Hepatitis B

What is hepatitis B?

Hepatitis B is a viral infection of the liver. The liver becomes inflamed and tender. It may also become swollen. Areas of liver tissue may be destroyed by the inflammation. Hepatitis B is a serious, sometimes severe and even fatal type of hepatitis.

How does it occur?

Hepatitis B is caused by the hepatitis B virus. You get hepatitis B by direct contact with the blood or body fluids of an infected person. For example, you can get it from:

• having unprotected sex with someone infected with hepatitis B
• sharing needles for drug injection with an infected person
• getting a body part pierced or a permanent tattoo with nonsterile equipment.
• being exposed to blood at work if you are a healthcare worker.

A baby can get hepatitis from the mother if she is infected when the child is born.

Because of improved blood screening methods, it is now rare to get hepatitis B from a blood transfusion.

The disease can be spread by people who do not have any symptoms and may not know they carry the virus. These people are called asymptomatic carriers.

What are the symptoms?

You may not have any symptoms of hepatitis until several weeks or months after you are infected with the virus. Or you may never have any obvious symptoms.

If you do have symptoms, they may include:

• yellowish skin and eyes (jaundice)
• tiredness
• dark urine
• abdominal pain
• loss of appetite
• nausea, vomiting
• joint pain.

How is it diagnosed?

Your healthcare provider will ask about your medical history and symptoms. Especially important is your history of hepatitis risk factors such as IV drug abuse or unsafe sex.

Your provider will examine your skin and eyes for signs of hepatitis. Your provider will check your abdomen to see if the liver is enlarged or tender.

You will have blood tests. If blood tests show that your liver is not working normally, your provider will do tests to see if you are infected with the hepatitis B virus.

If your provider thinks you may have chronic hepatitis or serious liver damage, or if the diagnosis is uncertain, you may have a liver biopsy. A biopsy is a procedure in which a needle is used to remove a small amount of tissue. This is done through the skin over the liver after the area is numbed with an anesthetic. The sample of tissue is sent to a lab for tests to check for damage to your liver.

How is it treated?

The usual treatment is rest. In addition, your healthcare provider will recommend that you avoid alcohol for at least 6 months. Usually it is not necessary to stay at the hospital. If you become severely dehydrated from nausea and vomiting, you may need to go to the hospital to receive intravenous (IV) fluids.

If you develop chronic hepatitis B, you may need treatment with medicines. The types of drugs used are interferon and other antiviral drugs.

How long will the effects last?

The symptoms generally last several weeks and are usually followed by a slow but complete recovery. It may take 6 months before tests of your liver show that it is working normally again.

Some people who have hepatitis B develop the chronic form of the disease. This means the virus continues to affect their liver for several months or longer. The continued inflammation can damage the liver, resulting in cirrhosis (scarring of the liver) and possible liver failure. Your healthcare provider may check your blood every few months for signs of chronic liver disease.

Infection with the hepatitis B virus increases your risk for liver cancer.

How can I take care of myself?

• See your healthcare provider regularly.
• Follow your healthcare provider's instructions for taking medicine to relieve your symptoms. When you have hepatitis, you need to avoid taking medicines that can further damage the liver (for example, acetaminophen). Ask your provider which medicines you can safely take for your symptoms (such as itching and nausea).
• Follow your provider's advice for how much rest you need and when you can return to your normal activities, including work or school. As your symptoms improve, you may gradually increase your level of activity. It is best to avoid too much physical exertion until your provider tells you it is OK.
• Eat small, high-protein, high-calorie meals, even when you feel nauseated. Sipping soft drinks or juices and sucking on hard candy may help you feel less nauseated.
• Do not drink alcohol unless your provider says it is safe.
• If you have liver damage from hepatitis B, you should get tested for hepatitis C and get vaccinated against hepatitis A.

What can be done to help prevent the spread of hepatitis B?

Hepatitis B is highly contagious for 2 to 6 weeks before symptoms appear. It continues to be contagious for some time after you start having symptoms. After you have been diagnosed, your healthcare provider will want to see you for follow-up. Your provider may test your blood to see if you are still contagious. Some people who get hepatitis B become chronic carriers of the virus. A blood test can determine whether you are a chronic carrier.

To avoid spreading the disease to others:

• Do not allow your body fluids, including saliva, to contact others.
• Clean any blood spills or stains with a mixture of 1 part household bleach to 9 parts water.
• Cover your cuts and open sores.
• Do not share anything that might have blood on it, such as needles, toothbrushes, or razor blades.
• Avoid sexual contact with others until your provider tells you that you are no longer contagious. If you are in a long-term relationship with one partner, ask your provider if you need to be using condoms.
• Do not donate blood, body organs, other tissues, or sperm.

All people who live with you should get the hepatitis B vaccine. Three shots of the vaccine can prevent infection with the hepatitis B virus. The second shot is given 1 to 2 months after the first shot. The third shot is given 4 to 6 months after the first shot.

People in the following categories have a high risk of getting hepatitis B and should get shots of the hepatitis B vaccine:

• healthcare workers
• public safety workers who work with drug abusers
• volunteers and employees at homeless shelters
• sexual partners of people who carry the virus
• men who have sex with other men.

In addition, the American Academy of Pediatrics and the American Academy of Family Physicians recommend that all children get hepatitis B shots. Teenagers and young adults are also encouraged to get the shot to prevent sexually transmitted hepatitis B. Ask your healthcare provider if you should be immunized against hepatitis B.

If you are pregnant, you should get a blood test for hepatitis B. Babies born to HBV-infected mothers should be given HBIG (hepatitis B immune globulin) and the hepatitis vaccine within 12 hours after birth.

For more information, contact:

American Liver Foundation
Phone: 1-800-GOLIVER (465-4837)
Web site: http://www.liverfoundation.org
Printed information about liver disease and hepatitis, information specialists