Viral Hepatitis B

What is hepatitis B?

Hepatitis B is a viral infection that results in the liver becoming inflamed. In the majority of cases the virus causes acute symptoms, though hepatitis B can develop into a chronic (long-term) condition. Hepatitis B can multiply via sexual contact and sharing needles with an infected individual. It is also possible for mothers with hepatitis B to pass the infection onto their newborn baby, but a vaccination can usually be given to prevent the infection from developing.

Hepatitis B is not all that common in the UK, but it is still common in other countries and you may be told to have a hepatitis B vaccination should you be visiting a country in which hepatitis B is prevalent.

Causes of hepatitis B

There are many possible causes of hepatitis B, including consuming large amounts of alcohol and being exposed to viruses; namely the hepatitis B virus. Hepatitis B can multiply via sexual contact, from a mother to a baby and by sharing needles with an infected individual. There is also potential to contract an infection via a blood transfusion, but the chances are very small as a result of a rigorous screening programme to check that blood used in transfusions is safe. Hepatitis B can also be spread via needlestick accidents and sharing equipment that has not been fully sterilised, such as instruments used for piercings or dental equipment.

Certain groups of people have a higher risk of developing hepatitis B. High risk groups include:

• People who have travelled to countries in Africa, parts of Asia, the Middle East and Eastern Europe and those who were born in these countries.
• Men who have sexual relationships with other men.
• People who have many sexual partners and do not choose to use condoms.
• People who work in the healthcare industry (health workers are advised to have vaccinations against hepatitis B).
• Drug users.

What are the symptoms of hepatitis B?

It can take a long time (up to six months) for symptoms to develop, which is identified as the incubation period. Some people never develop symptoms but most people experience acute symptoms, which include:

• Vomiting.
• Flu-like symptoms.
• Tiredness.
• Generally feeling unwell.
• Jaundice (when the skin and whites of the eyes appear yellow).
• Nausea.
• Abdominal pain.
• High temperature.

If the infection is ongoing for greater than six months this is classed as chronic hepatitis B. Most individuals with chronic hepatitis B experience mild symptoms, which tend to appear and disappear shortly after. Several individuals with chronic hepatitis B experience tiredness, a loss of desire to eat food and feel unwell for periods of time, but symptoms rarely progress into anything more serious.

If you believe you have come into contact with the hepatitis B virus, for instance if you have had unprotected sexual intercourse or you have come into close contact with an infected individual, you should visit your GP as quickly as possible.

How is hepatitis B diagnosed?

A blood test is able to confirm a diagnosis of hepatitis B. The blood sample is analysed for the presence of a protein on the exterior of the virus known as the hepatitis B surface antigen. If your GP suspects that hepatitis B is potentially in attendance they may order liver function tests to see the state of the liver and a biopsy of liver tissue may be needed to detect inflammation or cirrhosis.

Complications of hepatitis B

Complications of hepatitis B are not common and most people make a full recovery, but if the condition is left untreated it can become very serious. If the condition is not managed it is possible for patients to then get cirrhosis of the liver (otherwise known as scarring of the liver tissue) and this can in turn increase the risk of liver cancer. Around 10 percent of people who have cirrhosis as a result of chronic hepatitis B develop liver cancer.

In very rare cases it is possible for a problem of acute hepatitis B to develop into fulminant hepatitis B and this can be particularly serious. Fulminant hepatitis B should always be treated as a medical emergency. Symptoms to be aware of include jaundice, swelling in the abdomen and confusion.

Treating hepatitis B

Most individuals do not need treatment during the acute stage of the infection, although medication may be recommended to ease symptoms. It is not possible to stop acute hepatitis B from developing into chronic hepatitis B. Treatment for chronic hepatitis B typically involves preventing complications and further harm to the liver, which is achieved by restricting the actions of the virus. There are two forms of treatment for chronic hepatitis B and a liver specialist will advise patients about treatments. Treatments include:

• Interferon: this medication is injected (usually weekly) into the body to strengthen the immune system and decrease the risk of infections. Interferon works in a similar way to a chemical, also called interferon, which is produced naturally by the body.
• Antiviral medication: these drugs function by preventing the virus from reproducing in the body. There are different types of drug available and a liver specialist will advise which drug is best based on the individual case.

Individuals with chronic hepatitis B typically take medication for a prolonged period of time and are advised to see their doctor on a regular basis so that their condition can be monitored closely.

Preventing hepatitis B

There is a vaccination to shield against hepatitis B, but it is not a branch of the routine immunisation programme in the UK because the condition is uncommon. Certain people will be told to have a vaccination to protect them against the hepatitis B virus. These people include:

• Those who work in the healthcare industry or other industries where they may expose themselves to the virus, such as doctors, nurses, prison wardens and laboratory attendees.
• People who have a lot of sexual partners.
• People who are planning to take a trip to areas in which hepatitis B is prevalent.
• People who have come into contact with an infected individual.
• People who work in the sex industry.
• Babies born to mothers with the virus.
• Prisoners.