Hepatitis B (HBV)

Medical Author: Mohamad El Mortada, MD and Mary Nettleman, MD, MS
Medical Editor: Jay W. Marks, MD

• What is hepatitis?
• How is the hepatitis B virus spread (transmitted)?
• What are the symptoms of acute hepatitis B infection?
• What are the symptoms of chronic hepatitis B infection?
• How is hepatitis B diagnosed?
• What is the role of a liver biopsy in chronic hepatitis B?
• What is the natural course of chronic hepatitis B?
• What medications are used to treat hepatitis B?
• What are the effects of alcohol on hepatitis B?
• What are the effects of immunosuppressive medications on hepatitis B?
• What is delta hepatitis?
• What about co-infection with hepatitis B virus and hepatitis C virus?
• What happens in co-infection with hepatitis B virus and human immunodeficiency virus?
• What is the role of liver transplantation in hepatitis B?
• What can be done to prevent hepatitis B?
• What is new in the treatment of hepatitis B?
• Hepatitis B At A Glance
• Patient Discussions: Hepatitis B - Describe Your Experience

Featured hepatitis B patient discussions on experience "I was diagnosed with Hep B 2 weeks ago and was devastated by the news. I have been ill and sore for over 10 years, with no one being able to figure out what was wrong with me. It was always written off as a virus or infection. Then 2 years ago the severe muscle cramps started. I had them from scalp to toes, and it was when they ran the full spectrum of tests to figure the cramps out, that they discovered the Hep B along with severe Vitamin D deficiency, which I now link to the Hep B. I am so tired and nauseous and in constant pain. I am just sick and tired of feeling sick and tired!!" "I have had Hep B for some time now. Exactly when I contracted this virus is unknown of course as is the way of inception. I have experienced the Virus as coming and going to me. I will feel fine for a while and then bam I will wake up one morning and feel like I got a beating by ten people. I have been to many specialists and they cannot get a handle on it so they can try and treat it because the viral load is different all the time, and never going high enough to treat. Therefore I am in a catch 22 situation." "I have been diagnosed with Hepatitis B viral infection which I've realized was passed on to me at birth. I'm 49 years old and undergoing series of tests to determine the appropriate treatment." Read All Comments on Hepatitis B » Top Searched Hepatitis B Terms: vaccine, virus, symptoms, vaccination, treatment, causes, liver enzymes Patient Discussions are not a substitute for professional medical advice, or treatment. See the disclaimer at the bottom of the comments page.

What is hepatitis?

The term 'hepatitis' simply means inflammation of the liver. Hepatitis may be caused by a virus or a toxin such as alcohol. Other viruses that can cause injury to liver cells include the hepatitis A and hepatitis C viruses. These viruses are not related to each other or to hepatitis B virus and differ in their structure, the ways they are spread among individuals, the severity of symptoms they can cause, the way they are treated, and the outcome of the infection.

What is the scope of the problem?

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). It is estimated that 350 million individuals worldwide are infected with the virus, which causes 620,000 deaths worldwide each year. According to the Centers for Disease Control (CDC), approximately 46,000 new cases of hepatitis B occurred in the United States in 2006.

In the United States, rates of new infection were highest among people aged 25 to 44 years (3.1 cases per 100,000 population) and lowest among those younger than 15 years of age (0.02 per 100,000). This reflects the major modes of transmission of hepatitis B (sexual transmission, illicit drug use, exposure to infected blood) and the effect of universal vaccination of infants. In the United States, there has been a 75% decrease in newly diagnosed cases of hepatitis B during the past decade. This decrease is attributed to increased vaccination and to heightened public awareness of HIV/AIDS and the resulting safer sexual practices.

When a person first gets hepatitis B, they are said to have an 'acute' infection. Most people are able to eliminate the virus and are cured of the infection. Some are not able to clear the virus and have 'chronic' infection with hepatitis B that is usually life-long (see below). In the United States an estimated 800,000 to 1.4 million people are chronically infected with hepatitis B.

Hepatitis B is found throughout the world. Some countries have much higher rates of infection than the United States; for example, in Southeast Asia and Sub-Saharan Africa, as many as 15% to 20% of adults are chronically infected with hepatitis B.

What kind of a virus is hepatitis B?

The hepatitis B virus is a DNA virus, meaning that its genetic material is made up of deoxyribonucleic acids. It belongs to a family of viruses known as Hepadnaviridae. The virus is primarily found in the liver but is also present in the blood and certain body fluids.

Hepatitis B virus consists of a core particle (central portion) and a surrounding envelope (outer coat). The core is made up of DNA and the core antigen (HBcAg). The envelope contains the surface antigen (HBsAg). These antigens are present in the blood and are markers that are used in the diagnosis and evaluation of patients with suspected viral hepatitis.

How does hepatitis B virus cause liver injury?

The hepatitis B virus reproduces in liver cells, but the virus itself is not the direct cause of damage to the liver. Rather, the presence of the virus triggers an immune response from the body as the body tries to eliminate the virus and recover from the infection. This immune response causes inflammation and may seriously injure liver calls. Therefore, there is a balance between the protective and destructive effects of the immune response to the hepatitis B virus.

Hepatitis B - Describe Your Experience

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