Hepatitis B
Why should we opt for hepatitis B vaccination?
Introduction
Hepatitis B is a major global health problem. Hepatitis B is a viral disease which selectively damages liver. It is estimated that over 2 billion people worldwide had been infected with hepatitis B virus (HBV) and 3-5 % of Indian population is infected with HBV. Chronic HBV infection can progress to cirrhosis (advanced irreversible liver disease) and is a leading cause of Liver cancer. Most patients with chronic HBV infection will not develop these complications, but 15-40 % will and roughly 500000 people die from these complications each year. The availability of safe and effective vaccines and approved treatment options has made hepatitis B a preventable and treatable …show more content…
condition.
How does it spread?
HBV is more easily spread than HIV or hepatitis C (HCV).
A) Blood transfusion: Rare source of infection nowadays. Risk of transmission is almost 1 in 63000.
B) Sexual transmission: It remains a major source of transmission especially in persons with multiple sexual partners or high-risk behaviour.
C) Infected mother to infant: The chances can be reduced by institutional deliveries and by vaccinating the baby immediately after birth. Breast feeding is safe from infected mother to the child if the child is vaccinated.
D) IV drug abusers: Because of sharing of the same needle HBV infection is very common amongst IV drug users and it is a very common mode of transmission.
E) Health care workers: HBV can be transmitted to patient to patient or patient to health care personnel via contaminated surgical instrument or needle stick injury.
F) Other uncommon modes of transmission include tattooing, organ transplant and sharing razors or toothbrushes.
HBV infection is NOT transmitted by living together, sharing food, hugging or hand shaking.
Clinical Features
Most of the patients of HBV infection are asymptomatic. Acute Hepatitis B: The first symptom appears after 60-90 days of getting infected. Acute infections are heralded by nonspecific symptoms like weakness, nausea, vomitings, fever, jaundice and joint pain. These symptoms usually disappear in 1-3 months. In approximately 80% of cases, the HBsAg is cleared by body immunity in 12 weeks, rest 20% patient develop carrier …show more content…
state.
Chronic Hepatitis: Usually asymptomatic, if symptomatic, fatigue predominates. Physical examination is normal usually.
Diagnosis
It can easily be diagnosed by detection of a protein HBsAg in the blood of the infected person. HBsAg appears in serum 2-10 weeks after exposure to HBV. In acute hepatitis, HBsAg becomes undetectable after 12 weeks; persistence of HBsAg after 6 months implies chronic infection.
Treatment
Oral Drugs: Nucleos(t)ide analogues suppress HBV replication by inhibiting viral DNA polymerase. These drugs include lamivudine, tenofovir, adefovir, entecavir and emtricitabine.
Injectables: Pegylated interferon- alpha has been approved for the treatment of HBV infection.
Peg-IFN causes more rapid viral suppression and HBsAg loss. The duration of therapy is 48 weeks at a dose of 180 mcg injection once a week.
Prevention
Hepatitis B is a preventable disease. There are very effective vaccines available against HBV infection. Nowadays the hepatitis B vaccine has been included in universal vaccination programme.
Hepatitis B Vaccine: The HBV vaccine is administered intramuscularly in the deltoid muscle (shoulder muscle) of adults and the anterolateral thigh of infants.
Schedule: At 0, 1 and 6 months in immunocompetant persons. In immunocompromised persons, the 4th booster dose is recommended.
Effectiveness of vaccine: Measured by Anti-HBs titre after complete vaccination. It provides lifelong immunity.
Conclusion
The HBV infection is a major global health problem. The clinical spectrum can vary from asymptomatic carrier state to decompensated liver disease or hepatocellular carcinoma. The hepatitis B is a preventable disease as effective vaccines are available which give 100 % protection from this deadly disease. Every person must get vaccinated against hepatitis B to prevent future liver problems. Those who are already positive for HBV infection must meet doctor to discuss the available treatment
options.
Introduction
Hepatitis B is a major global health problem. Hepatitis B is a viral disease which selectively damages liver. It is estimated that over 2 billion people worldwide had been infected with hepatitis B virus (HBV) and 3-5 % of Indian population is infected with HBV. Chronic HBV infection can progress to cirrhosis (advanced irreversible liver disease) and is a leading cause of Liver cancer. Most patients with chronic HBV infection will not develop these complications, but 15-40 % will and roughly 500000 people die from these complications each year. The availability of safe and effective vaccines and approved treatment options has made hepatitis B a preventable and treatable …show more content…
condition.
How does it spread?
HBV is more easily spread than HIV or hepatitis C (HCV).
A) Blood transfusion: Rare source of infection nowadays. Risk of transmission is almost 1 in 63000.
B) Sexual transmission: It remains a major source of transmission especially in persons with multiple sexual partners or high-risk behaviour.
C) Infected mother to infant: The chances can be reduced by institutional deliveries and by vaccinating the baby immediately after birth. Breast feeding is safe from infected mother to the child if the child is vaccinated.
D) IV drug abusers: Because of sharing of the same needle HBV infection is very common amongst IV drug users and it is a very common mode of transmission.
E) Health care workers: HBV can be transmitted to patient to patient or patient to health care personnel via contaminated surgical instrument or needle stick injury.
F) Other uncommon modes of transmission include tattooing, organ transplant and sharing razors or toothbrushes.
HBV infection is NOT transmitted by living together, sharing food, hugging or hand shaking.
Clinical Features
Most of the patients of HBV infection are asymptomatic. Acute Hepatitis B: The first symptom appears after 60-90 days of getting infected. Acute infections are heralded by nonspecific symptoms like weakness, nausea, vomitings, fever, jaundice and joint pain. These symptoms usually disappear in 1-3 months. In approximately 80% of cases, the HBsAg is cleared by body immunity in 12 weeks, rest 20% patient develop carrier …show more content…
state.
Chronic Hepatitis: Usually asymptomatic, if symptomatic, fatigue predominates. Physical examination is normal usually.
Diagnosis
It can easily be diagnosed by detection of a protein HBsAg in the blood of the infected person. HBsAg appears in serum 2-10 weeks after exposure to HBV. In acute hepatitis, HBsAg becomes undetectable after 12 weeks; persistence of HBsAg after 6 months implies chronic infection.
Treatment
Oral Drugs: Nucleos(t)ide analogues suppress HBV replication by inhibiting viral DNA polymerase. These drugs include lamivudine, tenofovir, adefovir, entecavir and emtricitabine.
Injectables: Pegylated interferon- alpha has been approved for the treatment of HBV infection.
Peg-IFN causes more rapid viral suppression and HBsAg loss. The duration of therapy is 48 weeks at a dose of 180 mcg injection once a week.
Prevention
Hepatitis B is a preventable disease. There are very effective vaccines available against HBV infection. Nowadays the hepatitis B vaccine has been included in universal vaccination programme.
Hepatitis B Vaccine: The HBV vaccine is administered intramuscularly in the deltoid muscle (shoulder muscle) of adults and the anterolateral thigh of infants.
Schedule: At 0, 1 and 6 months in immunocompetant persons. In immunocompromised persons, the 4th booster dose is recommended.
Effectiveness of vaccine: Measured by Anti-HBs titre after complete vaccination. It provides lifelong immunity.
Conclusion
The HBV infection is a major global health problem. The clinical spectrum can vary from asymptomatic carrier state to decompensated liver disease or hepatocellular carcinoma. The hepatitis B is a preventable disease as effective vaccines are available which give 100 % protection from this deadly disease. Every person must get vaccinated against hepatitis B to prevent future liver problems. Those who are already positive for HBV infection must meet doctor to discuss the available treatment
options.