We’ll continue the series on hepatitis this week by focusing on hepatitis B.  Hepatitis B is another viral infection that causes inflammation of the liver.  The symptoms of hepatitis B are the same as those we previously discussed in the Health Tip on hepatitis two weeks ago. Unlike hepatitis A, the hepatitis B virus can cause an acute or chronic infection.

How do you get hepatitis B?

The hepatitis B virus is spread through contact with the blood, semen, or other body fluid of an infected person.  It is not spread by casual contact with an infected person.  It is not spread by drinking contaminated water or eating contaminated food, or sharing eating utensils.  A baby cannot get hepatitis B from breast milk.

How is the hepatitis B virus spread?

• Having unprotected sex with an infected person
• Sharing drug needles or other drug materials with an infected person
• Having an accidental needle stick with a needle that was used on an infected person
• Getting a tattoo or a piercing with tools that were not properly sterilized after being used on an infected person
• Sharing an infected person’s personal items, such as a razor, nail clippers, or toothbrush
• Coming in contact with the blood or open sores of an infected person
• Being born to a mother who is infected with hepatitis B

What is the difference between acute and chronic hepatitis B?

Acute hepatitis B is a short-term infection, which may last from several weeks up to 6 months.  Most healthy adults and children older than 5 years old will have a good immune response to the hepatitis B virus, so their body is able to fight off the infection, and the infection goes away.

Chronic hepatitis B is a long-lasting infection, sometimes lasting a lifetime.  It happens when your immune system is not able to fight off the acute infection and the virus does not go away.  Only about 5% of adults who develop an acute hepatitis B infection will go on to have chronic hepatitis B.  Children are much more prone to develop a chronic infection, because their immune system is not mature.  About 90% of infants infected with hepatitis B will develop chronic hepatitis B.

What are the complications of chronic hepatitis B?

• Cirrhosis – A condition in which scar tissue replaces healthy liver tissue.  This scar tissue can block the blood flow through the liver, causing many complications.
• Liver failure – As cirrhosis progresses over months or years, the function of the liver declines and the liver can no longer perform its important functions.  This is also called end-stage liver disease.
• Liver cancer – Chronic hepatitis B increases your chance of developing liver cancer.  If you have chronic hepatitis B, you should be screened for liver cancer at regular intervals.

What can be done to prevent hepatitis B?

• Immunization – A vaccine has been available for hepatitis B for many years, initially given to adults at high risk, such as health care workers.  In 1991, the vaccine was added to the recommended childhood vaccine schedule.  Since then the rate of new hepatitis B infections has gone down by 82%.
• Avoid the exposures that spread hepatitis B that I mentioned above.

Should you be screened for hepatitis B?

Some people do not have severe symptoms during the acute hepatitis B infection, and do not realize that they have chronic hepatitis B until they develop symptoms of liver failure.   These are some of the reasons that hepatitis B screening is recommended, if you:

• Are pregnant
• Were born in an area of the world where hepatitis B is more common (sub-Saharan Africa, parts of Asia, and the Pacific Islands), or if you did not receive the hepatitis B vaccine as an infant and have parents who were born in these areas of the world
• Are a man who has sex with men
• Are HIV positive
• Have injected drugs
• Have lived with or had sex with a person who has hepatitis B

For more information about hepatitis B, try these links…
https://www.cdc.gov/hepatitis/hbv/index.htm
https://www.mayoclinic.org/diseases-conditions/hepatitis-b/symptoms-causes/syc-20366802

If you have any more questions just Ask Hanna, our health advisors are here to help.

Dr. Anita Bennett MD – Health Tip Content Editor
Image: ©Shutterstock / Michail Petrov