HEPATITIS B

What is Hepatitis B ?

Hepatitis B is a virus infection of the liver. This organ is found beneath the lower right ribs and in the upper right abdomen. It has many functions, including the breakdown of unwanted substances and the production of proteins. Infection of the liver produces a striking loss of appetite and abdominal pain. The whole disorder may begin with a vague flu-like illness. There may be loss of appetite followed by vomiting and then jaundice (yellow discoloration of the white of the eye and skin) follows. Other symptoms include a mild fever, diarrhoea, joint pains and a rash. There is often quite severe weight loss. If the infection is caught as a young child it is usually very mild and not all infected individuals will develop signs of the disease. The infection can be prevented by advance vaccination that is very effective as well as safe.

How does Hepatitis B occur ?

The virus enters the body through a vein, a cut, or other break in surface tissue. After a period of 3 - 6 months (the incubation period), the first signs of infection are felt. The virus produces acute inflammation of the liver, which causes it to swell. This blocks the ducts that drain waste products from the liver. It also interferes with all other functions of the liver.

Why does Hepatitis B occur ?

Hepatitis B is a highly infectious disorder. It is due to a virus and is typically contracted through contaminated syringes used for injecting drugs or by sexual activity, both heterosexual or homosexual. Blood transfusions may transmit the virus if the blood donors have not been adequately checked. This is unusual in developed countries. Tattooing may be a source of the infection, as may accidental needle injury in health workers. In a small percentage of individuals the source of the infection remains unknown.

Treatment Involved for Hepatitis B

Blood tests will need to be taken to diagnose hepatitis B. The main treatment is rest. No special diet helps, although patients are more comfortable on a low-fat diet. Alcohol should be avoided completely. Occasionally if there is vomiting or no one to look after the patient at home, hospitalisation may be needed. An intravenous drip of fluids may then prove necessary, and anti-vomiting drugs may also be given. Antibiotics are of no value since they are ineffective against viruses. Drugs are available for dealing with the itchy skin, should the jaundice be severe. If you are on the oral contraceptive pill, this should be stopped and other forms of contraception used.

During Treatment for Hepatitis B

Patients usually improve after 2 to 3 weeks when appetite returns and jaundice subsides. Stools and urine return to their normal colour. Patients regain weight, but it may take up to 6 months to get back to normal. A period of convalescence should be planned and up to 2 months may be necessary. Return to full activity is always possible eventually. In a tiny proportion of individuals a more severe illness leading to liver failure may develop and this can be life threatening..

After Treatment for Hepatitis B

The majority of individuals will make a complete recovery and are protected against infection with the same virus in the future. In perhaps 5% of adults, and a much higher percentage of infected infants, the individual appears to make a complete recovery but blood tests indicate that the virus has not been controlled. If this persists for more than six months the individual is said to have developed chronic hepatitis B. This is a disease that may lead to serious liver problems, often after an interval of many years.

If Hepatitis B is Left Untreated

Most patients become better with no treatment. The most important part of treatment is observation and advice concerning the protection of others.

Effects on Family of Hepatitis B

The sexual partner of an infected person should consider having immunoglobulin to help prevent infection and vaccination against hepatitis B may also be appropriate for all the family.