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Hepatitis B is a potentially deadly disease of the liver which affects millions of people worldwide. It is highly contagious and, in some cases, untreatable. But it can be prevented.

Hepatitis B is a viral infection of the liver caused by the hepatitis B virus. The disease is spread by blood and other bodily fluids, such as saliva, semen, and vaginal or menstrual fluids. Although it spreads the same way as HIV, the hepatitis B virus is 50 to 100 times more infectious.

The disease can take an acute or a chronic form, depending on the age of the person; while less than five percent of adults develop a chronic form, almost 90 percent of infants develop a chronic form of the disease if infected, and up to 50 percent of children infected younger than the age of six develop this form of the disease. The virus can survive outside the body up to a week.

Some geographical regions are more affected by the disease than the others. In the Western Pacific Region and in the African Region about six percent of adult population is infected, as opposed to the Americas where 0.7 percent of the adult population lives with the disease.

In the acute form of the disease, the virus is cleared out of the organism in two to six months. Often, the patient doesn't experience any symptoms, and rarely can the disease lead to acute liver failure. The chronic form, however, is a life-long disease which, if left untreated, can lead to liver failure, cirrhosis, hepatocellular carcinoma and death.

What are the symptoms of hepatitis B?

The liver is an organ with multiple functions. It processes the toxins from our blood and byproducts of the metabolism. It also stores vitamins, produces proteins, enzymes, clotting factors etc. If the liver is affected by the disease, it can lead to loss of those functions, resulting in symptoms that include:

  • Fever
  • Loss of appetite
  • Jaundice
  • Itchy skin
  • Dark urine
  • Pale or clay-like stool
  • Jaundice
  • Hives
  • Pain in the upper right part of the abdomen
  • Getting bruises easily
  • Bleeding from cuts longer than normal
  • Fatigue
  • Nausea
  • Vomiting

How is hepatitis B spread?

Hepatitis B is spread by contact with infected blood or other bodily fluids.
  • Having unprotected sex with an infected person is one of the ways of getting infected.
  • Using IV drugs, or drugs in general, also increases the risk of an infection. While sharing needles and syringes is an obvious example of a risky thing to do, even using drugs which are inhaled through the nose pose a risk. Since the virus can survive for seven days outside the organism, it can be found on bank notes used to inhale the drug or the surface used to prepare it. Once the virus makes contact with the mucosa in the nose, it can cause an infection.
  • Getting a piercing or a tattoo also used to be a way of getting the disease, but improved conditions, hygiene and sterilization of the instruments have lowered the incidence of getting the disease this way. Still, this way of getting infected should not be neglected.
  • Sharing toothbrushes, razors and other equipment which can contain particles of infected bodily fluids can also get you infected. 
  • One of the ways the infection is spread, especially in the regions with higher incidence of the disease, is from an infected mother to her child during childbirth. 

How can hepatitis B be diagnosed?

There are several different ways to diagnose hepatitis B. When a foreign object enters our organism, be it a molecule (e.g. snake venom), a virus, bacteria or a parasite, our immune system usually has a way to fight it, and will at least try. Specialized white blood cells recognize specific proteins on the cell membrane of the intruder and order different, also specialized white blood cells, to produce molecules which fit them like jigsaw pieces.

The molecules on the surface of the intruder are called antigens, and the molecules produced by our organism are called antibodies. The antibodies are used by our immune system to either fight the intruder alone, or to trigger a cascade of reactions which causes other, again, specialized white blood cells to come to the location of the intrusion and kill them. Keep in mind that this is an oversimplified explanation of one of the ways our immune system works.

There are ways in which we can determine the levels of both antigens and antibodies in the blood and other samples taken from the patient, and, by thus, determine if a person is, or was, infected by hepatitis B. 

Usually, the doctor will draw your blood and search for either antigens or antibodies. The interpretation of these results is complicated, since the presence of the virus, and the presence and levels of different types of antibodies, vary depending on the time which passed between the infection and the tests. It is also possible to prove the presence of the virus in the material using the PCR method. 

How is hepatitis B treated?

In the case of an acute infection, there is no specific treatment. The virus is cleared out of the organism in a few months. However, in the case of chronic hepatitis, there are drugs to help fight this disease. These antiviral drugs will not cure the patient, but will delay, or even eliminate the emergence of cirrhosis or liver cancer. Chronic hepatitis patients have a decent chance of living a normal healthy life.

How can hepatitis B be prevented?

With a vaccine. It is highly recommended that all infants get the shot within the first 24 hours after birth (one of the reasons is that a significant number of mothers aren't aware of their disease). There are different vaccination schedules, but all of them have a success rate of over 95 percent. If you are not vaccinated, it is possible to get immunized as an adult as well. 

Other ways of lowering the chance to get infected include practicing safe sex, avoiding sharing razors, toothbrushes and other objects which might carry the virus, using your own personal equipment if you're using drugs, and covering open wounds as soon as possible.

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