HEPATITIS B - The Silent Killer

What is type B hepatitis?
Hepatitis is the Latin word for liver inflammation.
Type B hepatitis is caused by a virus called hepatitis B virus. Other types of infectious liver inflammation include hepatitis A and hepatitis C.

Hepatitis B happens to be the most deadly.

What causes type B hepatitis?
Hepatitis B virus can be spread in a number of ways.

By contact with blood from an infected person - transfusion of infected blood and blood products or by contaminated needles used by drug addicts, tattooists or acupuncturists.

By sexual contact with an infected person.

From a pregnant woman to her child during delivery.

What causes type B hepatitis?
Type B hepatitis is highly infectious and can, in rare cases, be spread among family members without sexual contact or contact with infected blood. In these cases, the virus is probably spread by toothbrushes or kissing.

The virus can also be contracted by a person, mostly healthcare workers, accidentally pricking themselves with a contaminated needle

Type B hepatitis is commonly seen in drug users, homosexual men, immigrants from countries in Asia and South East Asia (where hepatitis is very common) - and their sexual partners.

What are the symptoms of type B hepatitis?
The incubation period, from the time of exposure to the virus until the onset of the disease, is two to six months. Early symptoms include poor appetite, lack of interest in food, nausea, aching muscles and joints, and mild fever. Later symptoms include yellowing of the skin, mucous membranes, and white portions of the eyes (jaundice, icterus); light-coloured stools; and dark urine. When the late symptoms have developed, the patient usually begins to get better.

What are the symptoms of type B hepatitis?
In approximately 1 out of 20 patients, the infection becomes chronic. Patients with chronic type B hepatitis may have only mild symptoms, such as tiredness, aching muscles and joints and periodical pressure below the right ribs from the enlarged liver. Approximately one fifth of the patients develop cirrhosis (hardening of liver) over a number of years which may result in liver failure and other serious complications. On average, cirrhosis develops 15 years after the virus has been contracted. Newborn babies show no symptoms of acute hepatitis. However, in around 90 per cent of the cases, the infection becomes chronic.

How can type B hepatitis be prevented?
Avoid sharing needles and syringes with others.
Avoid sharing razors and toothbrushes with infected people

Use a condom during sexual intercourse.

Vaccination, which is very effective against type B hepatitis, is available. A person receives three injections in all. The last two are administered one and six months after the first injection.

What can be done at home?
Be careful to protect your family and sexual partners from the virus.

Abstain from all alcohol intake if blood samples show that the disease is active.

Refrain from drinking alcohol daily if you have chronic type B hepatitis.

If you have chronic hepatitis, you should be examined regularly by your doctor.

Eat a healthy, well-balanced diet.

How is type B hepatitis diagnosed?
The diagnosis is made on the basis of a blood sample which will demonstrate antibodies against hepatitis B, or hepatitis B components in the patient's blood
The blood sample can demonstrate the presence of several different viral components.
A blood test for liver function can determine the severity of the disease - the extent to which the liver is affected by the virus.

Future prospects
Most patients with acute type B hepatitis fully recover in about four to six weeks. Very few patients (about 1 in 300) develop liver failure as a result of acute hepatitis, and consequently risk dying. The infection becomes chronic in 1 in 20 adult patients. However, the number is much higher in cases of newborn babies who have contracted the virus from their mothers. The most serious complications of chronic type B hepatitis are cirrhosis, and, in rare cases, liver cancer.

How is type B hepatitis treated?
There is no specific medical treatment for acute type B hepatitis. Chronic type B hepatitis can by treated with injections of interferon alpha, when disease activity has been confirmed by a blood sample or a tissue sample from the liver. pproximately one third of the patients will benefit from the treatment. Longer courses of specific antiviral medicines are currently being given with hopeful results. Lamivudine (Zeffix), an antiviral medicine, is helpful for some patients.

By:
Kristian Obirikorang (Biomedical Scientist)
College of Health Sciences
School of Medical Sciences
Dept. of Molecular Medicine
KNUST, Kumasi.