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Overview

Hepatitis B is a viral infection that affects the liver and can cause acute and chronic diseases.  The virus is most frequently passed from mother to child during childbirth and delivery, through intercourse with an infected partner, by contact with blood or other bodily fluids during injections, or through exposure to sharp instruments.

In 2019, WHO estimates that 296 million people had chronic Hepatitis B infection, with 1.5 million new infections each year. Hepatitis B can be prevented by vaccines that are safe, effective, and readily available.

There is a safe and effective vaccine that offers 98% to 100% protection against Hepatitis B. 

Hepatitis B is most frequently transmitted horizontally (through exposure to infected blood) or from mother to child at birth in places with high endemicity, particularly during the first five years of life when infected children are most likely to infect uninfected children. Infants exposed to maternal infection or those under the age of five are more likely to acquire chronic infection.

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Hepatitis B can also be spread through needlestick injuries, tattooing, piercings, and exposure to infected blood and body fluids, such as saliva and menstrual, vaginal, and seminal fluids. The virus can also be transmitted through the reuse of contaminated needles and syringes or sharp objects in health care settings, in the community, or among people who inject drugs. Sexual transmission is more prevalent in unvaccinated people with multiple sexual partners.

Infection with hepatitis B acquired in adulthood leads to chronic hepatitis in less than 5% of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95% of cases. Vaccination of infants and children should be strengthened and prioritized based on this.

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Hepatitis B can survive outside the body for at least 7 days. During this time, it can still cause infection.

Symptoms of Hepatitis B Infection

When newly infected, most people do not experience any symptoms. Some people, however, experience acute illness with symptoms lasting several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting, and abdominal pain. The acute liver failure caused by hepatitis can be fatal. One of the long-term complications of HBV infection is the development of advanced liver diseases such as cirrhosis and hepatocellular carcinoma, which are associated with high morbidity and mortality.

Clinically, it is impossible to distinguish Hepatitis B from hepatitis caused by other viral agents, so laboratory confirmation of the diagnosis is essential. 

The regions with the highest HBsAg prevalence include the Amazon basin, Sub-Saharan Africa, and Asia. To detect the chronic HBV infection, a quick and reasonably priced test is commonly accessible. Before symptoms appear, the test enables doctors to confirm a diagnosis and provide a secure and efficient course of treatment. For everyone at high risk, Hepatitis B surface antigen screening is advised. (These broadly include individuals from regions with a high incidence of chronic infection, individuals at high risk of contracting HBV infection, those with elevated risk of transferring HBV, and individuals at risk for HBV reactivation.)

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Prevention

WHO recommends that all infants receive the Hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by two or three doses of Hepatitis B vaccine at least four weeks apart to complete the vaccination series. The protection lasts at least 20 years and is probably lifelong.  “Bringing hepatitis care closer to you”- WHO theme for world hepatitis day 2022