Hepatitis B

Hepatitis B is a viral infection that affects the liver. The hepatitis B virus (HBV) is very common worldwide and very infectious. It can cause the liver to become inflamed, tender, and swollen. Some people will have mild symptoms or no symptoms at all. Usually the body will fight off the virus, but in some people it becomes a chronic (persistent or long-term) infection. For those people, HBV can cause cirrhosis (scarring of the liver), liver cancer, liver failure, or even death.

Reporting

According to the Center for Disease and Control (CDC), in the United States there were 1.25 million people with a chronic (persistent or long-term) infection of the hepatitis B virus (HBV) in 2006. It is estimated there are 46,000 new infections of HBV and that 5,000 people die from the damage HBV does to the liver. (source)
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Transmission

The hepatitis B virus (HBV) is considered very infectious and can be transmitted through the semen, vaginal secretions, blood, or other body fluids of an infected person.

HBV can be transmitted through vaginal, anal, or oral sex. If the sex is rough and causes bleeding, the risk of transmission can increase. These forms of sexual activity are the most common ways for adolescents and adults to be infected by the virus.

Men who have sex with other men are at risk of being infected from anal and oral sex. Women who engage in oral sex or vulva (outer female genital area) to vulva contact are also at risk of infection.

Using non-sterilized needles for tattooing, body piercing, and acupuncture can cause transmission to occur. However, in the United States, these form of exposure only account for a small percentage of reported cases.

Drug users who inject drugs can be infected by HBV if they share needles with others who have the virus. Living in the same house as a person who is infected and sharing items such as toothbrushes and razors can also cause the virus to be transmitted. However, the virus can not be transmitted through casual contact like shaking hands or hugging, nor can the virus be transmitted through food or water.

Being bitten by a person who is infected with HBV can cause transmission to occur. Kissing can also cause transmission, but it is very unlikely unless there is a small cut or abrasion in the mouth.

HBV can also be transmitted through a blood transfusion. The risk of that happening in the United States is low because blood banks screen all donated blood.

An infected woman who is pregnant can transmit HBV to her baby during birth when the baby passes through her birth canal. Immunization at birth can prevent this from happening.
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Symptoms

Most adults will have few or no symptoms from hepatitis B. A person who is older is more likely to have symptoms. People with a lack of symptoms can still spread the virus.

One of the more obvious symptoms of hepatitis B is jaundice (yellowing of the skin and eyes, darker urine, and pale feces). Other symptoms that can be experienced are itchy skin, nausea, vomiting, diarrhea, loss of appetite, weight loss, abdominal discomfort, malaise (feeling of ill-health), or fatigue (feeling tired all the time). Prior to the onset of these symptoms however, a rash or arthritis can occur.

In rare cases, those infected with the hepatitis B virus (HBV) can have more severe symptoms, and liver failure can be experienced shortly after being infected. People who experience this may collapse with fatigue, become jaundiced, and develop swelling in their abdomen. If treatment is not sought immediately, death may occur.
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Testing / Diagnosis

Laboratory tests are used to diagnose an infection of the hepatitis B virus (HBV). Testing is done on a blood sample. A health care provider can order the blood drawn and tested.

Testing for HBV can show that immunity has been built up to the virus, which is a sign of past infection, or show if a person has an acute (newly acquired or short-term) or chronic (persistent or long-term) infection. Further testing may be ordered if a chronic infection is found to check for any liver damage.
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Treatment

Treatment for hepatitis B is different for those who have an acute (newly acquired or short-term) infection and those who have a chronic (persistent or long-term) infection.

For those with an acute infection, there is no specific treatment. Most people will fight off the virus on their own. Hospitalization should be avoided unless symptoms become severe. A health care provider should be consulted for any recommendations, but there usually is no restriction on diet or activity. However, all forms of sexual and non-sexual contact and activity that can infect others should be avoided.

Once the infection has been fought off, a person is immune and can not get hepatitis B again.

For those with a chronic infection, the anti-viral drugs interferon, lamivudine (Epivir), adefovir dipivoxil (Hepsera™), entecavir (Beraclude™), and peginterferon (Pegasys®) are available.
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Complications

Some people infected with the hepatitis B virus (HBV) can develop a chronic (persistent or long-term) infection. A chronic infection increases the risk of cirrhosis (scarring of the liver), liver cancer, liver failure, or death.
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Prevention

Hepatitis B can be prevented with a vaccine. The vaccine is recommended for people who live in a household with a person who is chronically (persistent or long-term) infected, health care professionals, staff and patients of institutions for the developmentally disabled, men who have sex with other men, people who have a sexual partner who is infected, people who have more than one sexual partner, people who work as prostitutes, drug users who inject drugs, hemodialysis patients, and people who receive blood transfusions or other blood products.

Abstaining from sexual contact can also prevent the transmission of the hepatitis B virus (HBV). A mutual monogamous relationship with a trusted partner known to be tested and uninfected is another way.

Correctly using latex condoms during vaginal or anal sex can reduce the risk of transmission. Correctly using a condom can also reduce the risk of transmission during oral sex (mouth to penis). For other forms of oral sex (mouth to vagina or oral to anal also known as rimming) using a dental dam, plastic wrap, or a latex condom cut up and opened flat can be risk reducers. However, it is important to remember the barrier method used (condom, dental dam, or plastic wrap) can have infected body fluids upon it. So hands should be washed immediately after handling and disposing of it.

People who share sex toys should place condoms on them, switching to a new condom when the toy goes from one person to another. People should also wash their hands after handling the sex toys or if their hands come in contact with body fluids.

Surfaces that could have been contaminated with infected body fluids should be disinfected with a solution of household bleach and tap water (1:10 dilution, 1 part bleach, 10 parts water).

Drug users should avoid sharing needles to prevent themselves from being infected.

In a household with a member who is infected, avoid sharing objects that could have blood on them, like toothbrushes and razors.
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