Hepatitis B Infection
Hepatitis B is caused by a DNA virus. The virus is spread through blood and blood products and the common ways of acquiring infection are intravenous drug use, needle stick exposure, tattoos, sexual promiscuity (multiple partners, gay population), sharing razors and toothbrushes etc. In Asia, where the virus is very common vertical transmission from mother to fetus during childbirth is common. Such infection causes high viral load as the child’s immune system is not developed to mount a response to clear the virus. Due to excellent blood screening techniques, blood transfusion is not a method of transmission.
What happens when one is infected with Hepatitis B virus?
When one is infected with the virus, it settles in the liver. This can lead to Hepatitis (inflammation of the liver) . Most patients have no symptoms at all; only a few develop jaundice (yellow skin, eyes), abdominal pain or fever. About 85% of patients with Acute Hepatitis B Infection recover fully with complete clearance of the virus in the body but 15% do not clear the virus and develop chronic liver disease (Chronic Hepatitis B). Chronic Hepatitis B is a slowly evolving disease (10-15 years) that can lead to cirrhosis of the liver (scar tissue with nodules) and some develop Liver Cancer (Hepatoma) even without developing cirrhosis.
How is Hepatitis B detected?
Patients with Chronic Hepatitis B infection often have elevated liver function tests and blood tests can detect the virus.
How is Hepatitis B treated?
Treatment of Chronic Hepatitis B has been difficult and frustrating. Numerous antiviral drugs have been used including Lamuvidine (Epivir), Hepsera, Baraclude (Entacavir), Tenofovir etc. PEGYLATED Interferon can also be used in some selected patients. Patients who develop cirrhosis of the liver are considered for transplantation.
What are the side effects of the drugs used to treat Hepatitis B?
Drugs used to treat Hepatitis B can cause side effects most of which are benign.
- Interferon: Can cause fever and body aches like the flu for a few days after injection but these improve with time. Other side effects include drop in white cell count, platelet count, hair loss etc.
- Antiviral Drugs: These drugs are well tolerated with minimal side effects.