Hepatitis B
The liver is an organ that is located in the right upper abdomen. It performs many functions that are essential to life including:
œRemoval of toxins from the blood
œMetabolizing medications
œProducing blood proteins that are essential for normal blood clotting
œProducing fluids and enzymes required for normal digestion œManufacturing albumin
Fortunately, Vaccines can prevent hepatitis B infection, and are now given routinely to newborns. Vaccination is highly recommended for adults who are at risk for acquiring the infection.
TRANSMISSION
The hepatitis B virus can be transmitted in a many ways. It is transmitted by needle sharing during injection drug use , unprotected sexual intercourse, perinatal transmission (transmission from a mother to her baby).
SYMPTOMS
Most infected people, even those with progressive disease, have no specific symptoms for many years. However, the absence of symptoms does not necessarily mean that the infection is under control. All persons who have chronic infection with hepatitis B are at increased risk of developing complications that include the development of liver scarring and liver cancer. About 10 to 20% of people with chronic hepatitis B develop complications in other organs and tissues outside the liver; vascular inflammation and kidney disease are the two most common complications. People with chronic hepatitis B who develop cirrhosis or liver cancer may experience symptoms such as fatigue, weight loss, fluid accumulation in the abdomen and legs, bleeding, mental confusion, and abdominal pain.
DIAGNOSIS
The diagnosis of hepatitis B is based upon a careful review of a person's medical history, the signs and symptoms noted during a physical examination, and the results of diagnostic tests such as blood tests that provide information about the presence of liver damage , blood levels of two liver enzymes (ALT and AST) and bilirubin and albumin .
Levels of several hepatitis markers found in the blood can confirm hepatitis B infection and differentiate acute from chronic infection.
TREATMENT
There is no specific treatment for acute hepatitis B; in 95 % of adults, the immune system controls the infection. Antiviral treatment may be considered in the rare patient with very severe acute or prolonged acute hepatitis B. In people who develop chronic hepatitis, the goals of treatment are to stop the virus from multiplying to reduce or reverse liver damage.
Antiviral therapy
Six drugs that can slow or stop multiplication of the hepatitis B virus are available:
lamivudine
adefovir
entecavir
telbivudine
interferon-alpha
pegylated interferon-alpha.
Factors that influence prognosis
Prognosis is largely influenced by the extent of viral multiplication and the immune system's ability to control the infection. Other factors that appear to worsen the course of hepatitis include male gender, habitual alcohol consumption, and coinfection with other hepatitis viruses.
IMPLICATIONS FOR THE FAMILY
Acute and chronic hepatitis B are contagious. Thus, people with hepatitis B should discuss measures to reduce the risk of infecting others. This usually involves minimizing blood and bodily fluid exposure, testing immediate family and household members, and vaccinating those at risk for acquiring the infection.
