Hepatitis B

What is hepatitis B?
Hepatitis B is an infection caused by the hepatitis B virus (HBV). The infection can be acute (new, short lived) or chronic (the virus remains in the body after the initial infection).

How common is hepatitis B?
Hepatitis B infections have dropped dramatically in the US since the development of the hepatitis B vaccine. Still, in 2013, an estimated 19,764 new infections occurred in the US.1
It is estimated that 1.25 million people have chronic hepatitis B and are carriers of the hepatitis B virus in the US.2

How is hepatitis B spread?
Hepatitis B can be spread through sexual contact or through blood (most commonly injecting drug use). HBV can also be transferred to a baby from an infected mother during delivery.

Does hepatitis B cause symptoms?
50% to 70% of infections cause no symptoms.3 When symptoms do occur, they are often confused with symptoms of other diseases. Therefore, many infections are not identified unless they become chronic and cause liver damage.

What are the symptoms of hepatitis B?
Hepatitis B infections may cause symptoms of a flu-like illness, with fatigue and loss of appetite. Nausea, vomiting, abdominal pain, and jaundice (yellowing of the skin) may also occur. Adults are much more likely to experience these symptoms than children are.3

Are there any treatments available for hepatitis B?
There is no treatment available for the initial onset of Hepatitis B. There are several medicines that are used to treat chronic hepatitis B. Unfortunately, these medicines are not effective in many people, cause significant side effects, and can be very expensive.2 Therefore, a doctor must evaluate each person with hepatitis B very carefully before using any of the medicines.

What complications can result from hepatitis B?
Most adults with early hepatitis B will successfully fight off the infection. The younger a person is when the infection occurs, the more likely he/she is to develop a chronic infection. Chronic Hepatitis B occurs in 90 % of infants who get the disease, compared to only 6-10% of children and adults over age 5years of age.3

Between 15% to 40% of people with chronic hepatitis B will develop serious complications, including liver damage, cirrhosis, and liver cancer.2 Premature death from liver disease happens in 15%-25% of people with chronic hepatitis B infections.4

Can hepatitis B be prevented?
Yes. Sexual transmission of hepatitis B can be prevented by refraining from sexual activity until a person is in a lifelong, mutually monogamous relationship with an uninfected partner.

Also, an effective vaccine is available for the prevention of hepatitis B. The HBV vaccine has been successful worldwide in decreasing rates of chronic hepatitis B and subsequent liver cancer. Since 1991, hepatitis B vaccine has been recommended for all infants and children in the US. It is recommended for adults that are at high risk for acquiring HBV.5

Pregnant women should be tested for hepatitis B. If the mother knows she has hepatitis
B, she should notify her healthcare provider of this infection. By providing early hepatitis
B vaccine and immune globulin to the baby, mother-to-child transmission can be prevented.5

Since the virus can be passed through the blood, any exposure to blood from an infected person should be avoided. The virus is frequently passed by illicit injectable drug use. Tatoos and body piercings are also potential sources of infection, so only sources compliant with Federal standards should be used.

 

This is an example of jaundice that occurs with hepatitis. This image is courtesy of CDC/Dr. Thomas F. Sellers/Emory University.

 

References:
1. Center for Disease Control and Prevention, “Hepatitis B FAQs for Health Professionals,” http://www.cdc.gov/hepatitis/hbv/hbvfaq.htm#overview
2. Lok ASF and McMahon BJ, “Chronic Hepatitis B: Update 2009,”Hepatology, Vol. 50, No.3, 2009 (Approved by the American Association for the Study of Liver Diseases and represents the position of the Association)
3 .Kukka, Christine, “Hepatitis B Fact Sheet,” Hepatitis C Support Project, version 3.5 June 2015: accessed July 2015 http://www.hbvadvocate.org/hepatitis/factsheets_pdf/Acute%20HBV.pdf
4. Centers for Disease Control and Prevention, “2015 Sexually Transmitted Diseases Treatment Guidelines,” http://www.cdc.gov/std/tg2015/hepatitis.htm accessed July 2015
5. Aspinall EJ, et al, “Hepatitis B Prevention, Diagnosis, Treatment and Care: A Review,” Occupational Medicine, (2011) 61(8): 531-540

Updated: July 2015