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What is hepatitis B?

Hepatitis B is an inflammatory liver disease caused by the hepatitis B virus (HBV) that results in liver cell damage, which can lead to scarring of the liver (cirrhosis) and increased risk of liver cancer in some people. An estimated 181,000 Americans are newly infected with HBV each year.

Hepatitis B virus is found in blood, seminal fluid, and vaginal secretions. It can be spread by:

Sexual contact with an infected person.

Contact with infected body fluids, and contaminated needles, including tattoo/body piercing instruments.

Infected mother to newborn at time of delivery.

Those living in the same household with an infected individual are at risk of being infected.
Pregnancy: A woman who is HBV infected can pass the infection to her baby at the time of delivery.

Prenatal blood tests for HBV should be done.

Without intervention, 90% of babies born to infected mothers will become chronically infected, reducing their life expectancy.

Babies born to infected mothers should receive HBIG within 12 hours of delivery plus the first injection of hepatitis B vaccine, with the second dose to follow at 1 month and the third at 6 months.

Babies should be tested at 9-12 months of age post vaccination.

Mothers may nurse their babies.

All newborns should be vaccinated against hepatitis B.

Many people with newly acquired hepatitis B have no symptoms at all, or they may be very mild and flu-like: loss of appetite, nausea, fatigue, muscle or joint aches, mild fever and a few may become jaundiced.

The only way to know if you are currently infected with HBV, or if you still carry the virus is to ask your doctor to do a specific blood test for hepatitis B as it may not be included in a routine blood test. The test may not show positive during the incubation period (45-180 days).

There are three standard blood tests for HBV.
1) HBsAG (hepatitis B surface antigen): When this test is positive or reactive, you are infected with HBV and can pass it on to others.

2) Anti-HBc (antibody to hepatitis B core antigen): When you test positive, it means you are currently infected with HBV or have been infected at some point in the past.

3) Anti-HBs (antibody to HbsAg): When this test is positive, it means that you are immune to hepatitis B either as a result of having had the disease or from having been given the vaccine.

I. Develop immunity:

95% of adults infected develop antibodies and recover spontaneously within 6 months. Upon recovery they develop immunity to the virus, and they are not infectious to others.

Blood tests will test positive for HBV antibody.

Blood banks will not accept donations of blood.
II. Become chronically infected: If the virus has not been cleared from the body within 6 months a person is
considered a carrier or chronically infected.

The chronically infected may show no signs or symptoms.

The virus remains in blood and body fluids, and can infect others.
Complications: In some HBV carriers, the virus continues its silent attack on the liver which over a period of years can lead to cirrhosis (scarring) of the liver. Cirrhosis slows the blood flow through the liver and causes increased pressure in the vein that carries blood from the stomach and the intestines to the liver. As a result, varicose veins (esophageal varicies) may develop in the stomach and esophagus and, without warning, these large veins can break, causing a person to vomit blood or have black, tarry stools. A small number of patients may develop cancer of the liver. Over 5,000 persons die from chronic liver disease caused by HBV infection each year.

If you are chronically infected: you should not drink any alcohol as it may cause additional damage to your liver. Avoid combining any drugs (prescribed, over the counter or herbal) with alcohol. A physician should check you periodically. Do not take any new medications, nutritional supplements or herbals without checking with your doctor first.

Treatment: There are two medications to treat chronic HBV: Interferon (IFN) and Lamivudine.

Less that 50% of patients with chronic HBV are candidates for interferon therapy.

Initially, 40% of HBV patients who are treated with IFN will respond; however, some will relapse when the treatment is stopped. Overall, about 35% of the eligible patients will benefit.

IFN treatments may have a number of side effects, including: flu-like symptoms, headache, nausea, vomiting, loss of appetite, depression, diarrhea, fatigue and thinning of hair.

Interferon may lower the production of white blood cells and platelets by depressing the bone marrow.

Thus, blood tests are needed to monitor blood cells, platelets and liver enzymes.

The response to oral Lamivudine, given for at least one year, may be somewhat lower.

There is no treatment for acute Hepatitis B.


Practice safe sex (use latex condoms).

Don't share anything that could have an infected person's blood on it, i.e. toothbrushes, razors, nail clippers, body piercing instruments.

Don't share drug needles, cocaine straws or any drug paraphernalia.

Cover all sores and rashes and do not touch them.

Clean up any blood spills with a 10% solution of household bleach.

Infected persons should not pre-chew food for babies.

If exposed to hepatitis B, get an HBIG (hepatitis B immune globulin) injection within 14 days following exposure.

Those who are chronically infected should be vaccinated against hepatitis A.

All individuals living in the same household with a chronically infected individual should be vaccinated against hepatitis B.
Vaccines: All newborns and children up to the age of 19 should be vaccinated for hepatitis B. Others who are at risk and should be vaccinated are those who are in positions where they are exposed to blood at work, through drug use, or who have multiple sex partners.

Vaccination provides protection for more than 15 years and possibly a lifetime. Boosters are not recommended.

Individuals with hepatitis C and other chronic liver diseases should receive the hepatitis B vaccine.

(Hepatitis Foundation International)

I hope this helps,



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