Hepatitis B: All you need to know!

   Bollywood star Mr Amitabh Bachchan recently declared that he was suffering from Hepatitis B for more than 20 yrs. He also said that Hepatitis B had significantly damaged his liver and now with treatment his condition is stable.

Dr Suresh Singhvi, Senior Liver transplant Surgeon at Sir Ganga Ram Hospital, New Delhi will give information to readers about Hepatitis B, a disease which is preventable and people effected by Hepatitis B, can be treated appropriately by specialists and can lead normal life.

Hepatitis B is a preventable disease and about an estimated 80 million people are infected in India.  

1. What is hepatitis B?

Hepatitis B means inflammation of the liver by Hepatitis B virus. Hepatitis B is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, life long illness. Hepatitis B can be either acute or chronic. In chronicity, the liver disease can progress and cause cirrhosis requiring liver transplantation. Some patients with cirrhosis develop liver cancer too.

2. How is hepatitis B spread?

Hepatitis B is spread when blood, semen , or other body fluid infected with the Hepatitis B virus enters the body of a person who is not infected. People can become infected with the virus during activities such as:

a) Birth ( spread from an infected mother to her baby during birth)

b) Sex with an infected partner.

c) Sharing needles, syringes, or other drug-injection equipment.

d) Sharing items such as razors or tooth brushes with an infected person.

e) Direct contact with the blood or open sores of an infected person.

f) Exposure to blood from needlesticks or other sharp instruments.

3. Can person spread Hepatitis B and not know it?

Yes. Many people with chronic Hepatitis B virus infection do not know they are infected since they do not feel or look sick. However, they can still spread the virus to others and are at risk of serious health problems themselves.

4. Can Hepatitis B spread through sex?

Yes. Many adults transmit infection through sexual contact and accounts for nearly two thirds of acute Hepatitis B cases. In fact, Hepatitis B is 50-100 times more infectious than HIV and can be passed through the exchange of body fluids, such as semen, vaginal fluids, and blood.

5. Can Hepatitis B spread through food?

Unlike Hepatitis A, it is not spread routinely through food or water. It is not spread by sharing utensils, breast feeding, hugging, kissing, holding hands, coughing or sneezing.

6. Who is at risk of Hepatitis B?

Although anyone can get Hepatitis B, some people are at greater risk, such as those who:

a) Have sex with an infected person.

b) Have multiple sex partners.

c) Have sexually transmitted disease.

d) Are men who have sexual contact with other men.

e) Inject drugs or share needles, syringes, or other drug equipment.

f) Are infants born to infected mothers.

g) Exposed to blood on the job

h) Hemodialysis patients.

7. If I think I have been exposed to the Hepatitis B virus, what should I do ?

If there is suspicion that a person has been exposed to Hepatitis B, he should contact a medical doctor for treatment and this will prevent the infection.

8. What are the symptoms of acute Hepatitis B?

Symptoms of acute hepatitis B if they appear, can include: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain and jaundice(yellow color in the skin or the eyes).

9. Can person spread Hepatitis B without having symptoms?

Yes, many people with Hepatitis B have no symptoms, but these people can still spread the virus.

10. How is hepatitis B diagnosed and investigated?

Doctors diagnose the disease with one or more blood tests even if they do not have any symptoms.

11. How is Hepatitis B treated?

Patient s with Hepatitis B should consult a specialist in liver diseases or a gastroenterologist who is specialized in the treatment of Hepatitis B. The patient needs to be monitored regularly for signs of liver disease and evaluated for possible treatment. The treatment of Hepatitis B is not required for all patients and hence the decision is based on every individual conditions which is decided by the specialist.

12. Can Hepatitis B prevented?

Yes. The best way to prevent Hepatitis B is by getting the Hepatitis B vaccine. The Hepatitis B vaccine is safe and effective and is usually given as 3-4 shots over a 6 month period. The cost of the vaccinations in India is approximately Rs 1500/- for the full course of vaccines in an adult.

13. Who should get vaccinated against Hepatitis B?

a) All infants, starting with the first dose of Hepatitis B vaccine at birth.

b) All children and adolescents younger than 19 years of age who have not been vaccinated.

c) People whose sex partners have Hepatitis B.

d) People seeking evaluation for a sexually transmitted disease.

e) Men who have sexual contact with other men.

f) People who share needles, syringes or other drug injection systems.

g) People who have contact with someone infected with Hepatitis B virus.

h) Health care workers- doctors, nurses, laboratory technicians and other medical staff.

i) Hemodialysis patients.

j) Anyone who wishes to protect themselves against Hepatitis B.

14. Is Hepatitis B vaccine safe?

Yes the vaccine is safe and affordable. More than 100 million people have been vaccinated all over India. It is not to be given to patients who are allergic to the vaccine in the past and to patients who are allergic to yeasts. The vaccine has to be taken under the guidance of a qualified doctor and prior to vaccination for adults and adolescents some blood tests are required.

15. What are the late complications of Hepatitis B?

Patients who have been silently suffering from Hepatitis B, present with symptoms and signs of Cirrhosis of the liver. Some of these patients present within a short period of sudden detoriation and will then require an urgent liver transplantation(acute on chronic liver failure) .Cirrhosis is the end stage liver disease which will necessitates liver transplant, as the treatment of choice. Patients will then return back to normal life.

Some of these patients with Hepatitis B, also suffer from Hepatitis C and if they have been drinking alcohol, then the liver is damaged much earlier and this will cause damage much faster and then the patients life is in danger, unless he undergoes liver transplantation. Hence is prevention is better than cure, and advisable to lead a healthy life, to be vaccinated for Hepatitis B infection.

(The Author is a Senior Consultant Liver transplant Surgeon with Sir Ganga Ram Hospital, New Delhi. Website: www.liverdiseaseindia.net)