Hepatitis B: transmission and treatment

What is hepatitis B?

Hepatitis B is a liver disease caused by infection with the hepatitis B virus. The virus specifically attacks one of the largest organs in the human body: the liver. This means that normal liver function can be impaired.

The defense mechanisms against the virus vary from person to person. Therefore, there are different manifestations: acute hepatitis, chronic hepatitis and asymptomatic carriers.

The liver is a vital organ. Their main functions are:

• Storage and distribution of nutrients from the digestive process
• Detoxification of the body by breaking down toxins, whether naturally produced by the body or supplied externally (e.g. alcohol)
• Production of most blood proteins
• Production of bile, which is needed for fat digestion

In France, an estimated 280,000 people are carriers of chronic hepatitis B. Every year, around 1,500 people die in France as a result of the infection. It is estimated that 350 million people are living with the disease worldwide. It is particularly widespread in sub-Saharan Africa, Eastern Europe and Southeast Asia. A full 10% of adults are affected there.

There is no known cure. However, the vaccine against hepatitis B is highly effective in prevention.

What are the symptoms of hepatitis B?

Acute hepatitis B is usually asymptomatic. Possible symptoms are tiredness and yellowing of the skin and eyes – the so-called jaundice. Loss of appetite, pain in the liver region and upper right abdomen, fever and general aches may also occur. Acute hepatitis lasts about two weeks. In adults, 90 to 95% of those infected fully recover, while only 5 to 10% in children.

The greatest danger of acute hepatitis is that it can progress to a rare but extremely serious condition called ‘fulminant hepatitis’. In this case, an urgent liver transplant may be needed.

Chronic hepatitis usually goes unnoticed for several years but progressively worsens until complications such as cirrhosis or cancer can develop as a result of progressive liver damage.

Even completely asymptomatic chronic carriers can transmit the virus. It is therefore important to systematically test risk groups.

What are the possible consequences?

Only 5% of adults who become infected with the hepatitis B virus develop the chronic form. In children and infants, on the other hand, this value is up to 95%. Chronic hepatitis B slowly and silently destroys liver tissue and can cause cirrhosis or cancer.

How is hepatitis B spread?

There are different ways of transmission.

• The virus can be transmitted through blood and other body fluids (saliva, vaginal and semen). Hepatitis B is classified as a sexually transmitted disease or STD.
• However, the other transmission options should not be ignored , e.g. B. sharing everyday objects such as toothbrushes, nail scissors or razors, contaminated syringes or needles (drug use, tattoos, piercings) and transmission from mother to child during childbirth.

Who is at increased risk of contracting hepatitis B?

Some people have an increased risk of infection. Hepatitis B screening is recommended for the following people:

• Travelers from regions with a high risk of infection
• Close contacts of carriers of the HBV virus
• Intravenous or intranasal drug users
• Persons with other sexually transmitted diseases (HIV, hepatitis C)

Hepatitis-B-Serologie

Serological testing for hepatitis B can detect the virus in people who may have been in contact with a carrier. The diagnosis is made with a blood test. Screening should take place as part of the health check-up for adults over the age of 35 and is particularly recommended for the following people:

• Unvaccinated people returning from a region with a high risk of infection
• People who have had unprotected sex
• Persons in close contact with carriers of the HBV virus
• Intravenous or intranasal drug users
• People who have had other STDs (HIV, hepatitis C).

How is infection with the virus treated?

After hepatitis B is diagnosed, you should see liver disease and infectious disease specialists for monitoring and follow-up.

Acute phase: The only treatment is rest. Avoid anything that could damage the liver (alcohol, potentially liver-toxic drugs). Liver function is closely monitored with regular blood tests. If fulminant hepatitis develops, you will receive antiviral treatment. A liver transplant may be necessary.

Chronic phase: Unlike hepatitis C, there is no cure for hepatitis B. Antiviral drugs can delay the onset of cirrhosis or cancer and reduce transmission. How effective they are depends on at what stage of the infection treatment is started. Therefore, clearly defined clinical and biological criteria apply to prescriptions. Specific drugs such as interferons and nucleoside analogues can be used. Avoid anything that could damage the liver (alcohol, liver-toxic drugs). Chronic hepatitis requires regular medical follow-up over the long term.

How can hepatitis B be avoided?

How can hepatitis B be avoided?

Vaccination can prevent infection with hepatitis B. Also, take the following precautions to avoid spreading the disease:

• Sexual intercourse with a condom
• Drug use only with disposable injection equipment
• Sterile disposable instruments for tattoos and piercings
• screening of blood donations

Vaccination against hepatitis B

In Germany, the Standing Committee on Vaccination (STIKO) recommends vaccination against hepatitis B in adulthood, especially for vulnerable groups. These include people with certain diseases as well as those with increased occupational and non-occupational exposure risks. In any case, an individual risk assessment should be carried out by the doctor.

Then you should consult a doctor

If you have not been vaccinated and are planning a trip to an area where the disease is prevalent, you should seek medical advice to avoid infection. If you find yourself in the situations described or require hepatitis B screening, we also recommend medical advice.

If you notice symptoms of hepatitis, see a doctor immediately:

• Fever, general pain, fatigue
• jaundice (yellowing of the skin and eyes)
• Very dark urine and discolored stools
• Pain in right upper abdomen

If you have the following symptoms, you should see a doctor urgently:

• Persistent severe jaundice
• abnormal bleeding
• sleep problems
• confusion or drowsiness

How can Med-Healths help?

Our doctors can inform you about hepatitis B and carry out a risk assessment. If you have symptoms of hepatitis, they can also advise you on arranging a personal consultation with a specialist.