What is Hepatitis B?
Hepatitis B infection is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV).
Hepatitis B is a blood-borne
pathogen and spread when blood, semen, or other body fluids from a person
infected with the Hepatitis B virus enters the person who is not infected.
Check out here what is viral hepatitis?
Epidemiological Triad for Hepatitis B
HBV present in contaminated
blood and body secretions such as saliva, vaginal secretions and semen of
infected person.
Host- Hepatitis B virus infection
commonly affects 20-40 years of age.
Infection occurs during
perinatally (time before and after birth) or during early childhood.
Environment- The contaminated blood or
secretion on the environment surface is the source of infection.
Risk Group of Hepatitis B Infection
1. Healthcare and laboratory
personnel’s
2. Homosexual
3. Prostitute
4. Drug abuser
5. Blood recipient through
Transfusion
Note - There are vaccines available to prevent hepatitis A and hepatitis B infection but no vaccine is available for hepatitis C.
Mode of Transmission of Hepatitis B
1. Parenteral route
2. Perinatal transmission
3. Sexual route
4. Person to person contact
1. Parenteral route
By infected blood and blood
products -
1. Transfusion
2. Contaminated syringes and
needles
3. Pricks/ penetration on skin
4. Handling of infected blood
5. Dialysis
6. Any surgical procedure
7. Tattooing
8. Shared rozors
9. Accupuncture
2. Perinatal transmission
From mother who is the carrier
of Hepatitis B virus to their babies during birth.
3. Sexual route
By sexual route -
1. Especially in male homosexuals
2. Having more than one sexual
relation individual
Read here the source of infection of hepatitis A and hepatitis B.
Incubation Period of Hepatitis B
The incubation period of
hepatitis B is 45-180 days (average 4 months) after exposure to HBV. Even
the incubation period can be a longer duration.
Pathophysiology of Hepatitis B
1. Blood and other body fluids
become exposed to HBV
2. Body rise cell-mediated
immune response by sending cytotoxic T cells (CD-8) and natural killer
cells (NK) to the virus and release inflammatory cytokines and eliminate and
destroy the viral infected hepatocytes.
3. Persistent viral replication
and immune system insufficient to clearance of virus-infected cells
4. Due to the interaction of
the virus and the host immune system, which leads to liver injury and damage to the hepatocytes, potentially
cirrhosis, and hepatocellular carcinoma.
Lab Investigation of Hepatitis B
1. Blood tests
2. Liver ultrasound
3. Serological tests for viral
antigens and antibodies
a. Anti-HBs test or HBsAg
(Hepatitis B surface antigen) test
b. HBcAg - anti-HBc test
c. anti-HBc IgM test
d. HBeAg Test
4. Liver biopsy
Clinical Manifestation of Hepatitis B
There are two types of
hepatitis B infection: acute and chronic. hepatitis infection
1. Jaundice (yellowing of skin
or whites of the eyes turn yellow)
2. Dark urine (pee) turns brown
or orange
3. Light-colored stool or feces
or poop
4. Fever
5. Weakness and fatigue
6. Abdominal pain
7. Loss of appetite
7. Nausea and vomiting
8. Joint pain
9. Chronic liver disease
10. Liver cancer
11. Cirrhosis
of the liver
12. Liver failure
Treatment of Heaptitis B
There is no specific treatment
for acute hepatitis B infection. Supportive care is given to
maintaining comfort and given adequate nutritional balance, including
replacement of fluids lost due to vomiting and diarrhoea.
Chronic hepatitis B infection
treated with medications, including oral antiviral agents. Treatment can slow
the progression of cirrhosis and reduce incidence of liver damage, liver cancer
and improve long-term survival.
Prevention and Control of Hepatitis B
1. Hepatitis B vaccine
A. Immunization
Used for both pre-exposure and
post-exposure administration.
There are two types of vaccine-
Plasma-derived and R-DNA yeast-derived
Vaccine
Age or time of administration
Dose Route
Plasma
derived
Initial dose (1st dose)
1ml
I /M
Hepatitis B
vaccine 1 month later (2nd dose)
1ml
I/M
6 months later (3rd dose) 1ml I/M
R-DNA yeast derived
Initial dose (1st dose)
10-20gm I/M
Hepatitis B
vaccine 1 month later
(2nd dose) 10-20gm
I/M
6 months later (3rd dose)
10-20gm I/M
Deltoid muscle is preferred for
injection of vaccine.
B. Hepatitis B Immunoglobulin (HBIG)
Given to those who are acutely
exposed to hepatitis B cases, such as-
a. Doctors, nurses, clinicians
b. New born babies of carrier
mother
c. For those who come in
contact with hepatitis B patients sexually
d. Needle stick injury
It should be administrated
within 6 hours of exposure and it should not delay for more than 48 hours.
The blood sample of the exposed
person is taken- if test negative then routine course of hepatitis B is given.
If positive, then another dose of hepatitis B with an interval of 30 days
is given.
Immunoglobulins
Dose
No. Of doses
Route
Hepatitis
B
0.05-0.07ml/kg
Two doses – 1st immediately I/M
Immunoglobulin
of body weight after exposure to 6 hrs.
2nd dose after 30 days
C. Combined immunization
Administration of hepatitis B
Immuno-globulin and hepatitis B vaccine is more effective as HBIG.
HBIG- 0.05-0.07ml/kg of
body weight within 24 hours.
Hepatitis B vaccine- 1.0 ml within 7 days of
exposure, then next dose after 1 month and 3rd dose after 6
months of 1st dose.
2. Screening
Patients who are
suffering from hepatitis B infection, their blood and secretions are having the
virus. They should not allow donating blood. All blood donors should be
screened for exposure to hepatitis viruses.
3. Universal precautions
Take
universal precautions when handling or in contact with blood and body
fluid.
4. Safe sexual Intercourse
Use a
barrier method of contraceptives at the time of having sexual relations.
5. Disinfection
Disinfect the
infective floor, wall and materials, and equipment.
Hepatitis B FAQs
1. What is hepatitis B?
Hepatitis B is liver
infection that caused by hepatitis B virus.
Hepatitis B virus cause Acute
hepatitis B and chronic hepatitis People with Acute hepatitis B are sick for
only a few weeks but the disease progresses to a serious, known as chronic
hepatitis B.
2. What are the differences
between hepatitis A, hepatitis B, and hepatitis C?
Hepatitis A, Hepatitis B,
and Hepatitis C are liver infections cause liver inflammation.
Hepatitis A, causative agent
is Hepatitis A virus. Hepatitis B, causative agent is Hepatitis B virus and, Hepatitis C, causative agent is Hepatitis C
virus.
Hepatitis A is usually a
short-term infection. Hepatitis B and hepatitis C as short-term infections and
can causes chronic, or lifelong, infection. Hepatitis A, Hepatitis B, and Hepatitis C are spread in different ways.
There are vaccines
available to prevent hepatitis A and hepatitis B; but hepatitis C no vaccine is
available.
3. How is hepatitis B
spread?
Hepatitis B infection is spread when infected with hepatitis
B virus blood, semen, or other body fluid virus enters the uninfected body.
Human can become infected with the Hepatitis B virus
from -
1. Direct contact with infected
person blood or open sores of an infected person.
2. Through needlesticks or other
sharp instruments
3. From an infected mother to her
baby during birth
4. Sexual contact with an infected
partner
5. Sharing needles, syringes, or
drug preparation equipment
6. Sharing items such as razors,
medical equipment (like a glucose monitor) with an infected person
7. Blood transfusion
4. Can hepatitis B be
spread through food?
No, Hepatitis B is not spread through food or water.
5. What should if exposed
to the hepatitis B virus?
Immediately call a healthcare provider or visit the local health
department. Infection with the hepatitis B virus can be prevented. if get the “hepatitis B immune globulin” HBIG / or hepatitis B vaccine as soon as possible within
24 hours after exposure to the virus.
6. Can hepatitis B infected
person donate their blood?
If anyone who has tested
positive for hepatitis B infection or symptoms of viral hepatitis, does not accept
blood donations.
7. Can hepatitis B
infection be prevented?
Yes, hepatitis B is prevented
by getting vaccinated.
0 Comments