Hepatitis B

Causes

Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from person to person through blood, semen or other body fluids. It does not spread by sneezing or coughing.

Common ways that HBV can spread are:

•  Sexual contact. You may get hepatitis B if you have unprotected sex with someone who is infected. The virus can pass to you if the person’s blood, saliva, semen or vaginal secretions
  enter your body.
• Sharing of needles. HBV easily spreads through needles and syringes contaminated with infected blood.
•  Accidental needle sticks. Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.
•  Mother to child. Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated to avoid getting infected in almost all cases.

Symptoms and Signs

Symptoms of chronic hepatitis B vary depending on the degree of underlying liver damage.

Many patients, particularly children, are asymptomatic. However, malaise, anorexia, and fatigue are common. Jaundice is usually absent.

Often, the first findings are

Signs of chronic liver disease or portal hypertension (eg, splenomegaly, spider nevi, palmar erythema) Complications of cirrhosis (eg, portal hypertension, ascites, encephalopathy)
A few patients with chronic hepatitis develop manifestations of cholestasis (eg, jaundice, pruritus, pale stools, steatorrhea). Extrahepatic manifestations may include polyarteritis nodosa and glomerular disease.

Diagnosis

• Serologic testing
• Liver biopsy

Treatment

• First-line treatment is usually with an oral antiviral drug, such as entecavir (a nucleoside analog) or tenofovir (a nucleotide analog)
• Liver transplantation should be considered for end-stage liver disease caused by HBV.t