Hepatitis B (HBV)
The term 'hepatitis' simply means localized reaction that produces redness,
warmth, swelling, and pain as a result of infection, irritation, or injury of the liver. Inflammation can be external or internal of the liver. Hepatitis may be
caused by a virus. Two more type of virus causes Hepatitis-A and Hepatitis-C .
These viruses are not
related to each other or to hepatitis B virus and differ in their structure,
the ways they are spread among individuals, the severity of symptoms they can
cause, the way they are treated, and the outcome of the infection.
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Hepatitis B is a viral
infection that attacks the liver and can cause both acute and chronic disease.
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The virus is transmitted
through contact with the blood or other body fluids of an infected person - not
through casual contact.
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It is world wide
syndrome ,2 billion people worldwide have been infected with the virus and
about 350 million live with chronic infection. Censes shows that about 600 000 persons die each year due to
the acute or chronic consequences of hepatitis B.
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About 25% of adults who
become chronically infected during childhood later die from liver cancer or
cirrhosis (scarring of the liver) caused by the chronic infection.
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The hepatitis B virus is
50 to 100 times more infectious than HIV.
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Hepatitis B virus is an
important occupational hazard for health workers.
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Hepatitis B is
preventable with a safe and effective vaccine.
Hepatitis B is a potentially life-threatening liver infection
caused by the hepatitis B virus. It causes major global health problem and the most
serious type of viral hepatitis. It can cause chronic liver disease and puts
people at high risk of death from cirrhosis
of the liver and liver cancer.
A vaccine against hepatitis B has been available since 1982.
Hepatitis B vaccine is 95% effective in preventing HBV infection and its
chronic consequences, and is the first vaccine against a major human cancer.
Symptoms
Hepatitis B virus can cause an acute illness with symptoms that
last several weeks, including yellowing of the skin and eyes (jaundice), dark
urine, extreme fatigue, nausea, vomiting and abdominal pain.
People can take several months to a year to recover from the
symptoms. HBV can also cause a chronic liver infection that can later develop
into cirrhosis of the liver or liver cancer.
What are the symptoms of acute hepatitis B?
Acute hepatitis B is the 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:
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Fatigue,
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Loss of appetite,
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Nausea
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Jaundice (yellowing of the skin
and eyes), and
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pain in the upper right abdomen (due to the
inflamed liver).
Rarely, 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. Small studies suggest that the drug lamivudine (Epivir), may be of limited assistance
in these cases (see below).
What determines the outcome of
acute hepatitis B?
The body's immune response 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. On the
other hand, 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.
Most infants and children who acquire acute hepatitis B viral
infection have no symptoms. In these individuals, the immune system fails to
mount a vigorous response to the virus. Consequently, the risk of an infected
infant developing chronic hepatitis B is greater than 95%. In contrast, only 5%
of adults who have acute hepatitis B develop chronic hepatitis B.
What are the symptoms of chronic hepatitis B?
The liver is a vital organ that has many functions. These include a role in the immune system, production of clotting
factors, producing bile for
digestion, and breaking down toxic substances,
etc. Patients with chronic hepatitis B develop symptoms in proportion to the
degree of abnormalities in these functions. 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.
Most individuals with 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 cirrosis (severe scarring) of the
liver. Significant amounts of scarring and cirrhosis lead to liver dysfunction.
Symptoms may include:
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Weakness,
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fatigue,
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loss of appetite,
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weight loss
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breast enlargement in
men,
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a rash on the palms,
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difficulty with blood
clotting, and
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spider-like blood vessels
on the skin.
Decreased absorption of vitamins A and D can cause impaired
vision at night and thinning of bones (osteoporosis). Patients with liver
cirrhosis 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.
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Increased pressure in
the blood vessels of the liver (portal hypertension) causes fluid to build up
in the abdominal cavity (ascitis) and may result in engorged veins in the swallowing tube (esophageal
varices) that tear easily and may cause massive bleeding.
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Portal hypertension can
also cause kidney falure or
an enlargement spleen resulting
in a decrease of blood cells and the development of anemia, increased risk of
infection and bleeding.
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In advanced cirrhosis,
liver failure also results in decreased production of clotting factors. This
causes abnormalities in blood clotting and sometimes spontaneous bleeding.
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Patients with advanced cirrhosis often develop jaundice because
the damaged liver is unable to eliminate a yellow compound, called bilirubin.
Transmission
Hepatitis B virus is transmitted between people by contact with
the blood or other body fluids (i.e. semen and vaginal fluid) of an infected
person. Modes of transmission are the same for the human immunodeficiency virus
(HIV), but HBV is 50 to 100 times more infectious Unlike HIV, HBV can survive
outside the body for at least 7 days. During that time, the virus can still
cause infection if it enters the body of a person who is not infected.
Common modes of transmission in developing countries are:
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Perinatal (from mother
to baby at birth)
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early childhood
infections (in apparent infection through close interpersonal contact with
infected household contacts)
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unsafe injections
practices
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blood transfusions
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sexual contact
HBV is not spread by contaminated food or water, and cannot be
spread casually in the workplace. The virus incubation period is 90 days on
average, but can vary from about 30 to 180 days. HBV may be detected 30 to 60
days after infection and persist for widely variable periods of time.
What is the scope of the
problem?
Hepatitis B is an infection of the liver caused by the hepatitis
B virus (HBV).As per report of Centers for Disease Control (CDC), approximately
46,000 new cases of hepatitis B occurred in the United States in 2011.
When a person first gets hepatitis B, they are said to have an
'acute' infection. Most people are able to eliminate the virus and are cured of
the infection. Some are not able to clear the virus and have 'chronic'
infection with hepatitis B that is usually life-long (see below).
The hepatitis B virus is a DNA (Deoxyribonucleic acid) virus, its means that it is made up of deoxyribonucleic acids.
It belongs to a family of viruses known as Hepadnaviridae. The virus is primarily
found in the liver but is also present in the blood and certain body fluids.
Hepatitis B virus consists of a core particle (central portion)
and a surrounding envelope (outer coat). The core is made up of DNA and the
core antigen (HBcAg). The envelope contains the surface antigen (HBsAg).
These antigens are present in the blood and are markers that are used in the
diagnosis and evaluation of patients with suspected viral hepatitis.
How does hepatitis B virus
cause liver injury?
The hepatitis B virus reproduces in liver cells, but the virus
itself is not the direct cause of damage to the liver. Rather, the presence of
the virus triggers an immune response immune response from the body as the body tries to eliminate the virus and
recover from the infection. This immune response causes inflammation and may
seriously injure liver calls. Therefore, there is a balance between the
protective and destructive effects of the immune response to the hepatitis B
virus.
What is new in the treatment of hepatitis B
virus?
The new development of nucleoside/nucleotide
analogues, they are help in treatment of hepatitis B. Scientists also are working on
treatment guidelines and the use of multi-drug therapy. Vaccination remains the
key to preventing hepatitis B and holds the most promise for reducing disease
burden.
How
Hepatitis B virus transmitted?
Hepatitis B is spread mainly by exposure to infected blood or
body secretions. In infected individuals, the virus can be found in the blood,semen,vaginal
dischrge, breast milk, and saliva. Hepatitis
B is not spread through food, water, or by casual contact.
Sexual contact is the most common means of transmission,
followed by using contaminated needles for injecting illicit drugs, tattooing,
body piercing, or acupuncture.
Additionally, hepatitis B can be transmitted through sharing toothbrushes and
razors contaminated with infected fluids or blood.
Hepatitis B also may be spread from infected mothers to their
babies at birth (so-called 'vertical' transmission). This is the most prevalent
means of transmission in regions of the world where hepatitis B rates are high.
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 immunoprophylaxis.
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.
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.