Hepatitis B is a term given to the liver infection which is caused by the hepatitis B virus (HBV). Some individual may suffer chronic infection, leading to liver failure, liver cancer, or cirrhosis. These conditions may result in permanent scarring of the liver. The common route of transmission of hepatitis B virus is by blood and body fluids of someone who is infected.

 

Persons who are intravenous drug users sharing the same needle, those indulging in unprotected sexual activity with an infected partner and those who travel frequently to infected areas are at more risk of developing the disease. Disease can also be transmitted from a pregnant mother to the baby during childbirth. Adults usually recover from hepatitis B without being passing into chronic phase or without leaving any consequences, even if their signs and symptoms are severe. Infants and children are the sufferers. They will develop a chronic phase. No definitive cure exists for hepatitis B, but the vaccination against the disease is quiet effective in preventive the infection. There are many methods for the prevention of spread to other persons, if someone is touching the infected person he or she should take all the Universal Precautions. Hepatitis B virus is a hepadnavirus. Black individuals have a higher prevalence of hepatitis B virus disease than persons of Hispanic origin or white persons. More cases of hepatitis B virus disease occur in males than in females. The disease shows a sexual preponderance. More early the infection sets in (in terms of age) more are the chances of developing the chronic phase of the disease. The incubation period of the Hepatitis B disease is up to 6 months.

Signs and Symptoms

• Anorexia
• Nausea
• Vomiting
• Low-grade fever
• Myalgia
• Fatigability
• Disordered smell sensations
• Hepatic encephalopathy
• Somnolence
• Disturbances in sleep pattern
• Mental confusion
• Coma
• Jaundice
• Hepatomegaly
• Splenomegaly
• Palmar erythema
• Swollen Peripheries
• Testicular atrophy

• Gynecomastia

Chronic Disease

Generally the patients will be disease free and will serve as carriers only to others but during the replicative phase of the virus sometimes they too may show some symptoms like -

• Mild pain in Epigastric region and upper quadrant of the stomach
• Anorexia

• Weakness

• Nausea

Diagnosis and Investigations

• High liver enzyme levels will be found like elevated levels of AST, ALT and Alkaline Phosphatase
• Albumin Levels may be low to normal
• Erythrocyte Sedimentation Rate (ESR) will be increased
• Prothrombin time may be deranged
• Complete Blood counts may reveal a varied findings including anemia
• Several Viral markers can be detected in the blood which will help in early detection also like the HBsAg or the Australian antigen and HBeAg antigen. Many antibodies can also be ordered and demonstrated in the blood of the patients
• Many other imaging modalities and enzyme levels can be asked by the treating physician depending on the underlying complications 

Treatment and Medications

• Apart from the symptomatic treatment including the antiemetics, antacids, and intravenous fluids many drugs and medicines are also used. But these drugs provide quick and symptomatic relief
• Newer drugs like Interferon’s and Pegylated interferons are indicated to some of the patients
• Other drugs which can be used depending on the case to case basis are Lamivudine, Adefovir dipivoxil, Entecavir, Telbivudine and Tenofovir
• The patients who develop fulminant hepatitis Orthotopic Liver Transplant (OLT) is prescribed