Hepatitis B Virus
Hepatitis B infection is a global healthcare problem. Various studies suggest that HBV is more widely transmitted in developing areas like ours.
According to various studies at the international level, it is estimated that more than 350-400 million people in the world have hepatitis B virus in their blood. As a result, more than 500,000 people die each year from hepatitis B-related liver diseases, according to periodic reports from the World Health Organization. Fortunately for them, many types of drugs are available in the western world to treat even chronic hepatitis B, and they are very effective in preventing hepatitis B infection since they can be given regularly to newborns in a safe condition to prevent hepatitis B infection.
How can I get hepatitis B?
There are several ways to get infected with the hepatitis B virus.
1. Contaminated needles; Sharing contaminated needles can spread the hepatitis B virus. This includes tattooing, acupuncture (dry needling), and ear piercing.
2. Sex (Sexual intercourse)
Sexual contact with an infected person is one of the most common ways to get infected with hepatitis B.
3. From mother to child
The Hepatitis B virus can be transmitted from mother to child during delivery or after birth. C-section does not prevent the virus from spreading.
Experts in the field have indicated that breastfeeding is safe.
All pregnant women should have a hepatitis B virus (HBsAg) blood test to prevent mother-to-child transmission. That is, the result should be negative. If the mother is HBsAg-positive, however, she should begin professional follow-up.
3. Close Contact
Hepatitis B can be transmitted through close personal contact. This can happen if blood or other body fluids get into small cracks or get on your skin or in your mouth or eyes.
The virus can live away from the body for a long time. The disease can be spread by sharing household items such as toys, toothbrushes, or razors.
4. Blood Transfusion & Organ Transplantation
Currently, hepatitis B is rarely transmitted through blood donation or organ transplant. (However, this is not common today because the blood or organ that is donated is after a thorough examination. As you have heard recently, around 1970, during blood donation in England, there was an outbreak of this disease, and many people were affected. The British government recently agreed to pay compensation to their families.).
5. In a health facility
In a hospital setting, the hepatitis B virus can be transmitted from one patient to another or from patient to health care worker through an accidental needle stick injury. Doctor-to-patient transmission is rare. Therefore, health professionals use personal protective equipment (PPE) such as gloves, eye protection, face masks, and hand washing to help prevent the virus.
Liver diseases caused by the hepatitis B virus show the following symptoms.
When a person is first infected with hepatitis B, they have symptoms such as fever, abdominal pain, fatigue, loss of appetite, nausea, and in some cases, yellowing of the skin and eyes (jaundice).
To make it easier to see the symbols in detail, we will divide them into two parts.
1. Acute Hepatitis B
A person may develop symptoms of acute hepatitis after first being infected with hepatitis B. Patients with acute hepatitis B virus infection are usually self-limited. However, in 5 percent of adults (1 in 20 people), the virus stays in their liver for a long time; From there, he continued to produce his own copies for many years.
People who continue to catch the virus are called "Carriers".
2. Chronic Hepatitis B (Chronic Hepatitis B)
As a result of long-term HBV infection, the liver virus can develop into chronic hepatitis B infection. Chronic hepatitis B often develops in people infected with the virus at a young age (usually at birth). Unfortunately, this is very common in some parts of the world, especially in sub-Saharan Africa, where studies suggest that 1 in 10 people have chronic hepatitis B infection.
Many people with chronic hepatitis B have no symptoms; Other people have symptoms such as fatigue and loss of appetite and liver inflammation.
There are several tests that can be used to diagnose or monitor hepatitis B infection.
1. Hepatitis B surface antigen (HBsAg) is a protein molecule on the hepatitis B virus that can be seen in the blood 1 to 10 weeks after exposure to the hepatitis B virus and even before symptoms of infection begin to appear in a person. In people who have recovered from the virus, this is usually 4 It will disappear after up to 6 months.
The continuous presence of HBsAg indicates chronic infection (chronic hepatitis).
2. Hepatitis B surface antibody (anti-HBs)
Anti-HB antibody helps the immune system to attack the hepatitis B virus. This protein molecule is usually found in people who have recovered or been vaccinated against hepatitis B. People with this protein are usually immune to hepatitis B.
3. Hepatitis B core antibody (anti-HBc) - It is usually found during the transmission of the disease and remains in the blood after recovery. It is not found in people who have been vaccinated against hepatitis B.
4. Hepatitis B e antigen (HBeAg) - The presence of this protein molecule shows that the hepatitis B virus continues to replicate itself. The presence of this factor usually indicates that a large amount of the virus is circulating in the blood, indicating a high probability of infection and transmission.
5. Hepatitis B e antibody (anti-HBe) - usually shows that the replication of the virus has slowed down, but in some types of hepatitis B virus, if the virus continues to multiply rapidly, a large amount of virus can be found.
6. Hepatitis B DNA (HBV DNA) - is the viral genetic information found in the hepatitis B virus.
HBV DNA usually disappears from the blood after a person recovers.
HBV DNA (viral load) is a measure of the amount of virus in the bloodstream.
Doctors use HBV DNA levels to determine who should give patients antiviral drugs and to monitor how well treatment is working.
Other Tests - Although there are many other types of tests that reflect the health status of the liver, they are not specific to the hepatitis B virus.
These tests measure liver enzymes such as [ALT, AST, ALP], bilirubin level, albumin level, prothrombin time, and platelet count. They work together as they may have warning signs of liver damage.
Liver biopsy to diagnose hepatitis B virus infection
A liver biopsy is used to monitor liver damage in people with chronic hepatitis, to determine the need for treatment, and to find signs of cirrhosis or liver cancer.
Should everyone be treated?
Specific treatment for acute hepatitis B virus disease is usually not required. Because in 95 percent of adult diseases, the natural immune system controls the infection and eliminates the virus within six months.
In people with chronic hepatitis, antiviral medication may be recommended to reduce or reverse liver damage and prevent long-term complications of hepatitis B.
If you don't need to start treatment right away, you will be monitored over time to see when hepatitis B becomes more active (then you can start antiviral treatment).
After you start treatment, you will have regular blood tests to see how well the treatment is working and to detect any side effects or drug resistance.
Monitoring will continue after treatment to determine if the infection has returned. Do not stop treatment without discussing this with your doctor. Because in some cases, the virus can quickly come back and cause serious damage to the liver.
A. Antiviral Medications - There are two types of antiviral medications that your doctor may prescribe if you need treatment.
1. There are many drugs called Nucleotides (nucleotide) analogs, and these are mostly used as part of drugs that are taken daily.
2. Interferon - This is an injectable drug, but your doctor will discuss these options with you.
B. Liver Transplantation - Liver transplantation may be the only option for people with severe cirrhosis.
Because it involves an extensive screening process to make sure someone is a good candidate for this treatment, due to the complexity of the condition and the lack of donors, not all patients, even those on the transplant waiting list, receive a liver transplant. )
All acute and chronic types of hepatitis B virus are contagious, so having close contact with people who have hepatitis B virus increases the risk of infection.
The following measures should be taken to reduce exposure to hepatitis virus.
It can be transmitted through any sexual contact, so stop loose contact. If not, use a condom.
Do not share razors, toothbrushes, or anything that has blood on it.
Do not touch open wounds carelessly: Cover wounds with bandages.
Do not touch blood, body parts, other tissues or other body fluids without wearing protective gear.
If a close family member has this disease, other members should also be tested for hepatitis B.
Anyone can get a hepatitis B infection. The good thing is that there is a vaccine for this disease that is very effective if taken correctly.
Do not share any injection drug equipment.
Studies suggest that hepatitis B is rarely transmitted in the following ways:
Hug or kiss
Sharing eating utensils or cups
Sneezing or coughing
by breastfeeding
Prevention of mother-to-child infection- If a mother tests positive for hepatitis B (HBsAg) during pregnancy, various measures can be taken to reduce the risk of transmission of the virus to the baby.
Among them:
Antiviral drugs can be prescribed to the mother if the viral load in her blood is high.
Babies should be given the hepatitis B immunoglobulin (HBIG) vaccine soon after birth.
HBIG provides immediate protection to the baby, but the effect lasts only for a few months, so babies should receive hepatitis B vaccination series. The first booster hepatitis B vaccine should be given at birth, but other vaccines can be given along with regular childhood vaccinations. Completing all vaccinations is important for long-term protection. These children should be screened for hepatitis B again between 9 and 12 months of age, or one to two months after the last hepatitis B vaccine if vaccination is delayed. If the test results show that the child is still susceptible to the disease, additional vaccinations may be given.
Note:- As we learned above, we revealed that there are five main types of hepatitis; However, even if we plan to write about them separately in terms of their different profiles, we will conclude by saying only a few about the remaining viruses, saying that you should not get bored.
1. One of the liver viruses we have seen above is called Hepatitis D (HDV). HDV - As the parasite is known as liver virus and everything can't stop without HBV, the channels, the defense mechanisms, the complications it causes, and other issues are all grouped together under HBV.
2. Another evil virus is the hepatitis C virus (HCV), which has characteristics similar to HBV, but usually causes chronic liver disease. Although there is an effective cure for this virus, there is no vaccine available yet.
3. The fifth and remaining hepatitis E virus (HEV) is most similar to hepatitis A virus (HAV). This type of virus rarely causes anything serious unless it happens to a pregnant woman. For this reason, we recommend that pregnant mothers take hygiene precautions as the passageways are similar to the HAV virus.
As discussed above, most people who get acute hepatitis B virus clear the infection right away. However, people with chronic infections should discuss their options with their medical professionals.
1. Vaccines - All people with chronic hepatitis B should receive a variety of immune booster vaccines to build up their immune system.
2. Liver Cancer Screening — Regular screening for liver cancer is also recommended.
Specifically:
- Elderly individuals,
- For those who have cirrhosis of the liver and
- For patients with a family history of liver cancer.
In general, this examination includes an ultrasound examination of the liver every six months.
3. Diet - A specific diet strategy to improve outcomes in hepatitis B patients has not yet been identified.
In any case, the best advice of all is to eat a balanced diet and maintain a healthy weight.
4. Alcohol - Alcohol can aggravate liver damage and should be avoided.
All types of alcohol can be harmful to the liver.
5. Exercise
Although physical activity has no specific effect on the hepatitis B virus, it is good for general health and is encouraged.
Exercise is not harmful to the liver, even in people with chronic hepatitis or cirrhosis.
6. Regarding prescription and non-prescription drugs
Because many medications have their own effects on liver health, it is very important to always consult your doctor or pharmacist before starting a new medication.
Generally speaking, unless the liver is already cirrhotic, most drugs taken by people with hepatitis B do not cause serious side effects.
If you have cirrhosis, however, you should avoid using over-the-counter pain relievers such as ibuprofen, paracetamol, and even aspirin at your own discretion.
Finally, remember:-
Herbal and other traditional medicines (Traditional herbal medicines) and liver disease:
No herbal or other traditional treatment methods used to treat or improve the outcome of patients infected with hepatitis B virus have been well proven.
Instead, some of them can cause severe liver toxicity.
In summary, herbal and other traditional treatments are not recommended for people with the liver disease based on the information we have so far.
Sometimes viral diseases improve on their own time, so people think they have understood these things and promote many things; However, as we will see in future studies, there is nothing convincing, so please don't use them so as not to damage your liver even more!
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