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Hepatitis B ... what I have found
Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, the infection becomes chronic, leading to liver failure, liver cancer or cirrhosis — a condition that causes permanent scarring of the liver.
The hepatitis B virus is transmitted through contact with the blood and body fluids of someone who is infected — the same way the human immunodeficiency virus (HIV), the virus that causes AIDS, spreads. Yet hepatitis B is nearly 100 times as infectious as HIV.
You're especially at risk if you are an intravenous (IV) drug user who shares needles or other paraphernalia, have unprotected sexual contact with an infected partner, or were born in or travel to parts of the world where hepatitis B is widespread. In addition, women with HBV can pass the infection to their babies during childbirth.
Most people infected as adults recover fully from hepatitis B, even if their signs and symptoms are severe. Infants and children are much more likely to develop a chronic infection. Although no cure exists for hepatitis B, a vaccine can prevent the disease. If you're already infected, taking certain precautions can help prevent HBV from spreading to others.
Signs and symptoms
Most infants and children with hepatitis B never develop signs and symptoms. The same is true for many adults. Signs and symptoms usually appear four to six weeks after you're infected and can range from mild to severe. They may include some or all of the following:
Loss of appetite
Nausea and vomiting
Weakness and fatigue
Abdominal pain, especially around your liver
Yellowing of your skin and the whites of your eyes (jaundice)
Hepatitis B can damage your liver — and spread to other people — even if you don't have any signs and symptoms. That's why it's important to be tested if you think you've been exposed to hepatitis B or you engage in behavior that puts you at risk.
Your liver is located on the right side of your abdomen, just beneath your lower ribs. It performs more than 500 functions, including processing most of the nutrients absorbed from your intestines, removing drugs, alcohol and other harmful substances from your bloodstream, and manufacturing bile — the greenish fluid stored in your gallbladder that helps digest fats. Your liver also produces cholesterol, blood-clotting factors and certain other proteins.
Because of the complexity of the liver and its exposure to so many potentially toxic substances, it would seem especially vulnerable to disease. But the liver has an amazing capacity for regeneration — it can heal itself by replacing or repairing injured tissue. In addition, healthy cells take over the function of damaged cells, either indefinitely or until the damage has been repaired. Yet in spite of this, your liver is prone to a number of diseases that can cause serious or irreversible damage, including hepatitis B.
Acute vs. chronic hepatitis B
Hepatitis B infection may be either acute — lasting less than six months — or chronic, lasting six months or longer. If the disease is acute, your immune system is able to clear the virus from your body, and you should recover completely within a few months. When your immune system can't fight off the virus, HBV infection may become lifelong, leading to serious illnesses such as cirrhosis and liver cancer.
Most people who acquire hepatitis B as adults have an acute infection. But the outlook isn't nearly as hopeful for infants and children. Most infants infected with HBV at birth and many children infected between 1 and 5 years of age become chronically infected. Chronic infection may go undetected for decades until a person becomes seriously ill from liver disease.
Hepatitis B is one of six currently identified strains of viral hepatitis — the others are A, C, D, E and G. Each strain is unique, differing from the others in severity and in the way it spreads.
Major ways transmission occurs
In industrialized countries, you're most likely to become infected with HBV in the following ways:
Sexual transmission. You may become infected if you have unprotected vaginal, anal or oral sex with an infected partner whose blood, saliva, semen or vaginal secretions enter your body. You can also become infected from shared sexual devices if they're not washed or covered with a condom. The virus is present in the secretions of someone who's infected and enters your body through small tears that can develop in your rectum or vagina during sexual activity.
Transmission through needle sharing. HBV is easily transmitted through needles and syringes contaminated with infected blood. That's why sharing IV drug paraphernalia puts you at high risk of hepatitis B. Your risk increases if you inject drugs frequently or also engage in high-risk sexual behavior. Although avoiding the use of injected drugs is the most reliable way to prevent infection, you may not choose to do this. If so, one way to reduce your risk is to participate in a needle exchange program in your community. These programs allow you to exchange used needles and syringes for sterile equipment. In addition, consider seeking counseling or treatment for your drug use.
Transmission through accidental needle sticks. Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood. If you fall into one of these categories, get vaccinated against hepatitis B in addition to following routine precautions when handling needles and other sharp instruments.
Transmission from mother to child. Pregnant women infected with HBV can pass the virus to their babies. If you have hepatitis B, having your baby receive a shot of hepatitis B immune globulin at birth, along with the first in a series of three hepatitis B vaccines, will greatly reduce your baby's risk of getting the virus.
For you to become infected with HBV, infected blood, semen, vaginal secretions or saliva must enter your body. You can't become infected through casual contact — hugging, dancing or shaking hands — with someone who has hepatitis B. You also can't be infected in any of the following ways:
Coming into contact with the sweat or tears of someone with HBV
Sharing a swimming pool, telephone or toilet seat with someone who has the virus
Anyone of any age, race, nationality, sex or sexual orientation can be infected with HBV. But you're at greatest risk if you:
Have unprotected sex with more than one partner. You're at risk whether you're heterosexual, homosexual or bisexual. Unprotected sex means having sex without using a new latex or polyurethane condom every time.
Have unprotected sex with someone who's infected with HBV.
Have a sexually transmitted disease such as gonorrhea or chlamydia.
Share needles during intravenous (IV) drug use.
Share a household with someone who has a chronic HBV infection.
Have a job that exposes you to human blood.
Received a blood transfusion or blood products before 1970 — the date the blood supply began to be tested for HBV. Today, the risk of contracting HBV per unit of donated blood is low.
Receive hemodialysis for end-stage kidney (renal) disease.
Travel to regions with high infection rates of HBV, such as sub-Saharan Africa,
Southeast Asia, the Amazon Basin, the Pacific Islands and the Middle East.
Are an adolescent or young adult residing in a U.S. correctional facility.
Newborns whose mothers are infected with HBV also are at high risk. The same is true of infants and children whose parents were born in areas where HBV infection is widespread. In many developing countries, the most common method of transmission of the virus is between mother and child or among children living in the same household.
Sometimes you may become infected with HBV even if you have no known risk factors for the disease.
When to seek medical advice
Seek medical care if you have signs or symptoms of hepatitis B or are at risk of the disease and haven't been vaccinated or don't know if you're protected.
Most children in the United States now receive HBV vaccine along with other routine shots. But some children — especially those who don't have access to regular medical care or whose parents are from countries with high infection rates — may be overlooked. If your child hasn't been vaccinated, contact a doctor, your state health department or a public health clinic. Many states offer low-cost or free vaccines for those who need them.
Lifelong monitoring of liver function and screening for liver cancer are important for adults and children with chronic HBV infection. If you or your child has already developed signs of liver disease, your doctor will refer you to a specialist for additional care.