Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic liver disease.

Mode of Transmission (How it spreads)

Hepatitis B is most usually transmitted vertically; from mother to child at birth (perinatal transmission) or horizontally through (exposure to infected blood), particularly from an infected child to an uninfected kid during the first 5 years of life, or in highly endemic areas.

Horizontal transmission is not only found in children within the age of five years but also other age groups.

Hepatitis B can also be transmitted by needlestick injuries, piercing, and contact with contaminated blood and bodily fluids such as saliva and menstrual, vaginal, and seminal secretions.

Hepatitis B can be transmitted sexually, especially in unvaccinated men who have sex with males (gay) and heterosexual people who have several sex partners or have sexual contact with sex workers.

Infection can also arise during medical, surgical, and dental operations, tattooing, or the use of razors, or any sharp objects and other devices contaminated with infected blood or body fluids.

Viral survival ability  of the virus

The hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine.

The incubation period of the hepatitis B virus is 75 days on average, but can vary from 30 to 180 days (that is one to six months). The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B.

Who is at risk of HB?

• Children of infected mothers

• Unvaccinated People in endemic areas

• Healthcare workers and others who may be exposed to blood and blood products through their work

• People who frequently require blood or blood products, dialysis patients and recipients of solid organ transplantations

• People in prisons

• People who inject drugs

• Household and sexual contacts of people with chronic HBV infection

• People with multiple sexual partners

• Travellers who have not completed their HBV doses, who should be offered the vaccine before leaving for endemic areas.

• People who take alcohol

• Drug addicts and drug abusers (at the risk of liver damage)

• Risk of chronic liver disease is higher in children when compared to adult.

Symptoms of Hepatitis B
Most people do not experience any symptoms when newly infected.

However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

A small subset of persons with acute hepatitis can develop acute liver failure, which can lead to death.

Hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer.

Diagnosis of HB
It is not possible, on clinical grounds, to differentiate hepatitis B from hepatitis caused by other viral agents, hence, laboratory confirmation of the diagnosis is essential.

A number of blood tests are available to diagnose and monitor people with hepatitis B. They can be used to distinguish acute and chronic infections.

Treatment of Hepatitis B

Acute hepatitis B has no specific treatment. As a result, treatment is focused on ensuring comfort and proper nutritional balance, as well as replacing fluids lost due to vomiting and diarrhoea.

The most important thing is to avoid taking medications that aren’t absolutely necessary, as they will need the liver (that is already under attack) to be ‘’digested’’.

Chronic hepatitis B infection can be managed with medications, including antiviral drugs taken orally.

Cirrhosis treatment can decrease the progression of the disease, lower the incidence of liver cancer, and enhance long-term survival.

However, the medication does not cure hepatitis B infection, but only prevents the virus from replicating. As a result, most people who begin hepatitis B therapy must continue it for the rest of their lives.

In many resource-constrained areas, access to hepatitis B diagnosis and treatment remains limited.

In 2016, 10.5 percent (27 million) of the more than 250 million persons living with HBV infection were aware of their infection.

Global treatment coverage is 16.7 percent of those diagnosed (4.5 million). Many people are only diagnosed once they have advanced liver disease.

Prevention (How not to get infected)
1. Take the vaccine

2. Vaccination of new-born

3. Vaccination of individuals who missed or did not complete the doses before

4. Vaccination of travellers going to where the disease is common

5. Avoid sharing sharp objects with others e.g; clipper, nail cutter, razor blade, needles etc.

6. Avoid multiple sexual partners

7. Know your Hepatitis B status
8. Share this publication with others.

Hepatitis B vaccination is the cornerstone of hepatitis B prevention.

The World Health Organization advises that all infants receive the hepatitis B vaccine as soon as possible after delivery, preferably within 24 hours, followed by two or three doses of hepatitis B vaccination at least four weeks apart to complete the series.

A timely birth dose is an efficient method of preventing transmission from mother to a child

According to the most recent WHO estimates, the proportion of children under the age of five who are chronically infected with HBV has reduced to just under 1% in 2019, down from over 5% in the pre-vaccine era, which lasted from the 1980s to the early 2000s.

The global rollout of the hepatitis B vaccination over the last two decades has been a huge public health success story, contributing to a drop in HBV infections in youngsters.

In 2019, global coverage of three doses of the vaccine reached 85 percent, up from roughly 30 percent in 2000.

The coverage of the hepatitis B vaccine birth dosage, on the other hand, remains unequal. For example, global coverage of the HBV birth dosage is 43 percent, whereas coverage in the WHO African Region is barely 6 percent.

More than 95 percent of new-borns, children, and young people have protective antibody levels after receiving the entire vaccine series. Protection lasts at least 20 years and is likely to last a lifetime.

As a result, WHO does not recommend booster immunizations for anyone who have finished the three-dose immunization program.

If they live in a country with low or intermediate endemicity, all children and adolescents under the age of 18 who have not previously been immunized should receive the vaccine.

According to the above figures, there were so much commendable efforts by the WHO in the combat against the deadly virus in the last recent decades.

however the big BUT is that a large number of the world population are unaware of their status, therefore the easier the spread among the population.

Reference:
WHO

Written by M.O Adeleke  A Veterinary Medicine Student from Unilorin