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Hepatitis B (HBV)

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. HBV has been found in vaginal secretions, saliva, and semen. Oral sex and especially anal sex, whether it occurs in a heterosexual or homosexual context, are possible ways of transmitting the virus.

Transmission

How common

In the United States, an estimated 700,000 to 1.4 million persons have chronic hepatitis B virus infection. Globally, chronic Hepatitis B affects approximately 240 million people and contributes to an estimated 786,000 deaths worldwide each year.

 

Hepatitis B prevalence is highest in sub-Saharan Africa and East Asia, where between 5–10% of the adult population is chronically infected. High rates of chronic infections are also found in the Amazon and the southern parts of eastern and central Europe. In the Middle East and the Indian subcontinent, an estimated 2–5% of the general population is chronically infected. An estimated 15-25% of persons with chronic HBV infection will die prematurely.

Chances of being infected

Hepatitis B is transmitted by coming into contact with blood or body fluids with someone who is infected with hepatitis B. Women have a 10% risk for getting HBV while men have a  5% risk for getting infected by doing sexual intercourse. The numbers are estimated Risk of Infection (%) from One Unprotected Encounter.

How to detect if someone has it

Jaundice - Detect

It is very important to note that 50% to 70% of infections cause no symptoms. Hepatitis B infections may cause symptoms of a flu-like illness.  Alopecia (loss of hair occurring at any site), Clay-colored bowel movements and Jaundice (yellow color in the skin or the eyes) may also occur.

Prevention

  • Vaccination

An effective vaccine is available for the prevention of hepatitis B. The HBV vaccine has been successful worldwide in decreasing rates of chronic hepatitis B and subsequent liver cancer. Since 1991, Hepatitis B vaccine has been recommended for all infants and children in the US. It is recommended for adults that are at high risk for acquiring HBV.

The vaccine is up to 95% effective against hepatitis B if you receive all the shots in the vaccination series (3 or 4 shots given at different times). The vaccine provides protection against infection for at least 20 years.
If you have not gotten a hepatitis B vaccine and think you may have been exposed to the virus, you should get a shot of hepatitis B immunoglobulin (HBIG) and the first of three shots of the hepatitis B vaccine. It is important to receive this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus.

  • Condom

Condoms significantly decrease transmission rates of Hepatitis B. However, the statistics on liver disease show that 60 percent of hepatitis carriers acquired the virus by means other than sexual intercourse, such as recreational IV drug use or by receiving a tainted blood transfusion. But for those 40 percent, a latex condom would have prevented transmission. As long as there is no breakage or leakage, using latex condoms for all sexual penetration prevents transmission of both hepatitis and HIV because those viruses are transmitted through body fluids. The condom should be worn from the beginning until the end of sexual activity, and care should be taken when handling and disposing of the condom afterward.

Condom effectiveness

Please note that latex condoms blocked passage of HBV in laboratory studies, but natural membrane condoms (made from lamb cecum), which contain small pores, did not. Natural condoms allowed leakage of hepatitis B virus, whereas synthetic condoms prevented leakage. These results suggest that natural condoms might not be effective in preventing sexually transmitted hepatitis B virus infection. Unfortunately we are not able to find the protection rate of condoms against HBV (Hepatitis B)

Treatment

Once-daily treatment for adults with chronic hepatitis B virus (HBV) infection

  • Interferon injections
    Treatment using Interferon injections may be considered in some people in certain high-income settings, but its use is less feasible in low-resource settings due to high cost and significant adverse effects requiring careful monitoring.
  • Liver transplantation

In high-income countries, liver transplantation is sometimes used in people with cirrhosis, with varying success.

Best sources for more information

  • Hepatitis B

http://www.who.int/mediacentre/factsheets/fs204/en/

  • Hepatitis and Sex: Frequently Asked Questions

http://www.webmd.com/hepatitis/hepatitis-and-sex-frequently-asked-questions

  • Company Update (NASDAQ:GILD): Gilead Sciences, Inc. Submits NDA to U.S. FDA for Tenofovir for the Treatment of Chronic Hepatitis B

http://hbvadvocat.blogspot.ca/2016/01/company-update-nasdaqgild-gilead.html

  • Hepatitis B virus: epidemiology and transmission risks

http://www.hpsc.ie/A-Z/EMIToolkit/appendices/app21.pdf

  • Hepatitis B

http://www.who.int/csr/disease/hepatitis/whocdscsrlyo20022/en/index1.html

  • Hepatitis B Vaccine What You Need to Know

http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/media/pdf/hw/form_vis04.pdf

The risk chart is the heart of this guide, and it can be found here

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