Sexually Transmitted Diseases (STDs In Women) (cont.)
Hepatitis B
What is hepatitis B?
Hepatitis B virus (HBV) is a virus that causes inflammation of the
liver. Most people do
not think of hepatitis as a sexually transmitted infection; however, one of the more common modes of the
spread of viral hepatitis B is through intimate sexual contact. Sexual
transmission is believed to be responsible for 30% of the cases worldwide.
(Improved screening of donated blood has diminished the risk of getting
hepatitis B from blood transfusion.)
Complications from hepatitis B are responsible for 1 to 2 million deaths yearly.
Hepatitis B virus can cause both an initial (acute)
and a chronic form of liver
inflammation. The initial phase of infection lasts a few weeks, and in most
people, the infection clears. People who recover from the initial infection
develop immunity to the HBV, which protects them from future infection with this
virus. Still, a small percent of individuals infected with HBV will develop
chronic or long-lasting liver
disease. These persons are potentially infectious to others. It is the
chronic form of hepatitis B that is dangerous to women. Chronic hepatitis B is
associated with cirrhosis of the
liver
, liver failure, and
liver cancer.
Transmission of hepatitis B can occur during the early phase of infection or
during the chronic carrier stage. Kissing and unprotected intercourse are
methods of spreading this virus. While hepatitis does not affect the
reproductive organs, a pregnant woman can transmit it to the fetus if she is
infected during the pregnancy. The hepatitis B virus is transmitted to 80% of the fetuses
in women that are infected during pregnancy. This is potentially dangerous,
since infected infants have an 80% chance of developing the chronic form of the
infection.
Symptoms of hepatitis B
Only 50% of acute infections with the hepatitis B virus produce symptoms. The
symptoms of hepatitis include yellow coloration of the skin or eyes (jaundice),
fever, upper abdominal pain, generalized
malaise, and nausea. In later
stages, hepatitis B can cause edema (swelling of the legs) and ascites (fluid
accumulation in the abdomen).
How can hepatitis B infection be prevented?
A highly effective vaccine that prevents hepatitis B is
currently available. It is recommended that all babies be vaccinated against HBV
beginning at birth, and all children under the age of 18 who have not been
vaccinated should also receive the vaccination. Among adults, anyone who wishes
to do so may receive the vaccine, and it is recommended especially for anyone
whose behavior or lifestyle may pose a risk of HBV infection.
Examples of at-risk groups include:
- sexually active men and women;
- illegal drug users;
- health-care workers;
- recipients of certain blood products;
- household and sexual contacts of persons known to be
chronically infected with hepatitis B;
- adoptees from countries in which hepatitis B is
common, such as Southeast Asia;
- certain international travelers who may have sexual
or blood exposures;
- clients and employees of facilities for the
developmentally disabled, infants and children; and
- patients with renal
failure on
hemodialysis.
The vaccine is given as a series of three injections in the muscle tissue of the
shoulder. The second dose is administered one month after the first dose and the
third dose is given five months after the second dose. In the event that a
non-immunized individual (who would not have protective antibodies against HBV)
is exposed to the genital secretions or blood of an infected person, the exposed
person should receive purified hepatitis B immunoglobulin antibodies (HBIG) and initiate the
vaccine series.
Diagnosis and treatment of hepatitis B
Liver tests in the blood become abnormal 1-10 days after infection with the
virus. Hepatitis B then can be diagnosed by detecting antibodies against the
virus and by blood tests that identify the virus in the blood.
Diagnosis of HBV infection involves blood tests to
detect the hepatitis B surface antigen (HBsAg, the
outer coat of the virus), hepatitis B surface antibody (HBsAb), and hepatitis B
core antibody (HBcAb). If the HBsAb antibodies are in the blood, their presence
indicates that the person has been exposed to the virus and is immune to future
infection. Furthermore, this person cannot transmit the virus to others or
develop liver disease from the infection. The HBcAb antibodies identify both
past and current infection with the HBV. If the HbsAg antigen is in the blood,
the person is infectious to others. There are also two possible interpretations
to the presence of this antigen. In one, the person has been recently infected
with HBV, may have acute viral hepatitis B, and will develop immunity in the
coming months. In the other interpretation, the person is chronically infected
with HBV, may have chronic hepatitis, and is at risk for developing the
complications of chronic liver disease.
Next: Hepatitis C »
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