Hepatitis B is a potentially life-threatening infection that attacks the liver. It’s caused by the Hepatitis B virus. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer. Globally, an estimated 257 million people are living with hepatitis B virus infection.
The transmission of the Hepatitis B virus is primarily through blood; it can be found in saliva, semen, and vaginal secretions and can be transmitted through mucous membranes and breaks in the skin. Mother to child transmission is also possible – this usually occurs during the time of birth and close contact afterward.
Those at a higher risk of the disease include health care workers, those who engage in male homosexual and bisexual activity, close contact with carrier of Hepatitis B Virus (HBV), patient on kidney dialysis (Hemodialysis), people with multiple sexual partners, recipients of blood or blood products or those with recent history of sexually transmitted disease.
Signs and symptoms of hepatitis B may be insidious and variable. Most people do not experience any symptoms during the acute infection phase. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
Most people (more than 90%) who contract HBV infection develop antibodies and recover spontaneously in 6months. However, 10% of patients who have hepatitis B progress to a carrier state or develop chronic hepatitis with persistent HBV infection. Chronic infection is determined by the persistence of Hepatitis B virus (HBsAg) for at least 6 months.
There is no specific treatment for acute hepatitis B. Therefore, care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhoea. The patient may be asked to report for retesting after 6months.
The goals of treatment for Chronic Hepatitis B infection are to minimize infectivity and liver inflammation and decrease symptoms. Alpha-interferon has proven to be a promising agent for the treatments of Chronic Hepatitis B infection. It’s an injectable drug which can be given once daily, three times weekly or once weekly for 16 – 24 weeks or up to 48weeks or more. It results in remission of disease in approximately one third of patients. Side effects of the drug include fever, chills, anorexia, nausea, myalgias and fatigue.
However, the World Health Organization recommends the use of oral treatments – tenofovir or entecavir, because these are the most potent drugs to suppress hepatitis B virus. They rarely lead to drug resistance as compared with other drugs, are simple to take (1 pill a day), and have few side effects so require only limited monitoring.
In most people, however, the treatment does not cure hepatitis B infection, but only suppresses the replication of the virus. Therefore, most people who start hepatitis B treatment must continue it for life.