What is Hepatitis B?
Hepatitis B infection is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV).
Hepatitis B is a blood-borne pathogen and spread when blood, semen, or other body fluids from a person infected with the Hepatitis B virus enters the person who is not infected.
Check out here what is viral hepatitis?
Epidemiological Triad for Hepatitis B
Agent- The causative agent of hepatitis B is the hepatitis B Virus (DNA Virus).
HBV present in contaminated blood and body secretions such as saliva, vaginal secretions and semen of infected person.
Host– Hepatitis B virus infection commonly affects 20-40 years of age.
Infection occurs during perinatally (time before and after birth) or during early childhood.
Environment– The contaminated blood or secretion on the environment surface is the source of infection.
Risk Group of Hepatitis B Infection
1. Healthcare and laboratory personnel’s
2. Homosexual
3. Prostitute
4. Drug abuser
5. Blood recipient through Transfusion
Note – There are vaccines available to prevent hepatitis A and hepatitis B infection but no vaccine is available for hepatitis C.
Mode of Transmission of Hepatitis B
1. Parenteral route
2. Perinatal transmission
3. Sexual route
4. Person to person contact
1. Parenteral route
By infected blood and blood products –
1. Transfusion
2. Contaminated syringes and needles
3. Pricks/ penetration on skin
4. Handling of infected blood
5. Dialysis
6. Any surgical procedure
7. Tattooing
8. Shared rozors
9. Accupuncture
2. Perinatal transmission
From mother who is the carrier of Hepatitis B virus to their babies during birth.
3. Sexual route
By sexual route –
1. Especially in male homosexuals
2. Having more than one sexual relation individual
Read here the source of infection of hepatitis A and hepatitis B.
Incubation Period of Hepatitis B
The incubation period of hepatitis B is 45-180 days (average 4 months) after exposure to HBV. Even the incubation period can be a longer duration.
Pathophysiology of Hepatitis B
1. Blood and other body fluids become exposed to HBV
2. Body rise cell-mediated immune response by sending cytotoxic T cells (CD-8) and natural killer cells (NK) to the virus and release inflammatory cytokines and eliminate and destroy the viral infected hepatocytes.
3. Persistent viral replication and immune system insufficient to clearance of virus-infected cells
4. Due to the interaction of the virus and the host immune system, which leads to liver injury and damage to the hepatocytes, potentially cirrhosis, and hepatocellular carcinoma.
Lab Investigation of Hepatitis B
1. Blood tests
2. Liver ultrasound
3. Serological tests for viral antigens and antibodies
a. Anti-HBs test or HBsAg (Hepatitis B surface antigen) test
b. HBcAg – anti-HBc test
c. anti-HBc IgM test
d. HBeAg Test
4. Liver biopsy
Clinical Manifestation of Hepatitis B
There are two types of hepatitis B infection: acute and chronic. hepatitis infection
1. Jaundice (yellowing of skin or whites of the eyes turn yellow)
2. Dark urine (pee) turns brown or orange
3. Light-colored stool or feces or poop
4. Fever
5. Weakness and fatigue
6. Abdominal pain
7. Loss of appetite
7. Nausea and vomiting
8. Joint pain
9. Chronic liver disease
10. Liver cancer
11. Cirrhosis of the liver
12. Liver failure
Treatment of Heaptitis B
There is no specific treatment for acute hepatitis B infection. Supportive care is given to maintaining comfort and given adequate nutritional balance, including replacement of fluids lost due to vomiting and diarrhoea.
Chronic hepatitis B infection treated with medications, including oral antiviral agents. Treatment can slow the progression of cirrhosis and reduce incidence of liver damage, liver cancer and improve long-term survival.
Prevention and Control of Hepatitis B
1. Hepatitis B vaccine
A. Immunization
Used for both pre-exposure and post-exposure administration.
There are two types of vaccine- Plasma-derived and R-DNA yeast-derived
Vaccine Age or time of administration Dose Route
Plasma derived Initial dose (1st dose) 1ml I /M
Hepatitis B vaccine 1 month later (2nd dose) 1ml I/M
6 months later (3rd dose) 1ml I/M
R-DNA yeastderived Initial dose (1st dose) 10-20gm I/M
Hepatitis B vaccine 1 month later (2nd dose) 10-20gm I/M
6 months later (3rd dose) 10-20gm I/M
Deltoid muscle is preferred for injection of vaccine.
B. Hepatitis B Immunoglobulin (HBIG)
Given to those who are acutely exposed to hepatitis B cases, such as-
a. Doctors, nurses, clinicians
b. New born babies of carrier mother
c. For those who come in contact with hepatitis B patients sexually
d. Needle stick injury
It should be administrated within 6 hours of exposure and it should not delay for more than 48 hours.
The blood sample of the exposed person is taken- if test negative then routine course of hepatitis B is given. If positive, then another dose of hepatitis B with an interval of 30 days is given.
Immunoglobulins Dose No. Of doses Route
Hepatitis B 0.05-0.07ml/kg Two doses – 1st immediately I/M
Immunoglobulin of body weight after exposure to 6 hrs.
2nd dose after 30 days
C. Combined immunization
Administration of hepatitis B Immuno-globulin and hepatitis B vaccine is more effective as HBIG.
HBIG– 0.05-0.07ml/kg of body weight within 24 hours.
Hepatitis B vaccine– 1.0 ml within 7 days of exposure, then next dose after 1 month and 3rd dose after 6 months of 1st dose.
2. Screening
Patients who are suffering from hepatitis B infection, their blood and secretions are having the virus. They should not allow donating blood. All blood donors should be screened for exposure to hepatitis viruses.
3. Universal precautions
Take universalprecautions when handling or in contact with blood and body fluid.
4. Safe sexual Intercourse
Use a barrier method of contraceptives at the time of having sexual relations.
5. Disinfection
Disinfect the infective floor, wall and materials, and equipment.
Hepatitis B FAQs
1. What is hepatitis B?
Hepatitis B is liver infection that caused by hepatitis B virus.
Hepatitis B virus cause Acute hepatitis B and chronic hepatitis People with Acute hepatitis B are sick for only a few weeks but the disease progresses to a serious, known as chronic hepatitis B.
2. What are the differences between hepatitis A, hepatitis B, and hepatitis C?
Hepatitis A, Hepatitis B, and Hepatitis C are liver infections cause liver inflammation.
Hepatitis A, causative agent is Hepatitis A virus. Hepatitis B, causative agent is Hepatitis B virus and, Hepatitis C, causative agent is Hepatitis C virus.
Hepatitis A is usually a short-term infection. Hepatitis B and hepatitis C as short-term infections and can causes chronic, or lifelong, infection. Hepatitis A, Hepatitis B, and Hepatitis C are spread in different ways.
There are vaccines available to prevent hepatitis A and hepatitis B; but hepatitis C no vaccine is available.
3. How is hepatitis B spread?
Hepatitis B infection is spread when infected with hepatitis B virus blood, semen, or other body fluid virus enters the uninfected body.
Human can become infected with the Hepatitis B virus from –
1. Direct contact with infected person blood or open sores of an infected person.
2. Through needlesticks or other sharp instruments
3. From an infected mother to her baby during birth
4. Sexual contact with an infected partner
5. Sharing needles, syringes, or drug preparation equipment
6. Sharing items such as razors, medical equipment (like a glucose monitor) with an infected person
7. Blood transfusion
4. Can hepatitis B be spread through food?
No, Hepatitis B is not spread through food or water.
5. What should if exposed to the hepatitis B virus?
Immediately call a healthcare provider or visit the local health department. Infection with the hepatitis B virus can be prevented. if get the “hepatitis B immune globulin” HBIG / or hepatitis B vaccine as soon as possible within 24 hours after exposure to the virus.
6. Can hepatitis B infected person donate their blood?
If anyone who has tested positive for hepatitis B infection or symptoms of viral hepatitis, does not accept blood donations.
7. Can hepatitis B infection be prevented?
Yes, hepatitis B is prevented by getting vaccinated.
Read here what are the symptoms of typhoid fever?
