HEPATITIS-B( Last Part)

                                             HEPATITIS-B( Last Part)

What is HBsAg and anti-HBs

The presence of hepatitis B surface antigen (HBsAg) in the blood indicates that the patient is currently infected with the virus. HBsAg appears an average of four weeks after initial exposure to the virus. Individuals who recover from acute hepatitis B infections clear the blood of HBsAg within approximately four months after the onset of symptoms. These individuals develop antibodies to HBsAg (anti-HBs).

Anti-HBs provides complete immunity to subsequent hepatitis B viral infection. Similarly, individuals who are successfully vaccinated against hepatitis B produce anti-HBs in the blood.

How are the hepatitis B blood tests interpreted?

The following table gives the usual interpretation for sets of results from hepatitis B blood (serological) tests.

Most Likely Status*	Tests	Results
Susceptible, not infected, not immune	HBsAg anti-HBc anti-HBs	negative negative negative
Immune due to natural infection	HBsAg anti-HBc anti-HBs	negative positive positive
Immune do to hepatitis B vaccination	HBsAg anti-HBc anti-HBS	negative negative positive
Acutely infected	HBsAg anti-HBc IgM anti-HBc anti-HBs	positive positive positive negative
Chronically infected	HBsAg anti-HBc IgM anti-HBc anti-HBs	positive positive negative negative

*Interpretation of the hepatitis B virus blood tests should always be made by an experienced clinician with knowledge of the patient's medical history, physical examination, and results of the standard liver blood tests.

What is the role of a liver biopsy in chronic hepatitis B?

During a liver biopsy, a small sample of liver tissue is collected and examined under the microscope. This test is valuable because this sample reflects the health of the liver. It can show the amount of liver injury (inflammation or cirrhosis). Liver biopsy is not routinely needed to diagnose hepatitis B, but it is used for monitoring the progression of liver damage in people with chronic hepatitis and helping to choose or evaluate treatment options.

What is the natural course of chronic hepatitis B?

The course of chronic hepatitis B is variable and depends on several factors. These factors are the patient's age at which the infection began, the extent of viral multiplication, and the immune system's ability to control the infection.

The infection can progress from an:

·         immune tolerant phase (in which the immune system ignores the virus)

·         immune clearance phase (in which the immune system attempts to eliminate the virus)

·         quiescent phase (in which the virus is less active)

Immune tolerant phase

For individuals infected at birth or at a young age, the immune system initially does not react to the hepatitis B virus. This phase of the infection is known as the immune tolerant phase. Despite high levels of virus in the body, there may be little evidence of inflammation and no symptoms. This phase typically lasts for years, even up to two or three decades. It is important to know that the immune tolerant phase is generally not seen in individuals who become infected during adulthood.

Immune clearance phase

During the third to fourth decade of chronic hepatitis B acquired in childhood, the immune system may start to react to the virus. This is known as the immune clearance phase. The immune system attacks the hepatitis B virus-infected liver cells in an attempt to clear the virus. This causes inflammation, liver injury, and the development of scar tissue. The more severe the destruction and fibrosis and the longer the phase, the more likely it is that cirrhosis will develop.

Quiescent phase

Following the immune clearance phase, the viral infection may enter a less active phase known as the quiescent phase. During this phase, there are no symptoms, the levels of hepatitis B virus become very low, and the standard liver blood tests become normal or nearly normal.

What are the effects of alcohol on hepatitis B virus?

Agents that damage the liver are particularly harmful in patients who already have hepatitis B. For this reason, it is recommended that persons with hepatitis B avoid drinking alcohol.

What are the effects of immunosuppressive medications on hepatitis B virus?

Even in people with chronic hepatitis B, the immune system is working to suppress the virus. Medications that suppress the immune system allow the virus to reproduce in large numbers and may cause the hepatitis to flare.

What is delta hepatitis?

Delta hepatitis is caused by a virus that only infects people who already have hepatitis B. The delta hepatitis virus (also known as hepatitis D or HDV) is an RNA virus, meaning that its genetic material is made up of ribonucleic acid. It is spread through exposure to contaminated blood, especially with illicit, intravenous drug use, and by sexual contact. There is no vaccine against delta hepatitis.

What is the role of liver transplantation in hepatitis B infection?

Liver transplantation has been successful in patients who have irreversible, life-threatening complications of hepatitis B. This includes patients with liver failure due to end-stage cirrhosis or unusually severe (fulminant) hepatitis. Liver transplantation does not cure hepatitis B, and hepatitis may occur in the new liver. The incidence of recurrent hepatitis has been reduced to less than 10% through use of lamivudine and HBIG in transplant recipients.

What can be done to prevent hepatitis B?

Hepatitis B is a preventable disease. Vaccination and post-exposure prophylaxis have significantly reduced rates of infection. Risk can also be reduced by avoiding unprotected sex, contaminated needles, and other sources of infection.

How effective is vaccination for hepatitis B?

The hepatitis B vaccine contains a protein (antigen) that stimulates the body to make protective antibodies. Examples of hepatitis B vaccines available in the United States include hepatitis b vaccine injection (Engerix-B, Recombivax-HB). Three doses (given at 0, 1, and 6 months) are necessary to assure protection. There are also combination vaccines on the market that provide protection against hepatitis B and other diseases. 

Homoeopathy Can Cure Hepatitis B

Target Groups
– Acute Hepatitis – B
-- Chronic Active Hepatitis-B
HBV Chronic Carriers
Management Protocol for Acute Hepatitis
1. Pathological Prescription
2. Drugs
3. Medicines
4. Plants

DRUG USED FOR

ACETIC ACID	Sleeplessness during hepatitis.
LYCOPUS VERG (Dol.)	Diarrhoea during jaundice
TARAXACUM	Weakness during jaundice
(PIC. ACID &                  FERR PICRICUM)	Head ache with jaundice
CORNUS CIRCINATA	Eruptions with jaundice. Aphthae
MERC	White coating of tongue with jaundice
CHEL	Stupor and Unconsciousness during Jaundice
SEP	Itching during jaundice
CHELIDONIUM	Chelidonium is not a remedy for chronic hepatitis
CARDUUS MARIANUS	Predominantly a remedy for diseases affecting the portal systems. Pain in left lobe. Not indicated in HBV Active cases but effective in cases with ascitis and Hepato cellular Carcinoma (where AFP is markedly elevated)
LEPTANDRA	Jaundice with black stools or white (clay colored) stools. Doubtful about recovery is an additional indication for leptandra. When frequently questioned about recovery
Kalmegh	Low potencies – A traditional Indian remedy.
LAUROCERASUS	Extreme weakness. When well selected remedies fails (lack of reaction)
PODOPHYLLUM	(Symptomatic relief only) – Pt. Holds the liver region
DOLICHOS	Carrier gets aggravated during pregnancy, presented as itching. White stools.

SOME BEST ACTING MIDICINE OF HOMOEOPATHY-

Ceanothus
Nux Vom
Lyc
Bryonia
Digitalis

Taking a natural approach

1         Reishi Mushroom has shown favorable results in treating hepatitis, especially in cases without severe impairment of liver function Reishi Mushroom balances the immune system - a remedy of first choice for all auto-immune disorders, it also aids liver function and circulation. 

2         Milk Thistle is renowned as a liver tonic. 

3         Silymarin protects the liver by strengthening the outer membranes of liver cells, which prevents toxins from entering the cells. Silymarin also stimulates protein synthesis in liver cells, which helps to regenerate and repair the liver.  .  They may protect liver from alcohol damage, cirrhosis, hepatitis, and pollutants.

4         Black Seed Oil improves liver function and associated digestive problems. Black Seed has an unprecedented strengthening effect upon the immune system, and works in a host of other ways to promote optimum health and well being. 

5         Liquorice to treat chronic Hepatitis B. Glycyrrhizin interferes with hepatitis B surface antigen and is synergistic with interferon against hepatitis A virus. 

6         Colloidal Silver may be useful in cases of Hepatitis and effective natural agent against bacteria. 

7         Olive Leaf Extract Capsules article for more in depth information.

8         Zell Oxygen will strengthen the immune system by re-establishing healthy cellular mitocondria and in turn health cellular respiration and metabolism. 

9         Sterols and Sterolins will further strengthen the immune system and specifically Help T cell production.

Hepatitis-B (part-2)

How is the hepatitis B virus spread (transmitted)?

Hepatitis B is spread mainly by exposure to

1.   Infected blood or body secretions.

2.   In infected individuals, the virus can be found in the blood, semen, vaginal discharge, breast milk and saliva.

3.   Hepatitis B is not spread through food, water, or by casual contact.

4.   Sexual contact is the most common means of transmission.

5.   Using contaminated needles for injecting illicit drugs, tattooing, body piercing, or acupuncture. Additionally,

6.   Sharing toothbrushes and razors contaminated with infected fluids or blood.

7.   infected mothers to their babies at birth (so-called 'vertical' transmission). The rate of transmission of hepatitis B from mother to newborn is very high, and almost all infected infants will develop chronic hepatitis B. Fortunately, transmission can be significantly reduced through immune prophylaxis.

Rarely, hepatitis B can be transmitted through transfused blood products, donated livers and other organs. However, blood and organ donors are routinely screened for hepatitis which typically prevents this type of transmission.

What are the symptoms of acute hepatitis B?

Period of illness that occurs during the first one to four months after acquiring the virus. Only 30% to 50% of adults develop significant symptoms during acute infection. Early symptoms may be non-specific, including fever, a flu-like illness, and joint pains. Symptoms of acute hepatitis may include:

·         fatigue,

·         loss of appetite,

·         nausea,

·         jaundice (yellowing of the skin and eyes), and

·         pain in the upper right abdomen (due to the inflamed liver).

It is found rarely that Acute hepatitis damages the liver so badly it can no longer function. This life-threatening condition is called "fulminant hepatitis." Patients with fulminant hepatitis are at risk of developing bleeding problems and coma resulting from the failure of the liver. Patients with fulminant hepatitis should be evaluated for liver transplantation.

What determines the outcome of acute hepatitis B?

The immune response of body is the major determinant of the outcome in acute hepatitis B. Individuals who develop a strong immune response to the infection are more likely to clear the virus and recover.

However, these patients also are more likely to develop more severe liver injury and symptoms due to the strong immune response that is trying to eliminate the virus. but a weaker immune response results in less liver injury and fewer symptoms but a higher risk of developing chronic hepatitis B. People who recover and eliminate the virus will develop life-long immunity, that is, protection from subsequent infection from hepatitis B.

What are the symptoms of chronic hepatitis B?

The liver functions include a role in the immune system, production of clotting factors, producing bile for digestion, and breaking down toxic substances, etc.

The signs and symptoms of chronic hepatitis B vary widely depending on the severity of the liver damage. They range from few and relatively mild signs and symptoms to signs and symptoms of severe liver disease such as cirrhosis or liver failure.

Mostly chronic hepatitis B remain symptom free for many years or decades. During this time, the patient's blood tests usually are normal or only mildly abnormal. Some patients may deteriorate and develop inflammation or symptoms, putting them at risk for developing cirrhosis.

Cirrhosis of the liver due to hepatitis B

Inflammation from chronic hepatitis B can progress to cirrhosis (severe scarring) of the liver. Significant amounts of scarring and cirrhosis lead to liver dysfunction.

Symptoms may include:

·         weakness

·         fatigue,

·         loss of appetite,

·         weight loss

·         breast enlargement in men,

·         a rash on the palms,

·         difficulty with blood clotting, and

·         spider-like blood vessels on the skin.

·         Decline d absorption of vitamins A and D can cause impaired vision at night and thinning of bones (osteoporosis).

·         The cirrhosis of liver also are at risk of infections because the liver plays an important role in the immune system.

Advanced cirrhosis of the liver due to hepatitis B

In patients with advanced cirrhosis, the liver begins to fail. This is life-threatening condition.

Several complications occur in advanced cirrhosis:

·         Confusion and even coma (encephalopathy) results from the inability of the liver to detoxify certain toxic substances.

·         Aabdominal cavity of blood vessels is develop in the live r due to increased pressure  in blood vessels (portal hypertension) causes fluid to build up in the (ascites) and may result in engorged veins in the swallowing tube (esophageal varices) that tear easily and may cause massive bleeding.

·         Portal hypertension can also cause kidney failure or an enlarged spleen resulting in a decrease of blood cells and the development of anemia, increased risk of infection and bleeding.

·         Advanced stage of cirrhosis, liver failure also results in decreased production of clotting factors. This causes abnormalities in blood clotting and sometimes spontaneous bleeding.

·         Patients with advanced cirrhosis often develop jaundice because the damaged liver is unable to eliminate a yellow compound, called bilirubin.

Hepatitis B virus and primary liver cancer

(hepatocellular carcinoma)

Developing liver cancer with chronic hepatitis B. Patients may have no symptoms, or they may experience abdominal pain and swelling, an enlarged liver, weight loss, and fever. The most useful diagnostic screening tests for liver cancer are a blood test for a protein produced by the cancer called alpha-fetoprotein and an ultrasound imaging study of the liver. These two tests are used to screen patients with chronic hepatitis B, especially if they have cirrhosis or a family history of liver cancer.

Other organ involvement in Hepatitis B (extra-hepatic)

Rarely, chronic hepatitis B infection can lead to disorders that affect organs other than the liver. These conditions are caused when the normal immune response to hepatitis B mistakenly attacks uninfected organs.

=======================================================