Hepatitis B (HBV) is the most common infectious disease globally that affects the liver, and the primary cause of acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis B is highly endemic in developing countries.

As per the report of the “World Health Organization (WHO)“, an approximate 257 million people are living with hepatitis B infection (hepatitis B surface antigen positive). In 2015, hepatitis B caused an estimated 887 000 deaths, mostly from complications (such as cirrhosis and hepatocellular carcinoma). Hepatitis B is a significant hazard for health workers. However, hepatitis vaccines are available which are safe and effective for the prevention of Hepatitis B infection.

What is Hepatitis?

Hepatitis means inflammation of the liver. When the liver gets inflamed or damaged, its function can be affected. This condition can be self-limiting or can progress to scarring, cirrhosis or liver cancer. Hepatitis viruses are the common cause of hepatitis in the world, but toxins, heavy alcohol use, some drugs, and certain medical conditions (autoimmune diseases) can also cause hepatitis.

What are the types of Viral Hepatitis?

Viral hepatitis is categories into five types such as hepatitis A, B, C, D, and E. A different virus is responsible for every kind of virally transmitted hepatitis. Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

These five types of hepatitis are of great concern because of the burden of illness, high mortality rate and potential for outbreaks and epidemic spread.

What is Hepatitis B?

It is a severe liver infection caused by the hepatitis B virus. Hepatitis B infection can range from a mild illness lasting a few weeks to a serious, lifelong illness. HBV infection can be acute or chronic.

    • Acute hepatitis B:

      It is a short-term illness that occurs within the first six months after exposure to the hepatitis B virus. The severity of acute infection can range from mild illness with few or no symptoms to life-threatening conditions. Some people who can clear the virus without treatment become immune and cannot get infected with the hepatitis B virus again. Acute infection sometimes leads to chronic infection.

    • Chronic hepatitis B:

      It is a lifelong infection with the hepatitis B virus. Over time, chronic hepatitis B can cause serious health problems, such as liver damage, cirrhosis, liver cancer, and even death.

How does Hepatitis B spread?

It is spread by infected blood, semen, and other body fluid which enters the body of a non-infected person.

People can get infected with a virus from

    • Direct contact with infected blood.
    • Infected mother to baby at the time of birth.
    • Intimate contact with an infected partner.
    • Sharing needles, syringes, toothbrushes, razors with an infected person.

This infection does not spread through food or water, sharing utensils, hugging, kissing, hand holding, coughing, breastfeeding, or sneezing.

The person may remain asymptomatic up to 3 months after exposure and infection last for about 2–12 weeks. But, you are still contagious, even without symptoms. The virus can stay outside the body for up to seven days.

Who is at high risk of getting Hepatitis B?

Some people are at high risk of getting hepatitis B such as:

    • Baby born to infected mothers.
    • Healthcare workers.
    • People who use IV drugs.
    • People with multiple sex partners.
    • People with chronic liver disease.
    • People with kidney disease (hemodialysis patients).
    • People above 60 years with diabetes.

Those traveling to other countries have a high incidence of HBV infection.

What are the symptoms of Hepatitis B?

In acute hepatitis, children below 5 years and adults with a suppressed immune system rarely have symptoms. Above 5 years and over, newly infected with hepatitis B may not have any noticeable symptoms. If symptoms do appear, they generally appear around 90 days (3 months) after initial exposure.

The symptoms of acute hepatitis B include:

    • Abdominal pain, especially around the liver.
    • Dark urine.
    • Feeling tired and fatigue.
    • Loss of appetite.
    • Nausea.
    • Vomiting.
    • Fever.
    • Joint and or muscle pain.
    • Clay-colored stools.
    • Jaundice (yellowish discoloration of the skin and sclera or whites of the eyes and under the fingernails).

If an acute infection does not resolve within six months, then the infection is considered to be chronic. Most of the individuals with chronic hepatitis B do not have symptoms unless the liver becomes severely damaged.

How is Hepatitis B diagnosed?

On clinical grounds, it is not possible, to differentiate hepatitis B from hepatitis caused by other viral agents. Hence, laboratory confirmation of the diagnosis is essential. Some blood tests are available to diagnose and monitor people with hepatitis B. They can be used to distinguish between acute and chronic infections.

There are various types of blood tests available to diagnose hepatitis B. This blood test mainly focus on the detection of the hepatitis B surface antigen HBsAg.

    • Hepatitis B surface antigen test:

      This test indicates whether you are contagious. A positive test result shows that you have an acute or chronic hepatitis B and can spread the virus to others and negative test result means that you do not have the hepatitis B virus in your blood.

    • Hepatitis B core antigen test:

      This test indicates whether you are currently infected with HBV. A positive test results mean you have acute or chronic hepatitis B. It may also suggest that you are recovering from acute hepatitis B.

    • Hepatitis B surface antibody test:

      This test is done to check the immunity against HBV. A positive test result means that you are immune to hepatitis B infection. One of the two possible reasons for a positive test is either you have been successfully vaccinated, or you have recovered from an acute HBV infection and are no longer contagious.

Liver function tests are also done in the individual to determine hepatitis B or any liver disease.

What is the treatment of Hepatitis B?

    • Acute Hepatitis:

      There is no particular treatment available to treat acute hepatitis B. During this short-term infection; doctors usually recommend rest and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhea, although some people may need to be hospitalized.

    • Chronic Hepatitis B:

      In chronic hepatitis B, people should be monitored regularly for signs of liver disease and treated with oral antiviral medicines. Treatment can slow the progress of cirrhosis, reduce the incidence of liver cancer and improve long-term survival.

The commonly used medications to treat chronic hepatitis B like antiviral drugs such as tenofovir, entecavir, adefovir, and interferon alfa (boosts your immune system).

    • Hepatitis B and Pregnancy:

      In pregnancy, if you get infected with HBV, you might pass the virus to your baby at the time of birth, but it is less likely to pass during pregnancy.

If untreated, hepatitis B infection in babies can lead to long-term liver problems. All newborn of the infected mother should get hepatitis B immune globulin and vaccine for hepatitis immediately after birth and during their first year of life.

How is Hepatitis infection prevented?

    • The hepatitis B vaccine is the primary choices to prevent infection. Get vaccinated (if you haven’t infected).
    • Use condoms every time you have sex.
    • Cover up all open wounds or cuts.
    • Do not share toothbrushes, razors, nail care tools, or pierced earrings with anyone.
    • Make sure that any needles for drugs, ear piercing, or tattoos or tools for manicures and pedicures are properly sterilized.

Who should get the Hepatitis B vaccine?

All newborn babies should get vaccinated. The following groups should also receive the hepatitis B vaccine:

    • Any children and adolescents who were not vaccinated at the time of birth.
    • Adults being treated for STD (sexually transmitted disease).
    • A healthcare professional who frequently comes in contact with blood.
    • HIV-positive people.
    • Men who have sex with men.
    • People with multiple sexual partners.
    • Individuals use needles to take recreational drugs.
    • Family members of those with hepatitis B.
    • Individuals with chronic diseases.
    • People traveling to areas with high rates of hepatitis B infections.


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