Hepatitis B (cont.)
What are the effects of alcohol on hepatitis B virus?
Agents that damage the liver are particularly harmful in patients who already
have hepatitis B. For this reason, it is recommended that persons with hepatitis
B avoid drinking alcohol.
What are the effects of immunosuppressive medications on hepatitis B virus?
Even in people with chronic hepatitis B, the immune system is working to
suppress the virus. Medications that suppress the immune system allow the virus
to reproduce in large numbers and may cause the hepatitis to flare.
Examples of
medications that suppress the immune system are:
- prednisone: used to treat many diseases, including
asthma, inflammatory bowel disease, and certain types of skin disease and
arthritis
- methotrexate
(Rheumatrex, Trexall): used to treat certain types of skin disease, arthritis, and
cancer;
- cyclophosphamide
(Cytoxan): used to treat some cancers.
If an immunosuppressant drug is stopped, the body's immune system's activity
may rebound and cause severe inflammation of the liver.
What is delta hepatitis?
Delta hepatitis is caused by a virus that only infects people who already
have hepatitis B. The delta hepatitis virus (also known as hepatitis D or HDV)
is an RNA virus, meaning that its genetic material is made up of ribonucleic
acid. It is spread through exposure to contaminated blood, especially with
illicit, intravenous drug use, and by sexual contact. Delta hepatitis can be
acquired at the same time as acute hepatitis B. When this happens, infected
people are quite sick but more than 95% are eventually able to eliminate the
viruses from their bodies. People who already have chronic hepatitis B can
acquire delta hepatitis as well. This often causes severe inflammation of the
liver, and the viruses are less likely to be cleared.
Delta hepatitis makes chronic hepatitis B much worse. It increases the risk
of complications, especially cirrhosis, which occurs in up to two-thirds of
patients.
There is no vaccine against delta hepatitis. Interferon treatment may cause
improvement in the hepatitis, but relapse is common after therapy is stopped.
Prevention includes avoiding contaminated needles and practicing
safer sex
(abstaining or limiting the number of partners, using barrier methods of
contraception). Universal vaccination of newborns with hepatitis B vaccine
effectively prevents delta hepatitis because the delta hepatitis virus only
causes disease in the presence of hepatitis B virus.
Next: What about co-infection with hepatitis B virus and
hepatitis C virus? »
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