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Show full transcript for Hepatitis B Details video

In this lesson, we'll be covering everything to do with Hepatitis B including what it is, the various classifications, who is most at risk, how common it is in the U.S., how it's transmitted, the signs and symptoms, how it is diagnosed, and treatment and prevention options.

What is Hepatitis B?

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). It can cause both acute and chronic infections, it's very contagious, and it can be easily spread from one person to another.

Hepatitis B Classifications

There are two classifications of Hepatitis B: acute and chronic.

  1. Acute Hepatitis B virus infection is a short-term illness that occurs within the first six months after exposure to the virus.
  2. Chronic Hepatitis B virus infection is a long-term illness that occurs when the Hepatitis B virus remains in the body.

Who is Most at Risk for Hepatitis B?

People most at risk of getting Hepatitis B include:

  • People who have sex with an infected person
  • People with multiple sex partners
  • People who have a sexually transmitted disease
  • Men who have sex with other men
  • People who share injectable drugs, needles, syringes, and other drug equipment
  • People who live with an infected person
  • Infants born to infected mothers
  • People who are exposed to blood at work
  • Hemodialysis patients
  • People who travel to countries with moderate to high rates of infection

How Common is Hepatitis B in the U.S.?

Acute Hepatitis B

Since routine vaccinations have been available, rates of acute infections have declined by approximately 82 percent since 1991 and have dramatically declined particularly among children.

In 2015, there were an estimated 19,200 new cases of Hepatitis B virus infections, though the actual number is likely much higher since many people don't know they're infected, don't have symptoms, and have never been tested.

Chronic Hepatitis B

It is estimated that between 850,000 and 2.2 million people in the U.S. have a chronic infection. And globally, approximately 240 million people are infected, contributing to around 786,000 deaths each year.

How is Hepatitis B Transmitted?

Hepatitis B is spread when blood, semen, and other body fluids infected with the virus enters the body of a person not infected.

People can become infected during activities like:

  • Birth, as it can be spread from mother to child
  • Sex with an infected partner
  • Sharing needles, syringes, and other drug-injection equipment
  • Sharing items like razors and toothbrushes with infected people
  • Direct contact with blood or open sores of an infected person
  • Exposure to blood from needlesticks and other sharp instruments

The incubation period is between 45 and 160 days with 120 days being average.

Signs and Symptoms of Hepatitis B

Acute Hepatitis B

Signs and symptoms of acute infection include:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay colored bowel movements
  • Jaundice (yellow skin or eyes)

Pro Tip #1: Symptoms usually last a few weeks; however, some people can be ill for as long as six months.

Chronic Hepatitis B

Some people have ongoing symptoms similar to acute Hepatitis B but most individuals with a chronic infection remain symptom free for as long as 20 or 30 years.

Around 15 to 25 percent of people with a chronic infection develop serious liver conditions like cirrhosis (scarring) or liver cancer.

Pro Tip #2: Even as the liver becomes diseased, some people still won't have symptoms. However, certain blood tests for liver function may show abnormalities.

How is Hepatitis B Diagnosed?

The number one way to diagnose Hepatitis B is with a blood test. And there are a number of those available.

Hepatitis B Surface Antigen (HBsAg) Test

This test looks for Hepatitis B Surface Antigens, a protein on the surface of the Hepatitis B virus. It can be detected in the blood during an acute or chronic infection. The body normally produces antibodies to HBsAg as part of the immune response to the infection.

A positive test means that a person has acute or chronic Hepatitis B and it can be spread to others. A negative test means there is no sign of the virus in the blood.

Hepatitis B Surface Antibody (anti-HBs) Test

This is an antibody that is produced by the body in response to the Hepatitis B Surface Antigen.

A positive test means that the person is protected or immune from getting the virus for one or two reasons:

1. The person was successfully vaccinated.
2. The person had an infection and recovered from it, meaning they can't get it again.

Total Hepatitis B Core Antibody (anti-HBc) Test

This is an antibody that is produced by the body in response to a part of the Hepatitis virus called a core antigen. The meaning of this test often depends on the results of two other tests – anti-HBs and HBsAg.

A positive test means the person is currently infected with the virus or was infected in the past.

IgM Antibody Core Antigen (IgM anti-HBc) Test

This test is used to detect an acute infection.

A positive test means the person was infected with the virus within the last six months.

Hepatitis B “e” Antigen (HBeAg) Test

This is a protein found in the blood when the virus is present during an active infection.

A positive test means the person has high levels of the virus in their blood and can easily spread it to others. The test is also used to monitor the effectiveness of treatment for chronic Hepatitis B.

Hepatitis B e Antibody (HBeAb or anti-HBe) Test

This is an antibody produced by the body in response to the Hepatitis B “e” antigen.

A positive test means the person has a chronic infection but is also at a lower risk of liver problems, as they have low levels of the virus in their blood.

Hepatitis Viral DNA Test

This test is used to detect the presence of the virus DNA in the person's blood.

A positive test means the virus is multiplying in the body, which means the person is highly contagious and can spread the virus to others more easily.

If a person has a chronic infection, the presence of viral DNA means they are possibly at an increased risk for liver damage. The test is also used to monitor the effectiveness of drug therapy for chronic Hepatitis B virus infection.

Hepatitis B Treatment Options

Acute Hepatitis B

Sadly, no medications are available to treat an acute infection. The best treatment options are focused on support. Therefore, during an acute infection, doctors recommend:

  • Rest
  • Adequate nutrition
  • Fluids
  • Possibly hospitalization

Chronic Hepatitis B

Treatment options for a chronic infection include:

  • Regular monitoring for signs of liver disease progression
  • Oral medications (oral antiviral agents) like Tenofovir and Entecavir – the most potent drugs on the market to suppress the virus and rarely leading to drug resistance.

Hepatitis B Prevention

The first line of defense is vaccination. The hepatitis vaccine includes a sequence of shots that stimulate a person's natural immune system to protect against HBV. After it's given, the body makes antibodies that protect against the virus.

The vaccine is recommended for:

  • All infants starting with a first dose at birth
  • All adolescents and children under the age of 19 who have not been vaccinated
  • People who are sex partners with those infected with the virus
  • People who have multiple sex partners
  • People who have a sexually transmitted disease
  • Men who have sex with other men
  • People who share needles, syringes, and other drug-injecting equipment
  • People with close household contact with an infected person
  • Healthcare and public safety workers who are at risk of exposure to blood or contaminated body fluids
  • People with end-stage renal disease including predialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
  • Residents and staff of facilities for developmentally disabled people
  • Travelers to regions where there is moderate to high rates of infection
  • People with chronic liver disease
  • People with HIV infection
  • Anyone who wants to be protected from the virus

Vaccinations are also recommended for anyone who works at:

  • Sexually transmitted disease treatment facilities
  • HIV testing and treatment facilities
  • Facilities providing drug abuse treatment and prevention services
  • Healthcare settings that target services to injection drug users
  • Healthcare settings targeting services to men who have sex with other men
  • Chronic hemodialysis facilities and end-stage renal disease programs
  • Correctional facilities
  • Institutions and nonresidential day care facilities for developmentally disabled people