Hepatitis B: The Basics

Christine M. Kukka
HBV Project Manager;
Alan Franciscus
Editor-in-Chief

What Is Hepatitis?

Hepatitis is an inflammation of the liver. "Hepa" refers to the liver and "titis" means inflammation. Hepatitis can be caused by toxins, drugs, too much alcohol, or a variety of germs called viruses. Viruses that infect the liver are called hepatitis viruses. Each virus is unique and is identified by a letter of the alphabet, in the order of its discovery. The hepatitis B virus (HBV), the second hepatitis virus ever identified by researchers, has infected one in 20 Americans. It can cause either a short-term (acute) infection or a long-term or lifelong (chronic) infection. When newborns are born to HBV-infected mothers, they face a 90 percent risk of developing a chronic HBV infection. But when adults are infected, only 10 percent of them develop chronic infections, and most will experience a brief, acute infection. Most people who get acute hepatitis B do not get very sick, but people with chronic infections can develop serous liver damage after years or decades of HBV infection.

What Are the Symptoms?

About 30 percent of people infected with HBV, especially children, experience no symptoms. The most common symptoms are jaundice (when your skin or the whites of your eyes turn yellow), fatigue, stomach discomfort and abdominal pain, loss of appetite, nausea and joint pain.

What Are the Tests for Hepatitis B?

A doctor will take a blood sample and test your blood for certain antigens, which are proteins that make up the virus, and for the antibodies your immune system creates to fight those foreign antigens. These include the surface antigen (HBsAg), which makes up the covering of the virus, and the “e” antigen (HBeAg). When you finally develop surface antibodies, it means you have completely cleared the virus and are no longer infected or able to infect others. Your doctor will also test your blood for HBV DNA, to assess your viral load – the quantity or number of viruses in your blood – and for certain liver enzymes that are released into the bloodstream when liver cells die as a result of the HBV infection.

Transmission and Prevention

HBV is spread mainly through exposure to infected blood and body fluids, especially during childbirth or during sex, or when syringes are shared. This virus is so hearty, it can live in dried blood on tabletops or in syringes for several days. There is a safe and effective vaccine that can safeguard you against hepatitis B. Because it’s so easy to spread hepatitis B, it is important to follow these rules:

• Get immunized immediately, and make sure your sexual partners are immunized.
• Practice safer sex and use a latex condom because semen and vaginal fluids transmit HBV.
• Don’t share needles or works.
• Don’t share personal items such as razors, nail clippers, toothbrushes, or pierced earrings.
• Make sure tattoo and body piercing equipment is sterilized.
• Cover open sores or wounds.
• Immunize all newborns within 12 hours of birth.

Health Tips:

• See your health-care provider for regular check-ups.
• Eat a healthy and balanced diet.
• Rest when you are tired.
• Exercise regularly.
• Get immunized against hepatitis A, you don’t want another virus infecting your life.
• Avoid alcohol.
• Be careful when using over-the-counter drugs such as Tylenol and ibuprofen.
• Do not ever mix alcohol, drugs, or herbs.
• Try not to worry too much.

What About Treatment?

Most people with hepatitis B lead normal, healthy lives. About 15 to 25 percent of people with chronic HBV infections develop liver disease, such as liver scarring or cirrhosis, often after many years or decades of infection. About 25 percent of people with cirrhosis may develop liver cancer.

Talk with your doctor about whether you need treatment. Unless you show signs of liver damage, and have elevated ALTs (liver enzymes) and a high viral load, you may not require treatment. Educate yourself and talk to your healthcare providers about what you can do to stay healthy. The medications approved by the U.S. Food and Drug Administration to treat hepatitis B include:

• Interferon, an injected medicine that helps boost your immune system to fight HBV.
• And lamivudine, adefovir and entecavir, three antiviral medications that deliberately interfere with the virus’s HBV DNA so they can’t replicate. These antiviral drugs come in pill form.

Getting Support

It is important that you get the information and support you need. The only adult support group for hepatitis B on the Internet is at www.hblist.org. Many adults and families from the United States, Canada and around the world participate in this well-supervised list. All those affected by or concerned about hepatitis B are invited to join.

Additional information is available at the Hepatitis B Foundation’s website at www.hepb.org and at the Hepatitis Foundation International’s website at www.hepfi.org.

Information about hepatitis B in children is available at the Parents of Kids with Infectious Diseases (PKIDs) website at www.pkids.org/pedheprep.htm.

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