Viral Hepatitis B

GENERAL INFORMATION:

What is hepatitis B? Hepatitis B is an inflammation (swelling) of the liver due to infection caused by a virus (germ). The hepatitis B virus (HBV) attacks and damages your liver. The liver is in the upper right side of the abdomen (stomach). It is located just below the right lung and behind the ribs. The liver does many things to help your body function well. It makes enzymes and bile that help digest food and removes harmful material from the blood. The liver fights infections and stops bleeding. It also stores and gives energy when you need it. Vitamins A, D, E, K, and B12, iron, and copper are also stored by the liver.

What causes hepatitis B? The hepatitis B virus is carried in the blood and other body fluids, such as saliva, semen (sperm), or vaginal fluids. Hepatitis B virus may be spread by any of the following:

• Direct: This happens when infected blood comes into contact with a cut or wound on your body. The virus can enter your bloodstream and cause infection.
  
  
  • Hepatitis B may be caused from a needle stick injury. Caregivers may get hepatitis B by getting pricked with a needle that has infected blood on it.
    
    
  • Sharing items that may have infected blood or saliva on them, such as eating utensils, toothbrushes, or razors.
    
    
  • Sharing infected needles to use illegal drugs.
    
    
  • Using unsterile (dirty or contaminated) needles or instruments for tattooing, body piercing, or other procedures.
    
    
  • A bite from an infected person can cause hepatitis B. It can also be spread if an infected person's blood gets into your skin wound, eyes, or mouth.
  
  
• Childbirth: Hepatitis B virus may be passed from a pregnant woman to her baby during childbirth.
  
  
• Sex: Some people may not know they have hepatitis B and and may pass the virus to their sex partner.

What are the signs and symptoms of hepatitis B? Hepatitis B does not usually cause symptoms in its early phase. The infection may have spread and damaged the liver by the time you have symptoms. You may have one or more of the following:

• Dark orange-colored urine or clay-colored stools.
  
  
• Fatigue (feeling more tired than usual).
  
  
• Fever.
  
  
• Jaundice (yellowing of the skin or the whites of the eyes).
  
  
• Joint pain, body aches, or weakness.
  
  
• Loss of appetite, nausea (upset stomach), or vomiting (throwing up).
  
  
• Pain in the right side of the abdomen (stomach).

What problems can hepatitis B cause? Hepatitis B may lead to the following serious health problems:

• Liver cirrhosis.
  
  
• Liver failure
  
  
• Liver cancer.
  
  
• Increased risk of having hepatitis D, which is a more serious type of viral hepatitis.
  
  
• Kidney disease.

How is hepatitis B diagnosed? You may have one or more of the following tests:

• Abdominal ultrasound: An abdominal ultrasound is a test that is done to see inside your abdomen. Sound waves are used to show pictures of your abdomen on a TV-like screen.
  
  
• Hepatitis B profile serological test: This blood tests checks for hepatitis B infection.
  
  
• Liver biopsy: A liver biopsy is when a small piece of your liver is removed and sent to a lab for tests. Caregivers will clean your skin, and you may be given medicine to numb (lose feeling) in the area. A needle is put through the wall of your abdomen or between your ribs. The needle is put into the liver and a small piece is taken out. A bandage will be placed over the area.
  
  
• Liver function tests: These blood tests check the enzymes (chemicals) and other substances made in the liver. Test results will tell caregivers how your liver is working.
  
  
• Alpha-fetoprotein test: This test measures the level of a substance called alpha-fetoprotein or AFP in the blood. People with liver cancer often show high blood levels of AFP.

How is hepatitis B treated? Treatment for hepatitis B depends upon the activity of the disease. Not everyone with hepatitis B needs treatment. The goal of treatment is to prevent the active disease to progress to more serious problems.

• Medicines:
  
  
  • Antivirals: These medicines work by stopping the virus from spreading. This may prevent or decrease more swelling and damage to the liver.
    
    
  
  
• Surgery: A liver transplant may be done if your liver stops working. Your diseased liver is removed and replaced with a healthy liver.

How can hepatitis B be prevented? The following people should get Hepatitis B vaccine (shots) to prevent getting the hepatitis B virus:

• Caregivers who may have contact with blood products or who are at increased risk of needle stick injuries. Prison guards and staff at day care or centers for persons with learning problems may also need the shots. There is an increased risk of scratching or biting from these groups.
  
  
• People who have many sexual partners or have unprotected sex.
  
  
• People who inject street drugs, including their sexual partners and children.
  
  
• People who come in close contact with someone infected with hepatitis B.
  
  
• People who regularly receive blood transfusions or those with kidney or liver diseases.
  
  
• Travelers to countries where hepatitis B is common.

How can I prevent passing hepatitis B to others if I am infected?

• Use bleach to clean infected blood that has spilled right away.
  
  
• Cover cuts or wounds you have with a clean dressing.
  
  
• Do not have close contact with other people. Do not kiss or have sex, including oral and anal sex, until your caregiver tells you it is okay. If you have sex, make sure the male partner is wearing a latex condom.
  
  
• Do not donate blood, body organs, semen, other tissues, or carry a donor card.
  
  
• Do not share needles or syringes if you use street drugs.
  
  
• Do not share food or eating utensils, toothbrushes, or razors with others until caregivers tell you it is safe. Wash your dishes and utensils in boiling water or a dishwasher. You may want to use disposable (throw away) dishes and utensils.
  
  
• People you live with and your sex partner should receive a shot for hepatitis B. If you use street drugs and share needles, those with whom you share should have a hepatitis B shot. After they are vaccinated, these people should be tested to make sure they are protected from hepatitis B. If you are pregnant with hepatitis B, your baby should be vaccinated within 12 hours of birth.

Where can I find support and more information? Hepatitis B is a life-changing disease for you and your family. Accepting that you have hepatitis B is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a hepatitis B support group. This is a group of people who also have hepatitis B. Contact the following for more information:

• American Liver Foundation
  75 Maiden Lane Suite 603
  New York, New York 10038
  Phone: 1-212-668-1000
  Phone: 1-800-465-4837
  Web Address: http://www.liverfoundation.org
  

• Hepatitis B Foundation
  700 East Butler Avenue
  Doylestown, PA 18901
  Phone: 1-215-489
  Web Address: www.hepb.org
  

• Hepatitis Foundation International
  504 Blick Drive
  Silver Spring, Maryland 20904-2901
  Phone: 1-301-622-4200
  Phone: 1-800-891-0707
  Web Address: http://www.hepfi.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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