Causes and Prevention of Hepatitis B Virus Infection
Hepatitis B virus-related liver damage is the principal cause of viral hepatitis type B, an infectious disease. Appetite loss, nausea, upper stomach pain, pain near the liver, and weariness are some of the clinical signs. The viral infection can cause liver damage, jaundice, fever, and enlarged livers in some patients. A small number of patients may develop liver cancer, while others may become chronic and even develop cirrhosis.
Name of the illness: type B viral hepatitis
Department visited: Infectious Diseases
Hepatitis B virus is a common cause.
Common signs and symptoms include exhaustion, loss of appetite, nausea, greasiness, and pain in the upper right abdomen.
How is the condition known as IBS treated?
Irritable bowel syndrome is generally treated by forming
healthy habits and avoiding items that cause gas.
Can hepatitis B be fully recovered from? What is the underlying science?
People with clinical signs of chronic hepatitis B who have
tested positive for the hepatitis B virus, whose disease has been present for
longer than six months, or whose onset date is unclear, are said to have
chronic hepatitis B (also known as hepatitis B).
Its clinical symptoms include tiredness, appetite loss,
nausea, bloating, and pain around the liver.
Because hepatitis B causes more damage, it may not be curable
and needs to be aggressively avoided.
General Information
What causes a person to contract hepatitis B?
Hepatitis B virus, often known as HBV, is the root cause of
the disease and is a DNA virus. DNA that is double-stranded, circular, and
partially closed makes up the genome. The outer membrane, also known as the
virus's envelope, is its topmost layer. The core is the inner layer.
The core antigen (HBcAg) is a nucleoprotein, which cannot be
found in serum.
Under the electron microscope, HBsAg-positive serum revealed
three different types of particles, including spherical and filamentous
particles with a diameter of 22 nm and a smaller number of 42.
Complete HBV particles are spherical particles, also called
Dane's particles.
HBV has a high level of resistance to environmental factors
and can withstand disinfectants at typical concentrations. It can withstand 60
° C of heat for four hours.
Boiling for 10 minutes, disinfecting with high-pressure
steam, and submerging it in 2% peroxyacetic acid for 2 minutes can all
inactivate it.
1. What symptoms are present in acute hepatitis?
Acute jaundice hepatitis and acute non-jaundice hepatitis are
the two types.
The incubation period for hepatitis B is lengthy, lasting
anywhere from 45 to 160 days on average. The sickness lasts for two to four
months overall.
(1) Chills, fever, exhaustion, loss of appetite, nausea,
oiliness, abdominal discomfort, pain near the liver, and a gradually darker
urine colour are symptoms of jaundice in its early stages.
It often lasts between five and seven days.
(2) Regression of the
jaundice fever, yellowing of the sclera and skin, improvement in consciousness as
jaundice appeared, discomfort and throbbing pain in the liver, and minor
splenomegaly in some patients.
It lasts for two to six weeks.
(3) Recovering phase: Liver and spleen function gradually
returns to normal, symptoms fade or even disappear, and jaundice gradually
disappears.
2. What symptoms are present in chronic hepatitis?
Chronic hepatitis can be diagnosed in people who have had
hepatitis B, HBsAg, or acute hepatitis for longer than 6 months but who still
exhibit symptoms, signs, and abnormal liver function. Common signs and symptoms
include signs of a dull complexion, yellow staining of the sclera, spider moles
or liver palms, large liver, medium or full texture, tingling pain, generalised
discomfort, appetite loss, discomfort or pain in the liver area, abdominal
distension, and mild temperature.
Deep jaundice, peritoneal effusion, lower extremities edoema,
bleeding tendency, and hepatic encephalopathy are possible symptoms of a severe
spleen. It can be categorised into three categories based on the severity of
liver damage:
(1) Mild Patients with mild disease may not show any overt
signs or symptoms, and their biochemical indicators may only show one or two
minor abnormalities.
(2) Moderate signs and symptoms, i.e., those in the range of
mild to severe abnormal alterations in liver performance.
(3) When alternative reasons are ruled out and patients have
no portal hypertension, liver disease, liver palms, spider moles, or
hepatosplenomegaly may be present alongside severe or persistent liver
inflammation symptoms such fatigue, poor appetite, bloating, loose stools, etc.
One of the three tests that can be used to diagnose severe
chronic hepatitis in a laboratory setting is the alanine aminotransferase
repeatedly or continuously increased, albumin decreased or abnormal A/G ratio,
gamma globulin significantly increased, and albumin 32 g/L, bilirubin > 85.5
mol/L, and thrombin 60% to 40% of the original activity.
3. What symptoms does severe hepatitis present with?
(1) Deep jaundice, a tiny liver, fast start, and rapid
progression characterise acute severe hepatitis.
Neuropsychiatric symptoms start to manifest within 10 days of
the outset, bleeding tendency is evident, and liver odour, peritoneal effusion,
hepatorenal syndrome, and prothrombin activity are all below 40%.
Low cholesterol and obviously impaired liver function are the
only contributing factors.
(2) Hepatic encephalopathy is more common in the later stages
of severe liver damage. Ten days after the onset of subacute severe hepatitis,
there is still extreme fatigue, poor appetite, severe jaundice (bilirubin >
171 mol/L), abdominal distension, and formation of peritoneal effusion, as well
as obvious bleeding phenomena. Total bilirubin, which is caused by bile enzyme
separation, an inverted A/G ratio, and gamma globulin, is dramatically elevated
while serum ALT is neither decreased nor raised. Prothrombin activity was only
40% and prothrombin time increased.
(3) Imaging, laparoscopy, or liver puncture are used to
support the chronic hepatitis manifestations in chronic severe hepatitis, which
differs from subacute severe hepatitis in terms of clinical manifestations and
laboratory changes. Chronic severe hepatitis also has cirrhosis from chronic
hepatitis or a history of carrying hepatitis B surface antigen.
4. What follows hepatitis is cirrhosis?
Chronic hepatitis B leads to the development of hepatitis B
cirrhosis. Ultrasound and CT scans are required for the pathological diagnosis
of early liver cirrhosis (the liver tissue has diffuse fibrosis and
pseudolobular development).
The most reference-worthy procedure is laparoscopy. Patients
with chronic hypertension who exhibit symptoms of portal hypertension, such as
varicose veins on the abdominal wall and in the oesophagus, peritoneal
effusion, liver shrinkage, splenomegaly, and enlarging portal vein and splenic
vein diameter, and who rule out other potential causes of portal hypertension
are said to have cirrhosis.
There are two types of cirrhosis: active and stagnant,
depending on the level of hepatitis activity.
5. What are carriers of the Hepatitis B surface antigen
(HBsAg)?
Healthy carriers, people with persistent HBV infection, and
even people with liver cirrhosis are all HBsAg carriers.
Only 10% to 29% of HBsAg carriers had normal liver tissues,
while the majority exhibited varied degrees of liver tissue damage, according
to the study.
In China, the following criteria are used to define HBsAg
carriers: HBsAg positivity, but no hepatitis symptoms or signs, normal liver
function tests, and no changes within six months.
Examining the liver
1. What is a test for liver function?
(1) Enzymatic
detection of serum: Alanine aminotransferase (ALT) is present in liver cells at
104 times higher levels than in serum.
The blood concentration can be increased with just 1% liver cell necrosis, and the likelihood of having acute hepatitis is between 80 and 100 percent.
Since the myocardium contains the largest concentration of
aspartate aminotransferase (AST), cardiac disease should be ruled out before
looking at the impact on liver function.
The mitochondria of liver cells contain 80% of the AST. In
general, ALT is the key factor in liver injury.
Significantly elevated serum AST levels frequently signify
highly necrotic liver cells.
However, in severe hepatitis, bilirubin may continuously
increase but transaminase may decrease, i.e., bile enzyme separation,
indicating that liver cell necrosis is serious. The release of AST into the
blood from mitochondria and the degree of increase in serum transaminase are
roughly parallel to the severity of the disease.
Most frequently, serum ALT and AST levels are used to gauge
the severity of liver cell destruction.
(2) The detection of serum protein: Serum protein is
frequently utilised in clinical settings as a biochemical marker of liver
protein metabolism, which reflects the liver's synthetic activity.
Serum albumin levels frequently fall as a result of chronic
hepatitis cirrhosis, whereas globulin levels and specifically -globulin levels
rise.
(3) Serum bilirubin detection: The liver performs the
bilirubin metabolic processes of absorption, transport, binding, and excretion.
Damage to liver function causes a rise in bilirubin levels.
The degree of liver damage is directly correlated with bilirubin
levels, with the exception of cholestatic hepatitis inside and outside the
liver.
(4) Prothrombin time (PT): The duration of PT in liver
disease is strongly connected with the extent of liver damage, which is of
considerable utility in determining disease progression and prognosis. It can
sensitively reflect the liver's synthesis of coagulation factors II, IX, IX,
and X.
2. What does "detection of hepatitis B viral indicators" mean?
i. HBsAg and anti-HBs: HBsAg positivity shows that HBV is
currently in the infection stage, whereas positive anti-HBs results in the
development of HBV immunity.
Chronic HBsAg carriers are diagnosed when they have normal
liver function, no clinical symptoms, and have been HBsAg positive for more
than six months.
The test serum's transition from an HBeAg-positive to an
anti-HBe-positive state shows that the disease has subsided and its
contagiousness has diminished.
iii. HBcAg and anti-HBc: HBcAg positivity indicates a
complete direct response of HBV particles and active replication of HBV;
nevertheless, it is rarely employed in clinics due to the challenging detection
procedure.
Anti-HBcIgM positivity suggests that the infection is in the
early stages and that virus replication is occurring in the body. Anti-HBc is a
marker of HBV infection. The majority of anti-HBc total antibodies are
anti-HBcIgG.
This antibody is positive regardless of whether the virus has
been eradicated as long as they have had HBV infection.
The signs are difficult to turn negatively, and HBsAg, HBeAg,
and anti-HBc positives in chronic mild hepatitis B and HBsAg carriers are
extremely contagious.
Molecular biological markers: The presence of HBV DNA in
serum, as determined by molecular hybridization or PCR, indicates that the
virus is actively replicating and spreading.
3. Describe a liver biopsy
Although it is the primary indicator for the identification
of various viral hepatitis types and the precise proof for the diagnosis of
early liver cirrhosis, the traumatic examination is not always available.
4. What are computer tomography (CT) and ultrasound?
The usage of ultrasound is common. It is possible to
distinguish between liver cirrhosis, liver cancer, and jaundice using the
diagnostic signs of chronic hepatitis and hepatitis cirrhosis that have been
found.
Additionally, a CT scan is quite helpful for making the
aforementioned diagnosis, locating lesions that take up space in the liver, and
tracking the progression of chronic hepatitis B.
How is Hepatitis B identified?
The aforementioned symptoms, indicators, laboratory results,
histology, and imaging tests are used to make the diagnosis of hepatitis B.
The serum HBV indicators and HBV DNA test findings must be
used to make the diagnosis.
According to clinical traits and laboratory results,
hepatitis B is classified into several clinical kinds, including acute,
chronic, cirrhosis, and primary liver cell cancer linked to hepatitis B virus.
Acute hepatitis B
Recently, there have been symptoms related to the digestive
system and weakness that cannot be attributed to other conditions, such as
jaundice or yellow urine, eyes, or skin.
1. Abnormal liver biochemical testing may reveal high serum bilirubin as well as raised serum ALT and AST.
2. HBsAg is present.
3. There is convincing proof that within six months, serum HBsAg was negative.
4. More than 1: 1000 positive test for anti-HBc IgM.
5. The alterations in acute viral hepatitis are consistent with the liver histology.
6. Negative serum HBsAg and positive anti-HBs conversion during the recovery phase.
Persistent Hepatitis B
1. The HBsAg status of an acute HBV infection remains positive or is positive for more than six months.
2. Anti-HBc IgM is negative and HBsAg positivity's duration is uncertain.
3. Patients' symptoms and liver illness, including liver palm, spider mole, liver and spleen, etc.
4. A persistent or repeated rise in serum ALT, a fall in plasma albumin and/or globulin levels, and a rise in bilirubin.
5. The histology of the liver is compatible with that of chronic viral hepatitis.
6. HBV DNA can be found or serum HBeAg is positive, ruling out other factors that could induce increased serum ALT.
3. Hepatitis B Cirrhosis
1. Positive serum HBsAg or a demonstrable history of chronic
hepatitis B
2. A decrease in serum albumin, a rise in serum ALT or AST,
an increase in serum bilirubin, or a clear oesophagus, fundus varices, hepatic
encephalopathy, or ascites, all of which are accompanied by hypersplenism
(platelet and/or leukopenia).
3. Imaging results from abdominal B-mode ultrasonography, CT,
or MRI exhibit classic liver cirrhosis characteristics.
4. Formation of pseudolobules and diffuse fibrosis in liver histology.
1. How is Hepatitis B generally treated?
Treatment Alcohol consumption is strictly forbidden while
acute and chronic hepatitis are active, necessitating hospitalisation, bed
rest, and acceptable nutrition to provide a supply of calories, protein, and
vitamins.
During the healing process, the patient should gradually raise
their activity levels.
Rest is when chronic hepatitis is most effective. To maintain
hydration and electrolyte stability in patients with severe hepatitis, it is
recommended that they stay completely bedridden, try to cut back on their
protein intake, supplement with calories and vitamins, and get human albumin or
fresh plasma transfusions.
2. How is Hepatitis B treated with Antivirals?
Antiviral therapy is typically necessary for chronic viral
hepatitis but not for acute hepatitis.
i. Interferon: Recombinant DNA interleukin (IFN-) can prevent
HBV from replicating. For 6 consecutive months after the intramuscular
injection, only 30% to 50% of patients experienced a longer-lasting impact.
Interferon, which can be used with ribavirin, is the primary treatment for
hepatitis C.
ii. Lamivudine is a synthetic dideoxycytosine ribolycoside medication that has an anti-HBV action. After 12 weeks of treatment, oral lamivudine can considerably lower serum HBV-DNA levels and increase the HBV-DNA negative rate to above 90%.
Although long-term treatment can lower ALT and
improve liver inflammation, only 16% to 18% of patients become HBeAg negative.
HBV mutations can develop after more than six months of treatment, but you can
still take this medication. Side effects may last for one to four years.
Famciclovir is a guanosine medication with a long half-life
and high intracellular concentration that has the ability to prevent HBV-DNA
replication. The effectiveness of this medication can be increased by combining
it with lamivudine interferon despite its mild adverse effects.
Acyclovir, adefovir, entecavir, sodium phosphonate, and other
antiviral medications have a particular inhibitory effect on HBV.
3. What is Immunomodulator?
Common examples include:
i. Thymosin 1 (Zidaxian) has a two-way immunomodulatory
impact that can help patients with primary and secondary immunodeficiencies
regain their immunological function.
ii. Thymosin T lymphocyte differentiation and maturation are
induced by the immunological response of the body's cells, which also enhances
T cells' reactivity to antigens and controls the number of T cell subgroups.
What does Hepatitis B Viral Infection Disease Prevention entail?
Since the hepatitis B virus is mostly spread by blood, vertical transmission from mother to child and iatrogenic infection are the most significant modes of transmission.
The precautions include:
1. Control the infection's source
Blood donations and diet-related activities should be avoided
for people with chronic hepatitis and asymptomatic HBV carriers.
Treatment and management recommendations for patients with
HBV-positive liver disease should be based on their symptoms, physical
manifestations, and outcomes of laboratory tests.
2. Block the communication pathway
Hepatitis B treatment focuses on preventing transmission
through bodily fluids like blood, enhancing blood donor screening, and tightly
regulating blood transfusion and blood product usage.
High-potency hepatitis B immunoglobulin can be applied if a
wound or area is discovered to be contaminated with the hepatitis B virus or is
believed to be so.
To prevent mother-to-child transmission, the devices used for
the interventional evaluation and treatment of syringes should be carefully
sterilised.
3. Look out for those who are weak
 |
| Dr. Shawna Reason |
Education: MBBS, MD
Occupation: Medical Doctor / Virologist
Specialization: Medical Science, Micro Biology / Virology, Natural Treatment
Experience: 15 Years as a Medical Practitioner
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See Also:
- Hepatitis Diagnosis Treatment
- Fatty Liver
- Herpes Virus
- Coronavirus Spread
- Telemedicine
- High Blood Pressure
- Blood Donation
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