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Hepatitis B

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OVERVIEW

What is hepatitis?

Hepatitis is a general term for inflammation of the liver. Normally, the liver breaks down waste products in your blood. But when the liver is inflamed, it doesn’t do a good job of getting rid of waste products. This causes waste products to build up in your blood and tissues.

Many different things can cause hepatitis. The most common cause of hepatitis is infection with one of the 6 hepatitis viruses (A, B, C, D, E, or G). Other potential causes are:

  • Lack of blood supply to the liver,
  • Poison,
  • Autoimmune disorders,
  • Excessive alcohol use,
  • An injury to the liver,
  • Taking certain medicines,
  • Viral infections such as mononucleosis or cytomegalovirus although this is less common.

There are 2 main kinds of hepatitis: acute hepatitis (short-lived) and chronic hepatitis (lasting at least 6 months). Most people get over the acute inflammation in a few days or a few weeks. Sometimes, however, the inflammation doesn’t go away. When the inflammation doesn’t go away in 6 months, the person has chronic hepatitis.

What is hepatitis B?

Hepatitis B is a serious liver infection caused by the hepatitis B virus. The virus is usually spread from person to person through contact with blood and/or body fluids of someone who has the infection.

SYMPTOMS

What are the symptoms of hepatitis B?

Symptoms of hepatitis B can range from mild to severe. If you have a mild case of hepatitis, you may not even realize that you have it. It may not cause any symptoms, or may only cause symptoms similar to the stomach flu. The symptoms of hepatitis B may include:

  • Loss of appetite
  • Nausea
  • Vomiting
  • Weakness and fatigue
  • Abdominal pain, especially in the area around your liver
  • Dark-colored urine
  • Jaundice (the yellowing of the skin and the whites of the eyes)
  • Joint pain

CAUSES & RISK FACTORS

What causes hepatitis B and how is it spread?

Hepatitis B is caused by infection with the hepatitis B virus. You can get the virus if you have unprotected sexual contact with an infected partner. People who use intravenous (IV) drugs can get hepatitis B when they share needles with someone who has the virus. Health care workers (such as nurses, lab technicians and doctors) can get hepatitis B if they are accidentally stuck with a needle that was used on an infected patient. The infection can also be passed from a mother to her baby during childbirth. You are also more likely to get hepatitis B if you travel to areas of the world where hepatitis B is common.

Hepatitis B cannot be transmitted through casual contact. For example, you cannot get hepatitis B by hugging or shaking hands with someone who is infected.

DIAGNOSIS & TESTS

How is hepatitis B diagnosed?

Blood tests are used to diagnose hepatitis B. Blood tests can tell your healthcare provider whether your liver is working properly, and they can also be used to monitor your condition during treatment.

Your healthcare provider may want to look at your liver with an ultrasound exam or X‑rays. A liver biopsy may also be needed. With a liver biopsy, a small piece of the liver is removed and looked at under a microscope. A liver biopsy can help your healthcare provider diagnose your illness and see the condition of your liver directly.

PREVENTION

Can hepatitis B be prevented or avoided?

The best way to prevent hepatitis B is to always have protected sex (use a condom) and, if you use intravenous (IV) drugs, to avoid sharing needles.

A vaccine is available to prevent hepatitis B. It is now routinely given as part of routine immunizations for children.  Check your province’s immunization schedule for more information.  This vaccine should be given to people who are at high risk for this illness, such as health care workers, all children, people who travel to areas where the infection is widespread, drug users and those who have multiple sex partners.

TREATMENT

How is hepatitis B treated?

If you have acute (short-lived) hepatitis B, your body may be able to fight the infection on its own, which means you might not need treatment. Your healthcare provider will help you manage your symptoms and monitor your condition while your body works to clear the hepatitis B from your system.

If you have chronic (long-lasting) hepatitis B, your family healthcare provider will probably refer you to a gastroenterologist or other subspecialist that treats people who have chronic liver problems. There are a number of medical treatments available that are often successful. These include treatment with antiviral medicines.

Treatment may take a year or more, depending on the severity of the infection and the response to treatment.

COMPLICATIONS

In some people, chronic hepatitis can lead to cirrhosis of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The damaged areas of the liver stop working and can’t cleanse the body of wastes. Cirrhosis can lead to liver failure and even liver cancer.

If you have hepatitis B, you are also susceptible to hepatitis D (also called delta virus). Hepatitis D can only develop in people who already have hepatitis B. It can make your symptoms of hepatitis B or liver disease worse. It is spread through contact with infected blood or other body fluids of people who have hepatitis D.

Living with hepatitis B

According to Health Canada: “About 90% to 95% of adults with acute hepatitis B will clear the virus on their own within 6 months and develop lifelong protection against it. Some people will not spontaneously clear the virus and will develop chronic hepatitis B. Children under 4 years old are at particular risk of developing chronic hepatitis B.”

Chronic hepatitis B infection can lead to serious health issues. If you have it, you should be monitored regularly by a healthcare provider. This means you should check in with your healthcare provider at least once or twice a year. Some people who have chronic hepatitis B infection require medicine, but others do not. Your healthcare provider can discuss treatment options with you.

FOR MORE INFORMATION

Nova Scotia Department of Health and Wellness

https://novascotia.ca/dhw/CDPC/hepatitis-B.asp

PEI Health and Wellness

https://www.princeedwardisland.ca/en/information/health-and-wellness/hepatitis-b-vaccine

Government of Canada Website

https://www.canada.ca/en/public-health/services/surveillance/blood-safety-contribution-program/bloodborne-pathogens-section/hepatitis/hepatitis-b-facts.html

This information provides a general overview and may not apply to everyone. Talk to your healthcare provider to find out if this information applies to you and to get more information on this subject.

Contributed by familydoctor.org editorial staff.

Copyright (c) by the American Academy of Family Physicians

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, March 2024

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