Hepatitis B
Summary/Definition
The causative agent of this acute infectious disease, which belongs to the infectious diseases of the 3rd class in the Republic of Korea, is the hepatitis B virus.
Ways of spreading
Hepatitis B virus is transmitted through contact with infected blood, sexual contact with an infected person, as well as through infected tools, such as needles, razors, etc., which can cause injury when used. There is a particularly high probability of transmission of the virus from mother to child during childbirth, including both natural childbirth and cesarean section.
Poor risk group
High-risk groups for hepatitis B infection include family members infected with hepatitis B virus, patients who often require blood transfusions, patients undergoing hemodialysis, people who inject drugs, medical workers, prisoners and prison staff.
World statistics
It is estimated that in 2015, 257 million people worldwide were chronically infected with hepatitis B, and 887,000 people died from hepatitis B, with the majority of deaths associated with cirrhosis of the liver and hepatocellular carcinoma.
Symptoms
Incubation period
Clinical symptoms appear after the end of the incubation period, which ranges from 45 to 160 days, on average 120 days after infection.
Clinical symptoms
1) Acute hepatitis B
The acute manifestation of the disease includes symptoms such as jaundice, darkening of urine, loss of appetite, nausea, muscle pain, severe fatigue and pain in the right upper abdomen. However, an asymptomatic course of infection is also possible. Usually, the clinical symptoms and functional parameters of the liver are restored, and the virus disappears within 6 months. However, if the virus persists in the body for more than 6 months, and the hepatitis B surface antigen remains positive, chronic hepatitis is diagnosed.
2) Chronic hepatitis B
The chronic form of the disease can be either asymptomatic or accompanied by chronic debilitating symptoms, for example, fatigue, general weakness, persistent or periodic jaundice, loss of appetite, as well as end-stage liver failure.
Diagnostics
If hepatitis B surface antigen (HBsAg) and hepatitis B-specific antibodies (IgM anti-HBc) are detected in the blood sample, a new case of the disease is diagnosed.
Treatment and course of the disease
Acute hepatitis B
Among adults infected with acute hepatitis B, most recover independently without the need for special treatment. However, the recovery process can be accelerated by following a rest regime and eating protein-rich foods.
Chronic hepatitis B
Patients who have developed a chronic form of hepatitis B may be prescribed interferon injections and oral antiviral drugs to reduce the degree of liver damage and prevent the development of liver cirrhosis. Before starting treatment, you should consult with your doctor, evaluate the indications for treatment, determine the genotype of the virus, choose the appropriate drug, take into account possible side effects, the potential occurrence of resistance, as well as evaluate the cost and other important aspects of treatment.
Prevention and vaccination
Vaccination period and schedule
Newborns are vaccinated at the ages of 0, 1 and 6 months, while children and adults are recommended to have 3 vaccinations at intervals of 0, 1 and 6 months.
Dosage of the vaccine
For children under 10 years of age, a dose of 0.5 ml is used, and for children over 11 years of age – 1.0 ml.
Method of administration of the vaccine
Infants are injected intramuscularly into the anterior-lateral part of the thigh, and older children and adults are injected into the deltoid muscle.
Purpose of vaccination
Vaccination is recommended for all infants and adults who have no signs of immunity.
* Signs of immunity include: a diagnosis of hepatitis B, a positive reaction to antibodies or a previous vaccination against hepatitis B.
Groups at increased risk of hepatitis B infection include
Patients with chronic liver diseases.
Patients undergoing hemodialysis.
People infected with HIV.
Patients who regularly receive blood preparations.
Medical staff.
Prisoners in pre-trial detention facilities, including disabled persons and detainees, as well as staff serving them.
Persons with disabilities living in groups and staff providing their care.
Family members of hepatitis B virus carriers.
Injection addicts.
Groups with a high risk of contracting sexually transmitted diseases.
Complications
In rare cases, acute hepatitis B can progress to fulminant hepatitis, and its main complication is the transition to a chronic form of the disease. Chronic hepatitis B is accompanied by serious complications, including varicose bleeding, hepatic coma, blood clotting disorders, splenomegaly, cirrhosis of the liver with the development of ascites and hepatocellular carcinoma.
