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Hepatitis B



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Chapter 4 : Hepatitis B

Topics covered in this snack-sized chapter:



Hepatitis B arrow_upward


  • Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
  • The virus is transmitted through contact with the blood or other body fluids of an infected person - not through casual contact.
  • About 2 billion people worldwide have been infected with the virus and about 350 million live with chronic infection.
  • About 25% of adults who become chronically infected during childhood later die from liver cancer or cirrhosis (scarring of the liver) caused by the chronic infection.
  • The hepatitis B virus is 50 to 100 times more infectious than HIV.
  • Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus.
  • It is a major global health problem and the most serious type of viral hepatitis.
  • It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer.

  • Symptoms arrow_upward


  • For a person with hepatitis B, symptoms (especially early symptoms) may include one or several of the following:
    • Fatigue
    • Excessive tiredness
    • Not feeling very hungry
    • Nausea or vomiting
    • Diarrhea
    • A low-grade fever
    • Muscle pain
    • Joint pain
    • Sore throat
    • Mild abdominal pain (or stomach pain)
    • Dark urine
    • Light-colored stool

    Causes arrow_upward


  • HBV spreads when blood, semen, or vaginal fluids (including menstrual blood) from an infected person enter another person's body, usually in one of the following ways:
    • Sexual contact
    • Sharing needles
    • Work related exposure
    • Childbirth
    • Body piercings and tattoos
    • Toiletries

    Sexual Contact

  • The hepatitis B virus can enter the body through a break in the lining of the rectum, vagina, urethra, or mouth.
  • Sexual contact is the most important risk factor for the spread of HBV in North America.

  • Sharing Needles

  • People who share needles and other equipment (such as cotton, spoons, and water) used for injecting illegal drugs may inject HBV-infected blood into their veins.

  • Work-Related Exposure

  • People who handle blood or instruments used to draw blood may become infected with the HBV virus
  • Health care workers are at risk of becoming infected with the virus if they are accidentally stuck with a used needle or other sharp instrument contaminated with an infected person's blood.
  • Infection also can occur if blood splashes onto an exposed surface, such as the eyes, mouth, or a cut in the skin.

  • Childbirth

  • A newborn baby can get the virus from his or her mother during delivery when the baby comes in contact with the mother's body fluids in the birth canal (perinatal transmission).
  • But breast-feeding does not transmit the virus from a woman with HBV to her child.

  • Body Piercings and Tattoos

  • HBV may be spread when needles used for body piercing or tattooing is not properly cleaned (sterilized) and HBV-infected blood enters a person's skin.

  • Toiletries

  • Grooming items such as razors and toothbrushes can spread HBV if they carry blood from a person who is infected with the virus.

  • Transmission arrow_upward


  • Hepatitis B virus is transmitted between people by contact with the blood or other body fluids (i.e. semen and vaginal fluid) of an infected person.
  • Modes of transmission are the same for the human immunodeficiency virus (HIV), but HBV is 50 to 100 times more infectious Unlike HIV, HBV can survive outside the body for at least 7 days.
  • During that time, the virus can still cause infection if it enters the body of a person who is not infected.

  • Prevention arrow_upward


  • No cure is available for hepatitis B, so prevention is crucial.
  • Vaccines can provide protection level of about 90% to 95% in healthy persons.
  • The vaccine can be given safely to infants, children, and adults in three doses over a period of 6 months.

  • Treatment arrow_upward


  • Treatment considerations for HBV vary depending on whether the infection is:
    • Acute
    • Chronic
  • Always consult your healthcare provider for specific recommendations and treatment options.

  • Acute (Newly Acquired)

  • No specific treatment is available for acute HBV infection.
  • Most patients with acute viral hepatitis experience a self-limited illness (one that runs a limited course), and go on to recover completely.
  • There is no accepted treatment and no restrictions on diet or activity.
  • In most cases, hospitalization should be avoided, to prevent spread of the virus to other patients. It should, however, be considered for patients who are severely ill.
  • Your healthcare provider can recommend the best options based on your individual needs for care.

  • Chronic (Persistent)

  • Lamivudine (Epivir) is now available to treat chronic HBV.
    • It is the first medication specifically formulated to do so.
    • Talk to your health care provider for more information about lamivudine and to learn if it is right for you.
  • Entecavir (Baraclude™) slows the progression of chronic hepatitis B by interfering with viral reproduction.
    • In clinical studies, patients treated with entecavir showed significant improvement in the liver inflammation caused by HBV and an improvement in the degree of liver fibrosis (scarring).
    • It is important to stay under your doctor’s care while taking entecavir.
    • Baraclude™ was approved by the Food & Drug Administration (FDA) in March 2005.
    • Talk to your doctor to learn more about this treatment.
  • Peginterferon (Pegasys®) is the first and only pegylated interferon approved for the treatment of chronic hepatitis B, including both variations of the virus.
    • Peginterferon has a dual mode of action; it slows replication of the hepatitis B virus and boosts the immune system.
    • Pegasys® was approved by the FDA to treat chronic hepatitis B in May 2005.
    • Talk to your healthcare provider to learn more about peginterferon.


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