SAFEGUARDING YOUR LIVER

What is Hepatitis B?

Hepatitis B is a contagious liver infection caused by the hepatitis B virus (HBV).  The natural course of hepatitis B disease is different from one person to another.

• The first phase of disease, during the first 6 months after a person becomes infected, is called acute hepatitis B infection. During this phase, many people show no symptoms at all. Among those who do have symptoms, the illness is usually mild and most people don't recognize that they have liver disease.
• In 90% of persons who become infected as adults with hepatitis B, the immune system successfully fights off the infection during the acute phase -- the virus is cleared from the body within 6 months, the liver heals completely, and the person becomes immune to hepatitis B infection for the rest of their life. In the other 10%, the immune system cannot clear the virus and hepatitis B infection persists past 6 months, usually for the rest of the person's life. This persistent state is known as chronic hepatitis B infection.
• When babies become infected at birth or during infancy, the percentages are reversed -- only 10% clear the infection. The remaining 90% develop chronic hepatitis B infection.
• In chronic hepatitis B infection, the liver becomes inflamed and scarred over a period of years. However, the speed at which inflammation and scarring take place varies between people. Some develop severe liver scarring (cirrhosis) within 20 years. In others, liver disease progresses slowly and does not become a major problem during their lifetime.
• Another concern is the potential for liver cancer. Hepatitis B infection is the single most important cause of hepatocellular (liver) cancer.

Treatment with anti-viral drugs works for some people with HBV who are starting to develop liver damage. Whether treatment will be successful depends on many factors, and these are best discussed with a physician who specializes in liver diseases. When treatment is successful, liver scarring and the potential for liver cancer are reduced.

How do people get the HBV Virus?

Hepatitis B virus is found in the blood of people with HBV infection. It enters the body through blood-to-blood contact.

Reliable blood tests for HBV were developed many years ago. Since blood donors and blood products are tested for HBV, this is no longer the typical means of infection.

In many parts of the world, hepatitis B virus infects more than 8% of the population. HBV-infected women pass the infection to their babies during the birth process. People can also get hepatitis B by sharing needles for injection drug use, through sexual contact with an infected person, by an accidental needlestick with a contaminated needle, or from improperly sterilized medical, acupuncture, piercing, or tattooing equipment.

Who is at Risk for Infection?

• Persons born in places where hepatitis B infection is common (especially China, Southeast Asia, the Pacific Islands, sub-Saharan Africa, and the Amazon basin in South America).
• Children of parents born in those places.
• Injecting drug users
• Hemodialysis patients
• Health care and public safety workers who may have contact with blood
• People having sex with an HBV-infected partner
• Men who have sex with men
• Those living in the same household with an HBV-infected person
• Travelers to places where hepatitis B infection is common who will have extended, close contact with the local population.

How is Hepatitis B Prevented?

Testing & Vaccination

• The hepatitis B vaccine offers excellent protection against HBV. The vaccine is safe and highly effective. Vaccination consists of 3 doses of vaccine (shots) over the course of 6 months. Protection lasts for 20 years to life.
• The American Academy of Pediatrics recommends that all children should receive hepatitis B vaccine starting at birth. (AAP Policy).
• The CDC recommends hepatitis B vaccine for persons traveling to countries where HBV is common (2008 Yellow Book).
• If you have one or more risk factors for hepatitis B infection, you should get a simple HBV blood test. The blood test will determine whether you are: 
  • immune to hepatitis B; or 
  • susceptible to hepatitis B and need vaccination; or 
  • infected with hepatitis B and need further evaluation by a physician
• The basic test for acute HBV infection is called the "Hepatitis B Core IgM Antibody test." People who have acute hepatitis B show positive IgM antibodies on this test.