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 Infectious Diseases - Detail

What do you need to know about Hepatitis B?

Dr. Kwang Yang, Family Physician
What is hepatitis B?
Hepatitis B is a serious infectious disease that sometimes can make people very sick and become life threatening. Worldwide, it is the ninth leading cause of death. Hepatitis B is very common, and you may either have the disease or be at risk of getting it.

Fortunately, your doctor has medicine that can be used to treat hepatitis B and to prevent hepatitis B. It is a good idea to learn about hepatitis B so that you and your doctor can work together to keep you as healthy as possible.

How does hepatitis B make me sick?
Hepatitis B makes you sick by damaging your liver. You can think of your liver as a factory that normally helps your body process foods. When your liver is working right, it helps your body convert the food that you eat into energy. Your liver can also break down waste products produced by your body so they do not hurt you.

But if you have hepatitis B, parts of your liver may become scarred and not working properly. If a large portion of the liver is scarred, a serious condition called cirrhosis may develop and cancer of the liver may also occur consequently.

What causes hepatitis B?
A virus, known as the hepatitis B virus causes hepatitis B. This virus affects the liver and damage the liver cells and liver tissue.

What is a virus?
A virus, like bacteria, is a very small germ that can live inside an animal or a human being. Once a virus like the hepatitis B virus is inside a person, it rapidly makes many copies of itself. Eventually, there may be millions of these duplicate viruses living in an infected person.


Who gets hepatitis B?
People who are at highest risk include:
  • People who live in countries where hepatitis b is very common, such as China, Southeast Asia, northern Canada, and most of Africa.
  • In these above mentioned countries, many babies are exposed to the hepatitis B virus, because their mothers are infected. People from countries where hepatitis B is very common may pass along the virus to other people.
  • People who have sex with several partners.
  • Injection drug users.
  • Healthcare workers or any other individuals who may be exposed to contaminated blood or accidental needle-stick injuries.
  • A person who gets a blood transfusion from infected blood. This is no longer very likely because the donated blood will be tested for the hepatitis B virus. If the blood is infected, the blood will then not be used for transfusion.
How do I get the virus?
The hepatitis B virus is found in blood, semen, saliva, and other body fluids. A person may get the virus through intimate contact with the body fluids of someone who is already infected.

This can happen when:
  • An infant is born to a mother who is infected with the hepatitis B virus. Most people get the virus when they are babies. Nine out of 10 babies with hepatitis B will still be infected when they are adults.
  • A man or woman has sex with an infected person without using a condom.
  • A person shares injectable needles, razors, or even toothbrushes with an infected person.
  • A person gets a tattoo or has a body part pierced by tools that were used on an infected person and were not properly cleaned and sterilized.
I may have been exposed to the hepatitis B virus. What should I do?
You should see your doctor, who is the only person who can tell whether you have infected with the hepatitis B virus. This is very important. Even if you feel well, you should be evaluated to make sure that you do not eventually get sick and pass the virus on to family members or other people.

How can my doctor tell whether I have hepatitis B?
To make the diagnosis, the doctor will order the blood tests to check for the hepatitis B virus. Sometimes, your doctor will also send you for a liver biopsy. This is a test in which the doctor removes a tiny tissue from your liver with a needle. The doctor will check the sample for the hepatitis B virus and for the degree of liver damage.

If my doctor told me that I have hepatitis B, how can I tell whether my children have it too?
The only way to find out whether your children are infected with the hepatitis B virus is to take them to see your doctor. You cannot tell by checking them for symptoms, since many infected babies and children seem perfectly well, no obvious symptoms or signs.

Is it safe to touch someone who is infected with hepatitis B?
Yes. You can touch and hug someone who is infected without getting the virus.

Is it safe to work with someone who is infected with hepatitis B?
Yes. You cannot become infected simply by being near an infected person, even if you are next to them all day long.

Is it safe to eat meals on the same table?
Yes, as long as you do not use the contaminated cutlery.

Does hepatitis B always make you feel sick?
Some people who are infected feel sick, while other people feel fine. Whether you feel ill depends on how long you have been infected with the virus and on how old you were when you became infected and the degree of liver damage.

People who were first exposed to the virus within the past few months have a condition known as acute hepatitis B. Some people with acute hepatitis , especially babies and children, have no symptoms of the infection. However, other people may experience a number of symptoms for a few weeks.

What are the symptoms of acute hepatitis B?
If you have acute hepatitis B, you may:
  • Feel as if you have the "flu"
  • Feel tired
  • Feel sick to your stomach or have a stomach ache
  • Have diarrhea
  • Have a skin rash
  • Have yellow eyes and skin, a condition known as jaundice
  • Have light-colored stools
  • Have dark yellow urine
Most people with acute hepatitis B feel fine again after a few weeks, and they will never be affected by the hepatitis B virus again. These people have developed immunity, or protection, from the virus.

What is chronic hepatitis B?
Some people do not develop protection or immunity from the hepatitis B virus and remain infected for many months or years. These people develop a condition known as chronic hepatitis B, and the people who have it are known as chronic carriers. Many people with chronic hepatitis B are without symptoms or signs for a long time. But after several years, some may feel increasingly sick and sometimes even die as a result of untreated hepatitis B. If you have chronic hepatitis B, your doctor may want to see you regularly to see how you are doing.

What are the symptoms of chronic hepatitis B?
At first, chronic hepatitis B may involve the same symptoms as acute hepatitis B, such as feeling tired or sick to your stomach. In addition, your muscles and joints may hurt or you may feel weak. These symptoms may last for several weeks or months.

After many years, you may start to feel very ill. You may be sick to your stomach all the time and the right side of your abdomen may hurt. You may also develop a serious condition known as cirrhosis or even hepatoma, which is the cancer of the liver.

People with cirrhosis may have some or all of the following symptoms:
  • Yellow eyes and skin (jaundice)
  • Itching
  • Fluid retention
  • Bleeding in the stomach and esophagus
  • Confusion, lethargy, or coma
  • Redness of the palms of the hands
  • Swollen abdomen
  • Spider-web like radiating branches from small arteries visible on the skin
  • A few people with chronic hepatitis B may eventually develop liver cancer
Both cirrhosis and liver cancer develop only after someone has been infected with the hepatitis B virus for many years. And both cirrhosis and live cancer can be deadly.

Does everyone with chronic hepatitis B get very sick?
No. Most people with chronic hepatitis B are feeling alright. However, some people with chronic hepatitis B will develop serious illness. If you have chronic hepatitis B infection, your doctor may want to treat you before you become sicker.

How is hepatitis B treated?
Fortunately, chronic hepatitis B now can be treated with medicine. They are either oral medications or injectable medications. Nowadays, more oral medications are used.

How do I know which drug is best for me?
The best way to decide which drug to take is to talk with your doctor.

I am pregnant and a chronic hepatitis B carrier. Is there anything I can do to make sure my baby doesn't get sick?
Yes. You should talk to your doctor about making sure your baby gets a series of vaccinations against hepatitis B starting soon after being born. The vaccination will help your baby from getting hepatitis B.

The vaccine is given in three injections. The first injection should be best given within twelve hours after your baby is born. The second injection can be given when your baby is 1 month old, and the third injection when your baby is 6 months old.

It is very important that your baby gets all three injections for the vaccination to work. If you have to miss an appointment, call your doctor or your medical clinic to set up a new one as soon as possible.

Is there anything I can do to make sure that other people do not catch the hepatitis B virus from me?
Yes. Vaccination can protect children and adults from catching the hepatitis B virus. Talk with your doctor about those in your home who need the vaccinations to ensure that they get a series of three injections to protect them from getting the hepatitis B.

There are also some other steps you can take to protect people around you:
  • Don't share your toothbrush, razor, or anything else that could have blood or body fluid on it.
  • Use a condom when you have sex.
The Goals of the BC Hepatitis B Society
The BC Hepatitis B Society is a subsidiary of the Canadian Health Awareness Society. Our goals are:
  • To promote public awareness and public education of hepatitis B
  • To support those who suffer from hepatitis B and their families
  • To share up-to-date information about hepatitis B with other medical professionals and the public
  • To exchange information about hepatitis B with other communities or other part of the world
  • To obtain and monitor the prevalence of hepatitis B in our communities and in whole B.C.
  • To promote universal hepatitis B vaccination in B.C.
The Canadian Health Awareness Society is a registered non-profit organization. Our Mission is to promote health awareness on health issues for all Canadians by education, support and advocacy.