Health Matters
Hepatitis B
million people worldwide are chronic carriers
‘ 350 of hepatitis B virus ’ ( courtesy CDC ). Chronic hepatitis B could result in hepatocellular carcinoma ( liver cancer ). Vaccination is a simple , cost effective way of preventing hepatitis B infection .
HEPATITIS B INFECTION
The liver is situated in the upper right quadrant of our abdomen and serves as a detoxifier . What this means is that anything that goes into our blood stream i . e . meals , medication , vitamins , alcohol , first pass through the liver , is filtered , before micronutrients and other factors are transported to where they are needed in the body . The liver also stores energy for later use , helps in digestion and produces proteins important in fighting infection and controlling bleeding . The liver usually regenerates well after acute inflammation and is an important portal in getting rid of degraded red blood cells . Bilirubin ( yellow pigment ) is a byproduct of degraded red blood cells . When liver inflammation occurs with impact on liver function , this yellow pigment cannot be eliminated effectively and levels rise in the blood stream giving a typical yellow discoloration of the eyes , skin , palms and mucus membranes called jaundice .
WHAT IS HEPATITIS ? Hepatitis is inflammation ( irritation and swelling ) of the liver . There are several things that can cause irritation and swelling of the liver VIRAL HEPATITIS is inflammation of the liver as a result of a viral infection . The most common and clinically significant is hepatitis B virus . Others are the A , C and D viruses and Epstein Barr Virus . These will be discussed in later articles .
ARE THERE ANY OTHER CAUSES OF HEPATITIS ?
Yes . Certain medications may also cause hepatitis . It is important to take medications as prescribed and use herbal preparations with care . Alcohol is also a common cause of hepatitis . Alcohol induced hepatitis is associated with long term use of significant quantities of alcohol – individual dependent . Severe bacterial infections could also cause hepatitis . Autoimmune hepatitis may also occur .
HEPATITIS B INFECTION
It ’ s an infectious hepatitis caused by the Hepatitis B virus . The virus is transmitted by
• Direct contact with infected blood or blood products
• Exposure to infected body fluids
• Vertical transmission from mum to baby during delivery . If mum is hepatitis B positive transmission to baby would usually occur during vaginal delivery . Caesarian delivery reduces risk of transmission of virus from a seropositive mother to baby , by a significant percentage .
HOW CAN I GET IT ?
You could get it through : blood transfusions , dialysis , and unprotected sex with a positive partner . Shared needles and unsterilized surgical equipment used in body piercing , tattooing and like procedures put you at risk . Institutionalized care ( including care givers & family members ) and healthcare workers are particularly at risk .
YOU CAN ’ T GET IT BY :
• Casual contact
• Hugging
• Shaking hands
• Eating or drinking water
• Aerosol dispersion ( sneezing , coughing ).
Once the virus gets into the blood stream , it causes an acute infection ; within one to four months of exposure , there may be a fever , headache , muscle pain , vomiting and abdominal pain / discomfort from mild swelling of the liver . There may also be dark urine and pale stools . These symptoms may mimic several other febrile illness , malaria being the first one on mind in our environment . So it ’ s important to get a confirmation of diagnosis for any febrile illness . Along with the fore mentioned symptoms , there may also be yellowing of the eyes or skin / palms ( jaundice ), which may occur in 9 out of 10 affected . The color change in the eyes and skin / palms will draw the clinicians ’ attention to the fact that there is something very wrong . 1 out of the 10 affected may not show any eye or skin changes at all . In this group of patients , the acute stage may proceed without confirmation of diagnosis . During the acute stage , your doctor will give you symptomatic treatment ; bed rest , lots of fluids , regular intake of small portions high energy foods / fluids , pain and fever relieving medications all in an effort to get you comfortable and also to rest your liver . If there is persistent vomiting , then hospital admission will be required along with i . v . fluids . It must be noted here that no specific treatment is required during the acute stage . This stage will last a couple of weeks or so , after which you should start feeling better . Recovery time is individual dependent . 9 out of 10 infected adults are able to fight off the virus . This group will have negative repeat hepatitis B antigen tests at the 6 month time line – complete cure . 1 out of the 10 infected adults will still have positive repeat blood tests . This group is outwardly healthy but have been tagged by the virus and are called carriers ; they carry the hepatitis B virus and can pass it on but are otherwise healthy looking adults .
The significance of the carrier stage is the long term effect of the presence of the B virus in the liver ; over many years ( individual dependent ), the virus gradually changes the structure of the liver increasing risk of cirrhosis and hepatocellular carcinoma ( Liver Cancer )
CHRONIC HEPATITIS
Chronic hepatitis B infection is just another name for the carrier stage . It means , six months after the initial infection , your blood test is still positive for hepatitis B virus . The risk of chronic infection is much greater in children and 9 out of 10 infected children may fall in this category . There are various tests your doctor can do to asses this stage of hepatitis . Liver function tests along with hepatitis B profiling will give information on how well your liver is working , whether the infection is old or new , whether the virus is resting or multiplying and how many viral particles you have circulating . A liver ultrasound may also be ordered . This information will help your clinician plan your care .
TREATMENT
Antiviral treatments are available for chronic hepatitis . These treatments reduce the ability of the virus to multiply in the liver and in turn reduce liver damage . Most of these medications require long term use .
HOW DO I PREVENT HEPATITIS B INFECTION ?
The best prevention method is testing and vaccination . A total of 3 shots are required at 0 , 1 and 6 months . Under special circumstances , your doctor may prescribe an accelerated vaccination schedule .
For more information or enquiries , email Dr L Decker info @ franklynmedical . com
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