What is Hepatitis B?
It is a hepatitis B virus (HBV) infectious disease that affects the liver; it is a viral hepatitis of the type of hepatitis. It can cause both chronic and acute diseases.
During the initial infection, many people have no symptoms. Some people can develop rapid disease with vomiting, yellowish skin, fatigue, dark urine and abdominal pain in acute infection.
These symptoms often take a few weeks and seldom lead to death from the initial infection.
Symptoms may take between 30 and 180 days. In people infected at birth, 90% develop chronic hepatitis B, while less than 10% develop chronic hepatitis B after age five.
Cirrhose and liver cancer can eventually develop, however, in the majority of people with chronic disease. Around 25 percent of those with chronic disease are affected by cirrhosis or liver cancer.
Symptoms Of Hepatitis B
Acute hepatitis B infection is associated with acute hepatitis, an illness that starts from general illness, loss of appetite , nausea, vomiting, body aches, mild fever and dark urine.
The disease lasts for a couple of weeks and is improving progressively in most people. A couple of people may have a more severe liver disease, called brilliant liver failure, resulting in death. The infection can be completely asymptomatic and unknown.
Chronic virus infection, either asymptomatic or linked to chronic liver inflammation (chronic hepatitis), can lead to circrhosis over several years.
The incidence of hepatocellular carcinoma ( HCC; liver cancer) is dramatically increased by this kind of infection. Hepatitis B and C cause hepatocellular carcinomas in all parts of Europe approximately 50 percent.
Chronic carriers are encouraged to avoid alcohol consumption as its risk of cirrhosis and liver cancer is increased. The development of MGN (membranous glomerulonephritis) has been linked to hepatitis B virus.
In 1–10 per cent of HBV-infected people, symptoms outside the liver are associated with serum-like syndrome, acute vasclitis necrotization (polyarteritis nodosa), membranous glomerulonephritis, and childhood papular acrodermatitis (Gianotti – Crosti syndrome).
Serum-like syndrome happens in the case of acute hepatitis B, often before jaundice occurs.Fever, skin rash and polyarteritis are the clinical characteristics.
The symptoms are often reduced just after jaundice, but can remain in the acute hepatitis B for a long time. About 30–5% of persons with acute vascular necrosis (polyarteritis nodosa) are carriers of HBV.
In adults, but more commonly in children, HBV-associated Nephropathy is described. The most common form is membrane glomerulonephritis.
Other hematologic immune-mediated disorders, such as critical mixtures of cryoglobulinemia and aplastic anemia were described as part of HBV infection extra-hepatic manifestation but their association was not as well defined.
Mode Of Transmission Of Hepatitis B
Hepatitis B virus transmission is a result of exposure to blood-containing infectious blood or body fluids. Infection rates are 50-100 times higher than the HIV virus.
Potential forms of transmettal include sexual contact, transfusion of blood and transfusion of other human blood products, the reuse and vertical transmission of infected needles and syringes (MTCT) during the birth.
A mother who is positive for HBsAg has 20% risk of passing the infection on to her offspring when she is born. Without intervention.
If the mother is also positive for HBeAg, this risk amounts to 90%. HBV can be transmitted among the family in families, possibly via non-intact skin or mucous membrane contact with HBV secretions or saliva.
However, no identifiable risk factor can be associated with at least 30% of the reported hepatitis B among adults. Breast-feeding does not seem to contribute to HBV mother-to – child (MTCT) transmission after adequate immunoprophylaxis.
The virus can persist and develop to chronic hepatitis B in 30 to 60 days after infection. The hepatitis B virus incubation period is averaged 75 days but may vary from thirty to eighty days.
Vaccine Of Hepatitis B
Since 1991, in the United States, hepatitis B prevention vaccines have regularly been recommended for babies. In general, the first dose is recommended within one day of birth. The first cancer prevention vaccine, namely liver cancer, was the vaccine of it.
Over a period of months, most vaccines are administered at three doses. Anti-HB’s antibody level of at least 10 mIU / ml in the recipient’s serum is defined as a protective response to the vaccine.
In children, the vaccine is more effective; 95% of those vaccinated have antimicrobial protective levels. This drops at 40 years to approximately 90 per cent and over 60 years to approximately 75 per cent.
Even if anticorps are under 10 mIU / ml the protection provided by vaccination is long lasting.
Hepatitis B immunoglobulin is alone or the vaccine combination plus immunoglobulin hepatitis B all prevents hepatitis B from occurring in HBs Ag-positive mothers’ neurons.
In addition , the combination of immunoglobulin vaccine plus hepatitis B is superior to vaccine alone. In 86 to 99 percent of cases, this combination prevents HBV transmission during birth.
Treatment Of Hepatitis C
Acute infection usually does not need treatment and the infection is spontaneously removed by most adults. In less than 1 percent of people who are infected or immunocompromised, early antiviral treatment may be necessary. Anti-viral treatment may be very aggressive.
On the other hand, it might be necessary to treat chronic infection to minimize the risk of cirrhosis and liver cancer. Candidates for therapy are chronically infected people with high serum alanine aminotransferase, a liver damage indicator and levels of HBV DNA.
Depending upon the medication and genotype, treatment takes six months to a year. However, treatment duration is more variable and usually more than one year when medications are taken by mouth.
While none of the drugs available can remove the infection, they can prevent the virus from replicating and minimize damage to the liver. Eight medicines have been licensed in the United States since 2018 to treat hepatitis B infection.
The two immune system modulators interferon-alpha-2a and PEGylated interferon-alpha-2a include antiviral drugs Lamivudina, adefovir, tenofovir disoprice, tenofovir alafenamide, telbivudine and enterecavir.
Tenofovir or entecavir was recommended as first-line agents by the World Health Organization in 2015. Current cirrhosis is most often necessary for treatment.