What are the other Names for this Condition? (Also known as/Synonyms)

• HBV Infection
• Hep B Infection
• Hepatitis B Viral Infection

What is Hepatitis B Infection? (Definition/Background Information)

• Hepatitis B Infection is a viral infection that affects the liver tissue causing liver damage. It is caused by the hepatitis B virus (HBV). The condition is generally prevalent in adults, mostly in certain developing regions/countries of the world
• The risk factors for Hepatitis B infection include contact with bodily fluids of infected individuals or sharing needles with the infected individuals
• The signs and symptoms of Hepatitis B Infection may include jaundice, nausea, diarrhea, and abdominal pain. HBV Infection can lead to complications such as liver scarring, anemia due to destruction of liver tissue, or even liver failure
• There is no specific treatment available for Hepatitis B Infection, however supportive care is provided to the infected individuals to maintain nutritional balance, maximize comfort, and minimize potential complications associated with liver tissue damage
• The prevention of Hepatitis B Viral Infection includes avoiding contact with the body fluids of infected individuals and ensuring that one takes the requisite vaccinations before traveling to high-risk regions
• The prognosis of Hepatitis B infection is generally good with suitable treatment. However, if the infection is left untreated or if it is severe, then the prognosis may be guarded

Who gets Hepatitis B Infection? (Age and Sex Distribution)

• Individuals in the age group of 19-60 years are most affected by Hepatitis B Infection
• The infection affects members of both sexes (males and females); no particular preference is noted
• There is no racial or ethnic group bias associated with Hepatitis B Infection. This means that members of one specific race are not more predisposed to the infection than members of another race
• Studies indicate that the hepatitis B virus has a geographical distribution. Regions of the world with the highest prevalence of HBV include sub-Saharan Africa and East Asia, followed by certain areas in the Middle East, the Indian subcontinent, and parts of Europe

What are the Risk Factors for Hepatitis B Infection? (Predisposing Factors)

Hepatitis B Infection spreads through contact with an infected person’s blood, semen, saliva, or other body fluids. Hence, the risk factors associated with the infection includes exposure to these bodily fluids. The risk of infection is increased in the following group of individuals:

• Those who have unprotected sex, especially with multiple partners; sex with a partner infected with the virus (HBV)
• Children born to infected mothers: Infected mothers can pass on the infection to the baby during childbirth
• Healthcare providers and related personnel who are often exposed to human blood (including nurses, physicians, lab workers, etc.)
• Living with an individual who has a chronic Hepatitis B Viral Infection
• Sharing needles with infected individuals (occurring during intravenous drug use)
• Traveling without vaccination to a region with high chronic infection rates
• Infected blood transfusions
• Organ donation; organ transplant from an infected individual

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hepatitis B Infection? (Etiology)

The cause of Hepatitis B Infection is a virus, the hepatitis B virus (or HBV). The infection can either be acute or chronic.

• In acute cases, the infection persists for less than 6 months. The individual’s immune system is able to clear the infection within a few months and fully recover from the condition. This is common in adults, who become infected with HBV
• In chronic cases of Hepatitis B Infection, the infection persists for 6 months or longer. The individual’s immune system cannot fight the infection. Such a state is usually common in infants or in children younger than 5 years

Acute Hepatitis B Infection can lead to chronic infection over time. Chronic Hepatitis B Infection can often remain undetected for years (even decades), until the individual becomes severely ill with symptoms of liver disease.

• While the main cause of developing Hepatitis B Infection is from contact with bodily fluids, some genes have been discovered that increase one’s susceptibility to developing chronic infection
• While Hepatitis B is not a genetic condition, some genetic defects in proteins lead to higher susceptibility to chronic infection because of a weaker immune response

What are the Signs and Symptoms of Hepatitis B Infection?

The signs and symptoms of Hepatitis B Viral Infection are not always present during the initial acute infection phase. In some individuals, whose acute infection persists for more than 6 months, a chronic infection of HBV develops.

The signs and symptoms of persistent infection typically appear 1-4 months after infection and may include:

• Jaundice that causes yellowing of the skin or the eye whites
• Dark, tea-colored urine
• Extreme fatigue and weakness
• Fever
• Joint pain
• Loss of appetite and/or weight loss
• Nausea and/or vomiting
• Diarrhea
• Abdominal pain

How is Hepatitis B Infection Diagnosed?

The diagnosis of Hepatitis B Infection may involve the following steps:

• Thorough medical history (including recent travel history) and a complete physical examination by a healthcare provider
• If there is a suspicion of Hepatitis B Infection, then the healthcare provider will likely order blood tests towards establishing the diagnosis
• Hep B blood test panel: The presence of the following 3 components must be determined in order to confirm Hepatitis B Infection diagnosis. These are the 3 proteins associated with a Hepatitis B Viral Infection
• The 3 components include:
  • HBsAg (hepatitis B surface antigen)
  • HBsAb or anti-HBs (hepatitis B surface antibody)
  • HBcAb or anti-HBc (hepatitis B core antibody)
• In rare cases, a healthcare provider may seek a liver biopsy (small sample of liver tissue for testing) in order to confirm the diagnosis of Hepatitis B Infection

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hepatitis B Infection?

The complications associated with Hepatitis B Infection include liver function abnormalities, including anemia, cirrhosis (or scarring) of the liver, liver cancer, and liver failure.

• The viral infection caused by HBV leads to inflammation in the liver. Chronic inflammation over time can eventually lead to scarring of the liver tissue, which is known as cirrhosis. Scarring of the liver tissue can impair the liver’s ability to function properly
• Another complication includes liver cancer: Individuals who develop chronic Hepatitis B Viral Infection have an increased risk of developing liver cancer. Individuals, whose infection remains in the acute stage, typically do not have this associated risk
• Another associated complication of Hepatitis B infection includes anemia, which is associated with low levels of iron in blood. Complications of anemia include paleness, increased fatigue and weakness
• In rare cases, liver failure can represent a complication associated with Hepatitis B. The vital functions of the liver begin to shut down, a condition known as acute liver failure. In such a situation, the individual would need a liver transplant as early as possible

How is Hepatitis B Infection Treated?

Currently, there is no specific treatment associated with Hepatitis B Infection.

• Instead, supportive care is given to keep the individual comfortable and maintain nutritional balance, to replace lost nutrients from associated diarrhea and vomiting
• Another treatment goal is to slow the progression of cirrhosis (liver scarring) and to decrease the risk for liver cancer in chronically-infected individuals

In individuals who are chronically infected, treatment can also include oral antiviral drugs.

• Drugs that are typically prescribed to suppress HBV include tenofovir and entecavir. These drugs are taken once a day and have few associated side effects. These drugs suppress the replication of the hepatitis B virus, rather than curing the individual completely of Hepatitis B.
• In chronically infected individuals who develop liver cancer, surgery and chemotherapy are treatment options to treat the associated complications
• Liver transplants may be necessary in individuals with severe liver damage (cirrhosis) or liver failure

The complications associated with Hepatitis B Infection are higher prevalent in regions of the world with limited access to resources needed to diagnose and treat the condition. In low-income regions, this lack of resources to diagnose and treat Hepatitis B Infection early enough, leads to high mortality rates.

How can Hepatitis B Infection be Prevented?

The preventive measures for Hepatitis B Infection may include the following:

• Hepatitis B vaccine: The World Health Organization recommends vaccination of all newborns with 2-3 follow-up doses. The Hepatitis B vaccination has an excellent record of being effective in preventing the infection
• Screening of blood components used for blood transfusions: Hepatitis B Infection can also be prevented with quality-assured screening of blood that is drawn to be donated to blood banks. These screenings can prevent the transmission of HBV from infected individuals who donate blood
• Safe sex: The prevention of Hepatitis B Infection also includes implementing safer sex practices, including minimizing the number of sex partners, and using condoms during sex, especially if with an infected partner

What is the Prognosis of Hepatitis B Infection? (Outcomes/Resolutions)

• In general, the prognosis of Hepatitis B Infection is good, if the infection remains at the acute infection stage. Typically, individuals who have an acute Hepatitis B Viral Infection improve rapidly when their immune system is able to clear the body of the virus
• Individuals who have chronic Hepatitis B Viral Infection, the prognosis depends on the course the disease takes. Some individuals experience slow improvement for many weeks to months after the viral infection, or experience periods of improvement followed by relapsing into periods of worsening symptoms
• The prognosis in chronic stage is worse than that of individuals whose infection remains in the acute stage, although improvement and a better prognosis are possible, if early adequate treatment is provided and the symptoms improve
• In some cases, an acute infection can progress to a chronic infection, leading to development of liver cancer or liver damage. In such cases, the prognosis is typically poor. Surgery and chemotherapy (if liver cancer develops) or liver transplants (should liver failure occur) have variable success rates and the prognosis is generally unpredictable

Additional and Relevant Useful Information for Hepatitis B Infection:

July 28th is recognized as World Hepatitis Day to increase awareness of viral hepatitis. Hepatitis causes over 100,000 deaths every year worldwide.