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Hepatitis B
Originally known as serum hepatitis, Hepatitis B has only been
recognized as such since World War II, and has caused current
epidemics in parts of Asia and Africa. Hepatitis B is recognized as
endemic in China and various other parts of Asia. Hepatitis B is
transmitted through exposure to bodily fluids containing the virus.
This includes unprotected sexual contact, blood transfusions, re-use
of contaminated needles and syringes, vertical transmission from
mother to child during childbirth, and so on.
Roughly 16-40% of unimmunized sexual partners of individuals with
hepatitis B will be infected through sexual contact.
The virus that causes hepatitis B is a member of the Hepadnavirus
family and it is composed of an icosahedral nucleocapsid (core)
enclosing a circular, double-stranded DNA genome. The virus is unique
amongst the DNA viruses in that it uses a reverse transcriptase to
generate the genomic DNA to deliver to its progeny. Additionally, the
DNA genome is incomplete on one strand.
Hepatitis D infection requires a concomitant infection with hepatitis
B. Co-infection with Hepatitis D increases the risk of liver cirrhosis
and subsequently, liver cancer.
Hepatitis B infection can lead to a chronic inflammation of the liver,
leading to cirrhosis. This type of infection dramatically increases
the incidence of liver cancer.
Treatment
Most people who become infected as adults or older children will stage
a full recovery and develop protective immunity to the virus. However,
a small group of people will not manage to clear the virus from their
bodies and will become chronic carriers of the virus.
There is currently no cure for Hepatitis B. Treatments are available
in the form of antivirals such as lamivudine and immune system
modulators such as alpha interferon. While these do not provide a
cure, they can help reduce the viral load in cases where there are
complications or other concomitant diseases.
Prevention
A recombinant vaccine is available to prevent hepatitis B.
Many countries now routinely vaccinate infants against hepatitis B. In
many areas, vaccination against hepatitis B is also required for all
healthcare workers. Booster doses are recommended every five to ten
years for healthcare workers.
Other at-risk groups of developing hepatitis B such as intravenous
drug users are also good targets for health prevention with a
Hepatitis B vaccination scheme.
Patients known to be infected with hepatitis B should be vaccinated
against hepatitis A. Patients known to be infected with
hepatitis C
should also be vaccinated against hepatitis B. There are two reasons
for this: first, hepatitis B and hepatitis C can be transmitted in the
same ways; second, a person who already has one form of hepatitis will
have a greater risk of severe liver damage if also infected with
another form.
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