| Hepatitis B
What is Hepatitis B and how do you get it?
Hepatitis is inflammation of the liver that can be caused by viruses,
bacteria, street and prescription drugs or alcohol. It can lead
to liver damage or liver cancer. There are several kinds of viral
Hepatitis, Hepatitis A, B and C being the most common.
Hepatitis B virus (HBV) is primarily transmitted in the same ways
as HIV, through unprotected sexual intercourse and sharing contaminated
needles. In general, blood, semen and vaginal secretions contain
enough virus to transmit it from one person to another. Saliva,
urine and stools do not contain enough HBV to transmit it from one
person to another, unless there is also blood present in these fluids.
Sharing toothbrushes, razors or nail files with someone that has
Hepatitis B also puts you at risk for infection.
What are the symptoms of Hepatitis B infection?
Hepatitis B can have no symptoms at all or the symptoms can be easily
confused with those of many other infections: fatigue, loss of appetite,
diarrhea, nausea, vomiting, weight loss and fever are some of its
signs. Only 25 – 35 % of people with HBV develop jaundice, a condition
where the skin and whites of the eyes turn yellow or dark urine
is produced along with light stools. Hepatitis may also cause the
liver to swell, which often results in pain in the right upper part
of the abdomen.
Most adults and some children under five will recover within six
months and develop immunity to HBV. But some adults and many children
under five are unable to get rid of HBV and become chronically infected,
which means the symptoms of Hepatitis B may continue throughout
their lives. People with active infection are at a high risk for
developing a hardening of the liver (also called cirrhosis). People
with HIV are far more likely to develop chronic Hepatitis B infections
and progress to cirrhosis quickly.
How is Hepatitis B diagnosed?
Hepatitis B infection can be diagnosed with a simple blood test.
The blood test shows the presence or absence of different types
of antigens and antibodies. Antigens are pieces of the virus, which
cause the immune system to react and produce antibodies. Antibodies
are part of the body's defense system against viruses. If the test
is positive for any of the antigens, it means that you are currently
infected with the Hepatitis B virus. If you test positive for the
antibodies, it means that you have developed immunity against the
virus, either after receiving the vaccine or after an active infection
has passed.
Can Hepatitis B be prevented?
Yes. Like HIV, you can avoid getting Hepatitis B by using a condom
or other latex barrier while having sex. Unlike HIV, cleaning your
syringes with bleach will not help you avoid Hepatitis B. Hepatitis
B is stronger than HIV. If you inject drugs, do not share your needles.
Also, watch out for items that may have been contaminated with someone
else's blood such as toothbrushes, needles and razors used for body
piercing, tattooing, acupuncture and shaving.
Can Hepatitis B be treated?
No and Yes. While there is no approved treatment for the initial
illness caused by Hepatitis B infection, chronic HBV is treated
with alpha-interferon injections, daily or three times a week, for
four months. However, alpha-interferon is only about 40% effective
and can be very difficult to tolerate. It often gives people severe
flu-like symptoms.
Epivir® (lamivudine), the same drug used for HIV at a higher
dose, was recently approved for chronic HBV infection in children
and adults. Side effects of Epivir-HBV include ear, nose and throat
infection, dizziness, low white blood cell count and raised liver
function tests. In children, Epivir-HBV can cause nerve damage and
inflammation of the pancreas. To reduce the chance of HIV resistance
to Epivir, HIV-positive people should take 300mg of Epivir a day
instead of 100mg of Epivir-HBV.
Ask your doctor about the following experimental treatments for
chronic Hepatitis B infection:
Famvir® (famciclovir/penciclovir)
Preveon® (adefovir dipivoxil)
Zadaxin® (thymosin alpha)
Hepatitis B Vaccine
There are two approved vaccines that protect against Hepatitis B
infection. Both vaccines require that children, adolescents and
adults get three injections within six months. Both vaccines are
95% effective and last for at least twelve years in people with
healthy immune systems. People with weakened immune systems may
not respond as well to the vaccine. There are blood tests to see
if the immune system has responded to the vaccine. Some doctors
recommend that people with HIV be given additional doses of the
vaccine if they do not respond to the standard dosage. Side
effects of the vaccines include soreness at the injection site,
flu-like symptoms and allergic reaction. The vaccines can be safely
given during pregnancy. Since HBV is so common, everyone should
consider getting vaccina
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