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What Is Hepatitis B?

Posted Aug 24 2008 1:49pm 1 Comment
ANNOUNCER: Hepatitis B is a viral infection of the liver that affects over a million Americans. Found in blood and certain body fluids, the hepatitis B virus can be spread in a number of ways.

EMMET KEEFFE, MD: Most of hepatitis B is spread by sexual contact with an infected individual or by use of intravenous drugs. Fortunately, our blood supply now has been clean from hepatitis B. All blood donors are checked for hepatitis B. If that blood unit's positive, it's discarded. So blood now is only an extremely rare way that hepatitis B can be spread.

Hepatitis B can also be spread by needle sticks, so physicians and nurses and other health care workers are at risk, but fortunately most health care workers now have become vaccinated to eliminate the risk for hepatitis B.

ANNOUNCER: Sharing personal products with an infected person can also be a mode of transmission.

EMMET KEEFFE, MD: We know that hepatitis B is a virus that is in blood. So we counsel patients not to share any personal items that might have particles of blood on them. The virus may last for a while on surfaces, so you don't want to share a razor or a toothbrush with a partner who you know has hepatitis B.

ANNOUNCER: People at higher risk for hepatitis B include men who have sex with other men, children of immigrants from countries with high hepatitis B rates, such as Asia and India, and children born to infected mothers. But hepatitis B is often an under-diagnosed disease because infected people can often show no symptoms and can live for years without knowing they have the disease.

EMMET KEEFFE, MD: There are about 150 to 300,000 new cases per year in the US. Most individuals are asymptomatic. They don't know they're infected. Hepatitis B might also be identified when you go to get your first life insurance policy, or if you're a good soul and you go to become a blood donor, you'll be notified by the blood bank that you have hepatitis B. So the first detection is often quite coincidental.

ANNOUNCER: This "coincidental detection" occurs because hepatitis B presents in two phases. In an "acute" infection, people often are ill with flu-like symptoms. The acute symptoms usually go away by themselves over a short period of time, but may lead to a "chronic" infection, which is usually more serious. Chronic infections may last a lifetime and can result in cirrhosis of the liver, potentially leading to cancer of the liver or liver failure.

EMMET KEEFFE, MD: When hepatitis B occurs acutely in a child, it's often asymptomatic. When it occurs in an adult, 50 percent or more will have symptoms, and the symptoms are typically flulike symptoms, and if it's severe, there may be jaundice.

EMMET KEEFFE, MD: When you're infected with acute hepatitis B as an adult, there's a 95 to 98 percent chance the virus will go away. But on the flip side there's a 2 to 5 percent chance that you will contract chronic hepatitis B.

About one in 300 in the case of acute hepatitis B, may progress to what we call fulminant, or severe, hepatitis B and need to be considered for liver transplantation and are at risk for sudden death. That, fortunately, is rare.

ANNOUNCER: For people at high risk, there is a vaccine available for hepatitis B. It was first developed in the early 1980's, but the Center for Disease Control guidelines have evolved over time.

EMMET KEEFFE, MD: The first recommendations were that all individuals at increased risk get vaccinated. Later, the CDC realized if we're really going to try to eradicate hepatitis B in the United States, we have to vaccinate all newborns. So the current recommendations for vaccination are that all newborn children be vaccinated against hepatitis B and that there be catchup vaccination for adolescents and young adults.

ANNOUNCER: If a person is infected with hepatitis B, several treatments have been developed to combat the virus.

EMMET KEEFFE, MD: Now, the case of hepatitis B, we have for treatment not only interferon, but pegylated interferon is approaching licensure, because the studies so far have been completed show promising results.

But we also have two oral agents, pills that are taken once a day. One is called lamivudine. The trade name is Epivir. And the other drug is called adefovir. Trade name is Hepsera. And both of those drugs are quite effective against hepatitis B.

ANNOUNCER: Despite the progress made in fighting hepatitis B, there are still certain myths and misconceptions about the disease that keep people at high risk from getting tested and treated.

EMMET KEEFFE, MD: Some of the mistakes I see with hepatitis are, in the case of my Asian population, a certain nonchalance, if you will, about hepatitis B, because many of the Asian people in our communities know that, "Mom has hepatitis B. My sister has hepatitis B. We all feel well, and I don't need to see a doctor or be tested."

The other error I see probably in hepatitis is lack of the recognition of how easily hepatitis B is spread by sexual contact. People all fear HIV or AIDS, but what is not widely known is that hepatitis B is the most easily spread virus by sexual contact.

The main thing I want people with hepatitis to know is that we have made tremendous progress in the past ten years, both diagnostically and therapeutically. We have now quite sophisticated tests. We more intelligently use liver biopsies in order to help patients and doctors make the right decisions, and we've had remarkable progress in therapy.

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Around 7-8 per cent of the world’s population is estimated to be infected with hepatitis B virus. It is mostly spread by blood and sexual transmission. In endemic areas, the carrier rate may be 10-20 per cent. It is often acquired at birth or in childhood, and is endemic in areas of Africa and Asia. Chronic hepatitis B virus carriers have a 100-fold greater chance of developing liver cancer than non-carriers.

- aadautech, a cancer drug discovery and therapeutics blog

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