What is Hepatitis B?

Hepatitis B is liver inflammation caused by the hepatitis B virus (HBV). HBV is one of five types of hepatitis virus. The others are hepatitis A, C, D, and E.

The Centers for Disease Control and Prevention (CDC) state that 2,000 to 4,000 people die each year from complications caused by hepatitis B .

HBV infection can be acute or chronic.

Acute hepatitis B causes symptoms to appear quickly in adults. Children rarely develop acute HBV. Any infections are far more likely to be chronic.

Chronic hepatitis B develops slowly. Symptoms may not be noticeable unless complications develop. According to the CDC, up to 1.4 million people in the United States have chronic hepatitis B (CDC).

Question: What Are the Different Types of Hepatitis?

Answer: There are 5 types of hepatitis - A, B, C, D, and E - each caused by a different hepatitis virus.

Hepatitis A is caused by eating food and drinking water infected with a virus called HAV. It can also be caused by anal-oral contact during sex. While it can cause swelling and inflammation in the liver, it doesn't lead to chronic, or life long, disease. Almost everyone who gets hepatitis A has a full recovery.

Hepatitis B is caused by the virus HBV. It is spread by contact with an infected person's blood, semen, or other body fluid. And, it is a sexually transmitted disease (STD). You can get hepatitis B by:

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Having unprotected sex (not using a condom) with an infected person.

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Sharing drug needles (for illegal drugs like heroin and cocaine or legal drugs like vitamins and steroids).

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Getting a tattoo or body piercing with dirty (unsterile) needles and tools that were used on someone else.

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Getting pricked with a needle that has infected blood on it (health care workers can get hepatitis B this way).

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Sharing a toothbrush, razor, or other personal items with an infected person.

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An infected woman can give hepatitis B to her baby at birth or through her breast milk.

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Through a bite from another person.

With hepatitis B, the liver also swells. Hepatitis B can be a serious infection that can cause liver damage, which may result in cancer. Some people are not able to get rid of the virus, which makes the infection chronic, or life long. Blood banks test all donated blood for hepatitis B, greatly reducing the risk for getting the virus from blood transfusions or blood products.

Hepatitis C is caused by the virus HCV. It is spread the same way as hepatitis B, through contact with an infected person's blood, semen, or body fluid (see above). Like hepatitis B, hepatitis C causes swelling of the liver and can cause liver damage that can lead to cancer. Most people who have hepatitis C develop a chronic infection. This may lead to a scarring of the liver, called cirrhosis. Blood banks test all donated blood for hepatitis C, greatly reducing the risk for getting the virus from blood transfusions or blood products.

Hepatitis D is caused by the virus HDV. You can only get hepatitis D if you are already infected with hepatitis B. It is spread through contact with infected blood, dirty needles that have HDV on them, and unprotected sex (not using a condom) with a person infected with HDV. Hepatitis D causes swelling of the liver.

Hepatitis E is caused by the virus HEV. You get hepatitis E by drinking water infected with the virus. This type of hepatitis doesn't often occur in the U.S. It causes swelling of the liver, but no long-term damage. It can also be spread through oral-anal contact. 


 

Is Hepatitis B Contagious?

HBV is highly contagious. It spreads through contact with infected blood, saliva, and other bodily fluids. Symptoms may not occur for a few days, or longer, after contracting the virus. However, you are still contagious, even without symptoms.

Possible methods of transmission include:

•using an infected toothbrush or razor

•from mother to baby during birth

•being pricked with a contaminated needle

•close contact with a person with HBV

•oral, vaginal, and anal sex

Hepatitis B Risk Factors

Certain groups are at particularly high risk of HBV infection. These include:

•those traveling to countries with a high incidence of HBV

•men who have sex with other men

•people with multiple sex partners

•people with chronic liver disease

•people with kidney disease

•diabetics over the age of 60


People who develop chronic HBV have a high risk of serious complications. The World Health Organization (WHO) states that 25 percent of adults who develop hepatitis B during childhood will later die from complications (WHO).

Hepatitis B is the most common form of hepatitis in Asia.

 

Symptoms of Hepatitis B

Symptoms of HBV may not be apparent for months or years. However, common symptoms include:

•dark urine

•joint pain

•loss of appetite

•fever

•abdominal discomfort

•weakness

•yellow eyes and skin (jaundice)


Any symptoms of HBV should be treated right away. In addition, you should let your doctor know immediately if you have been exposed to hepatitis B. You may be able to prevent infection.

 

How Is Hepatitis B Diagnosed?

Hepatitis B is usually diagnosed through routine or requested screening tests. People are often screened for HBV when they:

•have come in contact with someone with HBV

•have traveled to a country where HBV is common

•have been in jail

•use drugs

•receive kidney dialysis

•are pregnant

•are men who have sex with men

•have HIV


To screen for HBV, your doctor will perform a series of blood tests. Three tests are used to determine the state of your infection:

 

Hepatitis B Surface Antigen Test

A hepatitis B surface antigen test shows if you are contagious. A positive result means you are infected and can spread the virus. A negative result means you don’t have HBV. This test does not distinguish between chronic and acute infection.


Hepatitis B Core Antigen Test

The hepatitis B core antigen test shows whether you are currently infected with HBV. Positive results usually mean you have chronic HBV. It may also mean you are recovering from acute HBV.


Antibody Hepatitis B Surface Antigen Test


An antibody hepatitis B surface antigen test shows whether you are immune to HBV. A positive test means you cannot contract HBV. There are two possible reasons for a positive test. You may have been vaccinated. You may also have recovered from an acute infection with HBV.


Liver Function Tests


HBV symptoms can mimic the symptoms of other conditions, including liver diseases.

Liver function tests check your blood for heightened enzymes from your liver. The results of this test can reveal whether your liver is being stressed. It can also identify signs of disease.

If these tests are positive, you might be tested for HBV. Hepatitis viruses are a major cause of liver damage.

Hepatitis B Treatments

Hepatitis B Immune Globulin


If you have been in contact with someone who has HBV within the last 24 hours, talk to your doctor immediately. It may be possible to prevent infection with an injection of HBV immune globulin. This is a solution of antibodies against HBV.

Treatment Options for Hepatitis B


Acute hepatitis B usually doesn’t require treatment. Most people will overcome an acute infection on their own. However, bed rest will help you recover.

Chronic HBV may be treated with antiviral medications. These help you fight the virus. They may also reduce the risk of future liver complications.

If your liver has been seriously damaged by HBV, you may need a liver transplant. Your liver will be removed and replaced with a donor liver. Most donor livers come from deceased donors.

Potential Complications from Hepatitis B

If treatment for chronic HBV isn’t administered early, complications may occur.

These include:

•liver scarring (cirrhosis)

•liver failure

•kidney cancer

•kidney failure

•liver cancer


Another possible complication is Hepatitis D infection. This virus is only contracted by people with HBV. A combined infection can cause serious liver problems.

 

Hep C Hospital Admissions Spike Fivefold; Those for HIV Drop by Half

Rates of hospital admissions for people living with the hepatitis C virus (HCV) increased fivefold during a 15-year period, while those for people with HIV have dropped nearly 50 percent during the same span, according to a study described at the IDWeek 2012 meeting in San Diego and reported by MedPage Today. Meanwhile, hospital admission rates for people coinfected with both HIV and hepatitis C slightly more than doubled. The University of North Carolina at Chapel Hill study, whose findings are still preliminary and not yet peer-reviewed, examined the annual National Hospital Discharge Surveys from 1996 to 2010 and found 6.6 million hospital admissions coded for HCV, HIV or coinfected serostatus. Specifically, 39 percent of admissions were for HIV, 56 percent for hep C and 5 percent for coinfected patients. Because the analysis began at the advent of the antiretroviral era, HIV death rates unsurprisingly dropped, as did the rates for coinfected patients. Hep C death rates may have dropped as well, but according to Christine Oramasionwu, PharmD, PhD, of UNC-CH, this decrease was the “least pronounced.” The study’s findings are limited by the facts that they were based on retroactive observations and that the data lacked any insight into disease severity.

Methadone Linked to Drop in HIV Rates Among Injection Drug Users

A major research review has found that injection drug users (IDUs) on methadone treatment are 54 percent less likely to contract HIV, according to a study published in the online edition of the British journal BMJ and reported in The New York Times.

The study was conducted by a group of researchers from the United Kingdom, Italy, the United States, Canada and Australia. The consortium analyzed a dozen published studies with information concerning opiate replacement therapy’s impact on HIV transmission; pooling data from nine of these studies, researchers identified 819 HIV infections spanning 23,000 person years.

The scientists suggested that the dramatic risk reduction was due to the fact that methadone improved drug users’ ability to adhere to HIV medications—which in turn reduced their likelihood of infecting others—and to refrain from sharing needles or from exchanging sex for drugs. However, given that those who commit to methadone treatment may also be more motivated toward risk-reducing behaviors, methadone on its own may not be the full cause of the 54 percent reduction.

The findings are vital, however, for efforts to push for opiate-replacement programs in countries such as Russia where injection drug use is rampant and is a major driver of new HIV infections, but where methadone remains illegal.

Brief Treatment Interruptions for Cure Studies Are Safe, Well-Tolerated

A new study has shown that short treatment interruptions of antiretroviral (ARV) regimens are both safe and well-tolerated among people with HIV. This is good news for scientists pursuing functional cures because they can use such windows to study novel agents that would suppress the virus without an ARV regimen. University of Minnesota researchers presented their findings as a poster abstract at the IDWeek 2012 meeting in San Diego. They studied 14 HIV-positive people with a CD4 count above 350 and an undetectable viral load, all of whom were on stable ARV regimens. After stopping the subjects’ HIV medications, the researchers carefully monitored their CD4 counts and viral loads until HIV RNA was detectable in the blood, at which point the researchers took samples of the HIV reservoir, performed a genotyping test and then reinitiated ARVs. The average study participant took two weeks to reach a detectable viral load and another two weeks to reach full viral suppression once again. All subjects reached virologic suppression. None saw their CD4 levels change significantly; none suffered physical symptoms with the viral load’s return; and none developed drug-resistance or experienced virologic failure.

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What Are the Different Types of Hepatitis?

 

Types of Hepatitis

 

In a general sense, hepatitis simply means "inflammation of the liver" and though there are several different causes, it's likely that most people are thinking only about viral hepatitis. However, it's good to understand all the different types because, though they have different causes, they can all lead to dangerous complications such as liver cancer and cirrhosis.

1. Viral Hepatitis

Viruses are microscopic particles that can spread among living creatures (including humans) in different ways and cause many kinds of infections. There are five viruses, named after the first 5 letters of the alphabet, that specifically infect cells of the liver and cause most hepatitis disease. These are known as hepatotropic viruses, or more commonly, the hepatitis viruses. Other viruses might also cause liver inflammation, but they are usually only considered if no evidence of infection from the other five are found.

 

 

2. Autoimmune Hepatitis

Autoimmune disorders are mean the body's immune system starts fighting against itself in certain areas. There are several kinds of these diseases (rheumatoid arthritis and lupus are well-known autoimmune diseases) including a few specific to the liver that create chronic inflammation. These diseases aren't completely preventable because genetics are involved, which means some people are predisposed (genetically likely) to develop the disease based on their DNA.

3. Drug-Induced Hepatitis

Prescribed drugs are beneficial if taken correctly, but can be dangerous to the liver if taken carelessly. This is because many drugs are metabolized (broken down) in the liver and it's possible to get too much of a good thing. Since the liver can safely metabolize a certain amount of a drug (and probably most toxins), going over that safe amount causes the liver problems and inflammation develops. Sometimes the effects of the overdose can be reversed, but sometimes the toxic assault on the liver is too great and permanent liver damage happens.

4. Alcoholic Hepatitis

Drinking large amounts of alcohol (beer, wine, spirits) for prolonged periods of time is harmful to the liver and can lead to liver inflammation called alcoholic hepatitis. This disease has several progressive stages, but all of the early damage can be reversed if alcohol is avoided. However, if untreated, this type of hepatitis will lead to fibrosis and cirrhosis which are, essentially, irreversible. Early detection and treatment is necessary for the best outcome.

5. Chronic Hepatitis

Chronic hepatitis can be thought of as having inflammation that lasts for six months or longer caused by any of the above types. The distinction is necessary because the treatments and prognosis (how someone will recover) are often very different between the types of acute and chronic hepatitis. Still, the goal remains the same: Control the liver inflammation so that fibrosis and cirrhosis can be prevented.

6. Other Causses

Other causes of endstage liver disease that can lead to liver inflammation include nonalcoholic steatohepatitis (NASH), primary biliary cirrhosis, primary sclerosing cholangitis and genetic disorders such as hereditary hemochromatosis and alpha-1-AT.