Hepatitis B

What is Hepatitis B?

Hepatitis B infection is a condition where a person was infected by Hepatitis B virus (HBV), this virus commonly affects the liver. In some people, it can lead to complications like liver cirrhosis(scarring), chronic hepatitis (liver inflammation) and even liver cancer which can eventually lead to premature death after many years.

SYMPTOMS of HEPATITIS B

Most patients with hepatitis B do not have symptoms. Some adults with acute hepatitis B can have symptoms such as loss of appetite, persistent fatigue, vomiting, and jaundice. Late hepatitis B symptoms is when the person experiences the complications of cirrhosis. These complications are lower limb swelling, abdominal swelling, jaundice and vomiting blood. People with advanced liver cancer may experience weight loss and abdominal pain. Patients with advanced cirrhosis may also suffer from kidney failure, confusion or difficulty breathing

WHEN to See a Doctor for HEPATITIS B

If you have a raised Alanine Aminotransferease (ALT) in your liver function test, you should see a hepatitis B specialist to get tested for the virus.

If you have risk factors for hepatitis B, you should see a hepatitis B doctor to get tested from time to time.

If you are tested positive for hepatitis B, you should consult your hepatitis B specialist to determine if a follow-up visit is needed. Most patients need at least twice a year of follow-up visit. Some may need treatment. 

CAUSES of HEPATITIS B

Hepatitis B is an infection caused by the hepatitis B virus.It can be transmitted from mother to child during pregnancy, through contact with bodily fluid or through sexual contact. The virus affects mostly the liver and can cause liver inflammation. Subsequently, it can lead to liver hardening or cirrhosis.

RISK FACTORS of HEPATITIS B

People at high risk should see a hepatitis B doctor and get tested for hepatitis B. According to World Health Organisation, various groups of people who are identified to be at high risk of hepatitis B infection are those with:

  • Sexual and household contacts of people with hepatitis B infection
  • Injecting drug users
  • People who are exposed to or require blood/blood products such as healthcare workers
  • Those with multiple sexual partners
  • Dialysis patients
DIAGNOSIS of HEPATITIS B

Diagnosis of hepatitis B is made by having a blood test. 

Common blood tests used to diagnose hepatitis B include HBsAg, Anti-HBs, HBeAg and anti-HBe. Chronic hepatitis B is diagnosed when 2 HBsAg tests are positive, six months apart. Usually, when HBsAg is positive, anti-HBs would be negative. Positive anti-HBs could indicate the presence of immunity after vaccination or after an acute infection. HBeAg and anti-HBe tell us the infectivity and chronicity of the disease.

A liver function test is also commonly done. A raised ALT would indicate liver inflammation or damage. 

Other assessment tools we use include ultrasound liver and fibroscan. It is important to have a proper assessment of hepatitis B to ensure that you get the correct treatment and a follow-up visit.

TREATMENT of HEPATITIS B

Hepatitis B virus can be effectively suppressed with oral antiviral medication. Not all patients with hepatitis B infection require treatment. The side effects of medication are minimal. Typically hepatitis B treatment takes many years and must be supervised by a specialist. Treatment of some patients is very important to prevent the development of liver cirrhosis and liver cancer. 

Treatment will be needed, if a patient develops complications of liver hardening from hepatitis B. Some complications include ascites, oesophageal varices, liver cancer, hepatic encephalopathy and renal failure.