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Hepatitis B - The Disease
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Complications

Questions
Answers
  1. What does it mean to be chronically infected with hepatitis B virus?

    People who do not recover from hepatitis B infection are chronically infected, and there are over 1 million chronically infected people in the United States today. A chronically infected person is someone who has had hepatitis B virus in her or his blood for more than 6 months.

    About 5% of adults who acquire hepatitis B infection become chronically infected, but children younger than 5 years of age have a greater risk. The younger the child is at the time of infection, the greater the risk that the child will have a lifelong infection. Many babies born to chronically infected mothers will also become chronically infected with hepatitis B virus, unless the babies are given two shots in the hospital and at least two more during the 6 months after birth to protect them from the infection.

    A chronically infected person usually has no signs or symptoms of hepatitis B infection, but remains infected for years or for a lifetime and can pass hepatitis B virus to others. Sometimes, chronically infected people will clear the infection from their bodies on their own, but most will not. Although most chronically infected people have no serious problems with hepatitis B and lead normal, healthy lives, some develop liver problems later. Chronically infected people are at much higher risk than the general population for liver failure or liver cancer.



  2. How can I take care of myself, if I am chronically infected with hepatitis B?

    A person with hepatitis B infection should see a physician knowledgeable about the management of liver disease every 6 to 12 months. The physician will do blood tests to check the health of the liver, as well as test for liver cancer. It is best for chronically infected people to avoid alcohol, because alcohol can injure the liver. Additionally, your physician should know about all the medicines you are taking, even over-the-counter drugs, because some medicines can hurt the liver. If there are any liver test abnormalities, consult a liver specialist regarding your need for further testing and treatment.



  3. If your liver disease has progressed...

    If your physician tells you your liver disease has progressed, here are some extra precautions you should take:

    • Get a yearly influenza immunization. Patients with severe liver disease (cirrhosis) should also receive pneumococcal vaccine.
    • Get immunized against hepatitis A. Hepatitis A can further damage your liver, if you get infected with that virus.
    • Don't eat raw oysters. They may carry bacteria called Vibrio vulnificus, which can cause serious blood infections in people with liver disease. About 40% of people with this blood infection die.


  4. What can I do to protect others from hepatitis B infection?
    People with hepatitis B infection might feel healthy, but can still be capable of passing the infection on to other people. To protect others from getting hepatitis B infection, it is important to protect them from contact with your infected blood and other infectious body fluids, including semen and vaginal secretions. Sweat, tears, urine, and respiratory secretions do not contain hepatitis B virus. Hepatitis B virus transmission via saliva has only been documented through biting.

  5. Important DOs and DON'Ts for people with chronic hepatitis B infection:

    DO:

    • Cover all cuts and open sores with a bandage.
    • Discard used items such as bandaids and menstrual pads carefully, so no one is accidentally exposed to your blood.
    • Wash your hands well after touching your blood or infectious body fluids.
    • Clean up blood spills. Then reclean the area with a bleach solution (one part household chlorine bleach to 10 parts water).
    • Tell your sex partner(s) you have hepatitis B, so they can be tested and immunized (if not already infected). Partners should be tested after getting three doses, to be sure the vaccine worked.
    • Use condoms (rubbers) during sex, unless your sex partner has had hepatitis B or has been immunized and has had a blood test showing immunity. (Condoms may also protect you from other sexually transmitted diseases.)
    • Tell household members to see their doctors for testing and immunization for hepatitis B.
    • Tell your doctors that you are chronically infected with hepatitis B.
    • See your doctor every 6 to 12 months to check your liver for abnormalities, including cancer.
    • If you are pregnant, tell your doctor that you have hepatitis B infection. It is critical that your baby is started on the hepatitis B shots within a few hours of birth.

    DON'T:

    • Share chewing gum, toothbrushes, razors, washcloths, needles for ear or body piercing, or anything that may have come in contact with your blood or infectious body fluids
    • Pre-chew food for babies
    • Share syringes and needles
    • Donate blood, plasma, body organs, tissue, or sperm


    • What are the long-term effects of hepatitis B infection?

      Each year, about 5,000 people in the U.S. die of hepatitis B-related liver failure. And another 1,500 people die from hepatitis B-related liver cancer.

      Hepatitis B infection is the most common cause of liver cancer worldwide and ranks second only to cigarettes as the world's leading cause of cancer.



    • Is there a cure for hepatitis B?
      At this time, there are three FDA-approved medications (interferon alpha, lamivudine, and adefovir) that can help a person who is already infected with hepatitis B. Their use is reserved for people who have certain blood test abnormalities. Be sure to ask your doctor if you are a candidate for treatment or if you might benefit from enrolling in a clinical trial. Researchers continue to seek additional cures for hepatitis B.

    • Why is hepatitis B so serious in pregnant women?
      Pregnant women who are infected with hepatitis B can transmit the disease to their babies. Many of these babies develop lifelong hepatitis B infections, and up to 25% will develop liver failure or liver cancer later in life. All pregnant women should be tested early in pregnancy to see if they are infected with hepatitis B. If the blood test is positive, the baby should be immunized at birth with two shots, one of hepatitis B immune globulin (HBIG) and one of hepatitis B vaccine. The infant will need at least two more doses of hepatitis B vaccine by 6 months of age.

    • What should I do if I'm in a risk group?
      If you are in a risk group for hepatitis B, get immunized! All people in risk groups should protect themselves from hepatitis B infection. Every day you delay getting immunized increases your chances of getting this highly contagious liver disease. The problems caused by hepatitis B—liver cancer and liver failure—are too great. See your doctor or visit your health department.

    • What does the term "hepatitis B carrier" mean?
      "Hepatitis B carrier" is a term used for people who have chronic (long term) infection with hepatitis B virus. If infected, 2% to 6% of people over 5 years of age; 30% of children 1 to 5 years of age: and up to 90% of infants develop chronic infection. People with chronic infection can infect others and are at increased risk of serious liver disease, including cirrhosis and liver cancer. In the United States, about 1.25 million people are chronically infected with hepatitis B. There are three drugs licensed for the treatment of people with chronic hepatitis B: adefovir dipivoxil, interferon alpha, and lamivudine.