The hepatitis B virus is one of the causes of hepatitis, which is an inflammation of the liver cells. There are 8 different genotypes of the hepatitis B virus (hepatitis B type a toy h). The liver is a vital organ with remarkable regenerative abilities. It filters the nutrients that are absorbed by the intestine and transforms them. It transforms and eliminates drugs and drugs, alcohol and other toxins. It produces the bile that is necessary for the digestion of fat. It produces cholesterol and proteins including those that are involved in blood clotting. In case of hepatitis, bilirubin can accumulate in the blood and cause jaundice.
Possible evolution of hepatitis B
There is acute hepatitis, lasting less than 6 months, of chronic hepatitis that lasts longer. It is an infection that can be very serious, leading to cirrhosis of the liver, cancer, and liver failure with multiple neurological, hematologic and renal complications.
Hepatitis B is fatal in about 1% of cases, and this occurs mostly in people 60 years of age and older.
Chronic infection is inversely proportional to age. More than 90% of infected newborns will progress to chronicity compared to less than 5% in adolescents and adults.
Hepatitis B and hepatitis C are the two most common causes of chronic hepatitis.
Symptoms of hepatitis B
There may be no symptoms, especially in children under 5 and in immunosuppressed persons. When there are symptoms, they occur from 6 weeks to 6 months after the virus has infected the liver. We notice:
- Decreased appetite
- Nausea and vomiting
- Abdominal pain
- Very dark urine
- Pale stools
- Joint pain
Fatigue and loss of appetite usually occurs two weeks before jaundice, which is not always present.
Risk Factors for Hepatitis B
Hepatitis B is a disease caused by a virus, so it must have been exposed to develop the disease. Let’s discuss modes of transmission of the virus.
The virus is found in greater concentration in the blood of an infected person, but is also found in semen and saliva. It can remain viable in the environment for 7 days, on objects with no visible trace of blood. People with chronic hepatitis are the main source of new infections.
The main sources are:
- Unprotected sex;
- Sharing of needles and syringes by drug users;
- Accidental bites by caregivers with a needle contaminated with the blood of a patient with hepatitis B;
- Mother-to-child transmission during childbirth;
- Cohabitation with an infected person
- Sharing of toothbrushes and razors;
- Oozing lesions of the skin;
- Contaminated surfaces;
- Blood transfusions are now a very rare cause of hepatitis B. The risk is estimated at about 1 in 63,000;
- Treatment in hemodialysis;
- All surgical procedures with non-sterile equipment;
- In certain cases of medical, surgical or dental intervention in developing countries where the conditions of hygiene and sterilization are less favorable;
- Shaving at a barber.
Prevention of hepatitis B
It is important to have safe sex.
Drug addicts should never share needles. Cactus Montreal , the first to offer a needle exchange in North America to intravenous drug users, also offers condoms. This type of intervention reduces the transmission of HIV, hepatitis and other types of infections.
Adoption of the principle of universal precautions by all stakeholders in health care settings.
The vaccine for the prevention of hepatitis B is made by yeast, Saccharomyces cerevisiae that produces the hepatitis B surface antigen it is not a question of the whole virus.
Since 2013, the hepatitis B (and hepatitis A) vaccine has been included in the Routine Infant Immunization Schedule. It is also administered in 4th year of primary school. Vaccines are not mandatory in Canada.
In France, we opted for compulsory vaccination of newborns. This has raised a lot of controversy (see below). Vaccination of newborns is no longer mandatory in France, but recommended.
Some thought there was a link between the hepatitis B vaccine and demyelinating diseases such as multiple sclerosis. Research has shown an identical proportion of vaccination in patients with and without the disease.
Medical treatments for hepatitis B
More than 95% of people will recover spontaneously without any special medical or alternative treatment. Only a small number will have severe hepatitis that will require treatment, especially if there is co-infection with hepatitis C or D.
For acute hepatitis
there is no special treatment for acute hepatitis. Medicine merely recommends simple support measures:
– take rest if necessary;
– have a balanced diet and low in fat;
– to drink a lot of water;
– do not consume alcohol.
In very rare cases, hospitalization is necessary. Of these, there are sometimes cases of hepatitis failure that require liver transplantation.
For chronic hepatitis
on a case-by-case basis, physicians may recommend antiviral drugs, based on certain biological parameters, to patients with chronic infection. Antivirals cannot eliminate the virus, but keep it under control. Antivirals also reduce the risk of liver cancer caused by the virus. The treatment could include interferon or oral antivirals, for a few months up to a year.
Note: The American Liver Foundation advises informing the doctor about over-the-counter medications or natural products that are being used. Some can seriously affect the liver. Several cases of fatal fulminant hepatitis or requiring transplantation have been reported.