Hepatitis B

Cause:Hepatitis B Virus
How transmitted: Contact with infected blood, sexual fluids ;and possibly saliva.
Symptoms:May have no symptoms. May have flu-like illness including fatigue, lack of appetite and jaundice (yellowing skin).
Diagnostic:Tests Blood test
Treatment: There is no cure. There is a vaccine available. Hepatitis B immune globulin may provide protection after exposure.
Complications:Can lead to Cirrhosis and Cancer of the liver.
Can be passed from mother to infant during birth.

Hepatitis B is an inflammation of the liver and is caused by the Hepatitis B virus (HBV), a member of the Hepadnavirus family[1] and one of hundreds of unrelated viral species which cause viral hepatitis. It was originally known as "serum hepatitis" and has caused current epidemics in parts of Asia and Africa.[2] Hepatitis B is recognized as endemic in China and various other parts of Asia.[3] The proportion of the world's population currently infected with the virus is 3 to 6%, but up to a third have been exposed. Symptoms of the acute illness caused by the virus include liver inflammation, vomiting, jaundice, and rarely, death. Chronic hepatitis B may cause liver cirrhosis which may then lead to liver cancer,
a fatal disease with very poor response to current chemotherapy.

Transmission results from exposure to infectious blood or body fluids containing blood. Possible forms of transmission include (but are not limited to) unprotected sexual contact, blood transfusions, re-use of contaminated needles and syringes, and vertical transmission from mother to child during childbirth. Without intervention, a mother who is positive for the hepatitis B surface antigen confers a 20% risk of passing the infection to her offspring at the time of birth. This risk is as high as 90% if the mother is also positive for the hepatitis B e antigen. HBV can also be transmitted between family members within households, possibly by contact of nonintact skin or mucous membrane with secretions or saliva containing HBV.[6]

The primary method of transmission reflects the prevalence of chronic HBV infection in a given area. In low prevalence areas such as the continental United States and Western Europe, where less than 2% of the population is chronically infected, injection drug abuse and unprotected sex are the primary methods, although other factors may be important.[7] In moderate prevalence areas, which include Eastern Europe, Russia, and Japan, where 2-7% of the population is chronically infected, the disease is predominantly spread among children. In high prevalence areas such as China and South East Asia, transmission during childbirth is most common, although in other areas of high endemicity such as Africa, transmission during childhood is also a significant factor.[8] The prevalence of chronic HBV infection in areas of high endemicity is at least 8%.

Roughly 16-40% of unimmunized[citation needed] sexual partners of individuals with hepatitis B will be infected through sexual contact. The risk of transmission is closely related to the rate of viral replication in the infected individual at the time of exposure.

Hepatitis B virus infection may either be acute (self-limited) or chronic (long-standing). Persons with self-limited infection clear the infection spontaneously within weeks to months.

Children are less likely than adults to clear the infection. More than 95% of people who become infected as adults or older children will stage a full recovery and develop protective immunity to the virus. However, only 5% of newborns that acquire the infection from their mother at birth will clear the infection. Of those infected between the age of one to six, 70% will clear the infection.[citation needed] When the infection is not cleared, one becomes a chronic carrier of the virus.

Acute infection with hepatitis B virus is associated with acute viral hepatitis - an illness that begins with general ill-health, loss of appetite, nausea, vomiting, body aches, mild fever, dark urine, and then progresses to development of jaundice. It has also been noted that itchy skin all over the body has been an indication as a possible symptom of all hepatitis virus types. The illness lasts for a few weeks and then gradually improves in most affected people. A few patients may have more severe liver disease (fulminant hepatic failure), and may die as a result of it. The infection may also be entirely asymptomatic and may go unrecognized.

Chronic infection with hepatitis B virus may be either asymptomatic or may be associated with a chronic inflammation of the liver (chronic hepatitis), leading to cirrhosis over a period of several years. This type of infection dramatically increases the incidence of liver cancer.

Hepatitis D infection usually only occurs with a concomitant infection with hepatitis B.[11] Co-infection with hepatitis D increases the risk of liver cirrhosis and subsequently, liver cancer.

Polyarteritis nodosa is more common in people with hepatitis B infection.

In the first few months of infection, hepatitis B does not usually get treated. Up to 95% of adults clear the infection spontaneously without treatment. Therapy in this stage of infection does not seem to further improve the chances of spontaneous cure. Early antiviral treatment may only be required in fewer than 1% of patients, whose hepatitis B takes a very aggressive course ("fulminant hepatitis").

There are currently several treatments for chronic hepatitis B. While none of the available drugs usually clear the infection, they can stop the virus from replicating, and prevent liver damage such as cirrhosis and/or liver cancer. Treatments are available in the form of antiviral drugs such as lamivudine, adefovir, entecavir or telbivudine, and immune system modulators such as interferon alpha (Uniferon) or peg-interferon alpha (PEGASYS). There are several other antivirals under investigation. However, some individuals are much more likely to respond than others. It does not appear that combination therapy offers any advantages,[15] but may help in patients with resistant viruses, or in advanced liver disease where resistant viruses may lead to liver failure. In general, each treatment works by reducing the viral load by several orders of magnitude. In some patients, chronic hepatitis B takes a mild course and does not require immediate treatment. Treatment strategies should be individualized. Considerations include a person's risk for developing complications of persistent infection, a person's likelihood of adhering and responding to treatment, and potential risks such as side effects or development of viral resistance.

While abstinence is the only guaranteed way of preventing sexual transmission of hepatitis B., latex condoms, if used properly, greatly reduce the chances of transmission.

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