Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). The hepatitis B virus was the first hepatitis virus to be identified. It is a disease that affects 300 million people in the world and is estimated to be responsible for between 250,000 and 500,000 deaths per year. The prevalence of infection with the hepatitis B virus varies greatly in different parts of the world. The highest rates of infection are found in Southeast Asia, China, and southern Africa.
Most people who acquire the hepatitis B virus recover without consequences. This form of infection, which lasts less than 6 months, is known as acute hepatitis B. On the contrary, when the infection lasts for more than 6 months, it is known as chronic hepatitis B. Approximately 5% of adults who acquire the infection develop the chronic form. The likelihood of developing chronic hepatitis B depends on the age and immune status (defenses) of the patient, being higher when acquired in childhood than when acquired as an adult.
The clinical manifestations of hepatitis B virus infection are very varied, and it is important to emphasize that frequently this infection may not give any symptoms for many years, which does not necessarily mean that the infection is controlled. The damage that the hepatitis B virus causes in the liver is also variable and depends on the ability of the liver to repair itself and the body’s ability to control the infection. The most important consequences of this infection in the long term are the development of liver cirrhosis and hepatocellular carcinoma.
In the last time a series of new alternatives for the treatment of the disease have been developed. On the other hand, there is a highly effective and safe vaccine to prevent infection.
Symptoms of Hepatitis B
Acute Hepatitis B:
Symptoms of acute hepatitis B occur 1 to 4 months after virus acquisition. Many people may not have any symptoms. Symptoms include: Fatigue, decreased appetite (anorexia), nausea, jaundice or yellowing of the skin, coluria, pain in the upper right area of the abdomen, pain or inflammation of the joints. These symptoms usually disappear within 3 months.
A very low proportion of people with acute hepatitis B (0.1 to 0.5%) develop a more severe form of the disease characterized by liver failure (fulminant hepatitis).
Chronic Hepatitis B:
Chronic hepatitis B is often asymptomatic or is manifested only by nonspecific symptoms such as fatigue or decreased appetite. Occasionally there are exacerbations of the inflammatory activity of the liver that can result in exacerbations of the symptoms. To the extent that the infection causes greater damage to the liver, symptoms of liver cirrhosis may manifest. 10 to 20% of patients may have extra-hepatic manifestations of the disease, most frequently vasculitis and glomerulonephritis.
Can Hepatitis B Go Away Completely?
Acute hepatitis B does not require specific treatment, since 95% of adults recover spontaneously. It is important to remember that contacts of the person with acute hepatitis B should be evaluated and eventually vaccinated. Acute hepatitis B is highly contagious, so measures should be taken to prevent its transmission.
People who develop chronic hepatitis B should be evaluated by a doctor experienced in the management of this disease (gastroenterologist or hepatologist). Treatment decisions are individualized. The aim of the treatment is to keep the replication of the virus under control to avoid the progressive damage of the liver.
Prognosis of Hepatitis B
The evolution of the disease is quite variable. There are probably genetic factors that are associated with the different ability to keep viral replication under control. The magnitude of the damage is also associated with age (often children have great viral replication with little liver damage), sex (usually the disease progresses faster in men than women), alcohol consumption and the presence of other viruses such as hepatitis C and D viruses.
It is important to know that you can spread the virus to others, even if you do not feel sick.
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