepatitis B is a major global health problem. The World Health Organisation (WHO)  estimates that 254 million people were living with chronic hepatitis B infection in 2022, with 1.2 million new infections each year. In 2022, hepatitis B resulted in an estimated 1.1 million deaths, mostly from cirrhosis and primary liver cancer.  The burden of infection is highest in the WHO Western Pacific Region and the WHO African Region, where 97 million and 65 million people, respectively, are chronically infected.

This infection can be spread in various ways. It can be spread from mother to child during delivery. Hepatitis B is also spread through contaminated needles and syringes when they are reused , particularly amongst people who inject drugs. It is also commonly spread through needle stick injuries, tattooing, piercing and exposure to infected blood and body fluids. It can also be transmitted through unprotected sexual intercourse.

In most cases people who have a new infection of Hepatitis B do not experience any symptoms. However some people may have an acute illness which may manifest with the following symptoms; tiredness, nausea, vomiting, abdominal pains and yellowing of the skin and eyes. In severe cases it can lead to acute liver failure and death.

Most people with an acute infection recover with no complications. A small proportion will have a persistent infection which can lead to scarring of the liver and even cancer of the liver.

The diagnosis of Hepatitis B is based on blood tests. They are no clinical symptoms or signs that are confirmatory of the condition. It is usually suspected when patients present with the above symptoms of those with abnormal liver function tests.

Acute hepatitis B does not have any specific treatment. We usually give supportive treatment to manage the symptoms associated with it. As previously mentioned the majority of the cases are self-limiting. Chronic Hepatitis B on the other hand can be treated. Unbeknown to many, some of the medications used to treat the Hepatitis B virus are also used to treat HIV. This is something that often causes confusion and distress amongst patients if not explained properly. The objective of treatment is to reduce liver scarring, reduce cases of liver cancer and ultimately improve long term survival.

Hepatitis B is preventable by vaccination. Most countries have added the vaccine as part of their immunisation schedule.  The vaccine is protective for 20 years. Other measures that prevent spread of Hepatitis B include measures that reduce the risk such as practicing safe sex, not sharing needles, and hand washing when in contact with blood or body fluids.

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