Hepatitis B

Hepatitis literally means inflammation of the liver. Some types of hepatitis pass on their own without causing serious problems, while others can become long-lasting (chronic) and, by creating scar tissue in the liver, can lead to cirrhosis, loss of liver function and, in some cases, liver cancer.

Hepatitis B is a serious disease that affects the liver and is caused by the Hepatitis B virus. The Hepatitis B virus is transmitted mainly through blood, sexual contact and from mother to baby during childbirth; it is not transmitted by kissing, hugging or sharing spoons and forks.

400 million people worldwide and 3 million people in Turkey carry the Hepatitis B virus. If left untreated, there is a risk of developing cirrhosis and liver cancer. In this case, a liver transplant may be considered.

While Hepatitis B carriers may not experience any problem caused by the virus throughout their lives, they carry a 10 percent risk of developing the disease. For this reason, it is important to have periodic blood checks.

Blood contact holds an important place among the routes of transmission of Hepatitis B. For this reason, it is very important to be careful in procedures where blood contact may occur, such as tattoos and manicures. In addition, vaccination of people in high-risk groups for transmission of the disease, such as healthcare workers, is of great importance.

Types;

Hepatitis B disease is divided into acute and chronic forms. Acute Hepatitis B virus infection is a short-term illness that occurs within the first 6 months after exposure to the Hepatitis B virus and causes the following complaints:

1. Fever, fatigue, loss of appetite, nausea and/or vomiting
2. Jaundice (yellow skin or eyes, dark urine, clay-coloured stools)
3. Muscle, joint and stomach pain

Most acute hepatitis B infections follow a course of recovery, but in about 0.1% of cases a picture of sudden-onset, rapidly developing liver failure called "fulminant hepatitis" occurs, and this can be fatal.

Chronic Hepatitis B virus infection, on the other hand, is the form in which the Hepatitis B virus enters the body and cannot be eliminated for more than 6 months, and which can lead to serious outcomes such as liver damage (cirrhosis), liver cancer and death.

The rate at which acute hepatitis B infection becomes chronic is around 90% in newborns, falls as age advances, and is between 1-5% in adulthood.

In addition to these two forms, in some infected individuals the virus may remain in the body without causing disease, or may not be cleared from the body even after the disease has developed and resolved. In these patients, there is a carrier state without any symptoms or complaints; therefore the infectiousness of the disease continues.

The Hepatitis B virus can survive in the external environment for a week and is 10 times more infectious than Hepatitis C and 100 times more infectious than HIV.

In addition, children born to mothers infected with this virus constitute a particularly important risk group. For this reason, children should be given the Hepatitis B vaccine from the moment they are born, and adults should have it without delay if they work in an occupation at high risk of transmission.

In our country, the Hepatitis B vaccine has been in the vaccination schedule since 1998. Although vaccination provides lifelong protection, it is recommended that individuals at particularly high risk, even if they have been vaccinated before, have a blood test to determine whether they have developed antibodies, and receive one booster dose if the antibody level is not at a protective level.

The Hepatitis B virus is present at a low concentration in breast milk and does not cause infection in the baby. However, the baby can catch the virus through cracks in the nipple during breastfeeding.

With immunoprophylaxis (hepatitis B immunoglobulin and vaccine) given right after birth, breastfed babies are protected from infection.

Who Should Be Vaccinated?

The Hepatitis B vaccine is recommended for all unvaccinated adults aged 19-59. Over the age of 60, the following risk groups should be vaccinated:

1. People working in high-risk occupations
2. People whose sexual partners have Hepatitis B
3. People with multiple sexual partners
4. People who share needles, syringes or other injection equipment
5. People in household contact with someone infected with the Hepatitis B virus
6. Healthcare and public safety workers at risk of exposure to blood or body fluids
7. People in correctional facilities
8. People travelling to regions where hepatitis B rates are high
9. People with chronic liver disease, kidney disease, HIV infection or diabetes.

There is no known drawback to giving the Hepatitis B vaccine at the same time as other vaccines. However, people who have previously had the Hepatitis B vaccine and shown an allergic reaction, and people who are allergic to a substance in the vaccine, should not be vaccinated.

Causes

Hepatitis B is a virus transmitted especially through blood and body fluids and through sexual contact. Hepatitis B is transmitted by contact of infected blood, semen or other body fluids with the body of a person who does not carry the virus. People can catch the virus in the following ways:

1. Transmission from mother to baby during childbirth,
2. Transfusion of blood and blood products that have not been screened for infection risks,
3. Sharing items such as razors or toothbrushes with an infected person,
4. Coming into contact with the blood or open wounds of an infected person,
5. Having unprotected sex with an infected partner,
6. Sharing needles, syringes or other drug injection equipment,
7. Undergoing dialysis on a haemodialysis machine that has not been checked for infection risks,
8.   Needlestick injuries or exposure to blood through other sharp instruments.
9. Because it is transmitted by blood and sexual contact, the risk groups are people who have surgery, tattoos, or procedures such as manicures and pedicures where proper sterile conditions are not provided, people with multiple sexual partners or who have unprotected sex, and healthcare workers.

In addition, care should be taken because of transmission through the shared use of personal items such as nail clippers, razors and toothbrushes. The Hepatitis B virus is not transmitted through the respiratory tract, water or food sources

Symptoms

The virus causes disease by damaging the liver. It may cause no symptoms while doing this damage, and a diagnosis of liver cirrhosis or liver cancer may be made directly. When it does cause symptoms, it shows itself with the complaints listed below.

1.  Extreme fatigue
2. Loss of appetite
3. Yellowing of the whites of the eyes
4. Weight loss
5. Abdominal swelling (due to fluid accumulation in the abdomen)
6. Swelling (oedema) in the legs
7. Bleeding that is slow to stop
8. Vomiting blood
9. Headache and body aches
10. Nausea or vomiting
11. Diarrhoea
12. Dark-coloured urine
13. Light-coloured stools
14. Easy bleeding and bruising

Treatment Methods

Short-term (acute) Hepatitis B generally does not require specific treatment, but medications may be given to relieve complaints. Long-term (chronic) hepatitis B is usually treated with medication to keep the virus under control.

The aim of medication treatment is to suppress the multiplication of the Hepatitis B virus and thereby minimise its damaging effect on the liver.

Points to Consider

Hepatitis B patients and carriers need to pay attention to the following:

1. Do not have unprotected sex.
2. Do not share needles or other items that can carry blood, such as toothbrushes, nail clippers and razors, with other people.
3. To prevent transmission of the infection, make sure the people you live with are vaccinated.
4. Take care to eat a balanced diet (there is no special diet for Hepatitis B).
5. Avoid alcohol. Alcohol is an important cause of liver damage.
6. Do not neglect your child's vaccination schedule
7. If you are planning to have a baby, consult your physician.

It is possible for Hepatitis B patients and carriers to have healthy children, but some precautions may need to be taken during pregnancy and childbirth. Therefore, if you have hepatitis B or are a carrier, it is important to inform your physician and consult them.

To have your test done in Northern Cyprus, please visit our Nicosia or Kyrenia branch. We wish you good health!