Hepatitis B Support Group

Originally known as serum hepatitis, hepatitis B has only been recognized as such since World War II, and has caused current epidemics in parts of Asia and Africa. Hepatitis B is recognized as endemic in China and various other parts of Asia. Over one-third of the world's population has been or is actively infected by hepatitis B virus (HBV).

Hepatitis B virus infection may either be acute (self-limited) or chronic (long-standing). Persons with self-limited infection clear the infection spontaneously within weeks to months.

The greater a person's age at the time of infection, the greater the chance their body will clear the infection. More than 95% of people who become infected as adults or older children will stage a full recovery and develop protective immunity to the virus. However, only 5% of new-borns that acquire the infection from their mother at birth will clear the infection. Of those infected between the age of one to six, 70% will clear the infection. When the infection is not cleared, one becomes a chronic carrier of the virus.

Acute infection with hepatitis B virus is associated with acute viral hepatitis -- an illness that begins with general ill-health, loss of appetite, nausea, vomiting, bodyaches, mild fever, and then progresses to development of jaundice. The illness lasts for a few weeks and then gradually improves in most of the affected people. A few patients may have more severe liver disease (fulminant hepatic failure), and may die as a result of it. The infection may also be entirely asymptomatic and may go unrecognized.

Chronic infection with hepatitis B virus may be either asymptomatic or may be associated with a chronic inflammation of the liver (chronic hepatitis), leading to cirrhosis over a period of several years. This type of infection dramatically increases the incidence of liver cancer.

Hepatitis D infection requires a concomitant infection with hepatitis B. Co-infection with hepatitis D increases the risk of liver cirrhosis and subsequently, liver cancer.

There are currently several treatments for chronic hepatitis B that can increase a person's chance of clearing the infection. Treatments are available in the form of antivirals such as lamivudine and adefovir and immune system modulators such as interferon alpha. There are several other antivirals under investigation. Roughly, all of the currently available treatments, when used alone, are about equally efficacious. However, some individuals are much more likely to respond than others. It does not appear that combination therapy offers any advantages.[6] In general, each works by reducing the viral load by several orders of magnitude thus helping a body's immune system clear the infection. Treatment strategies should be individualized by a doctor and patient. Considerations include the risks associated with each treatment, a person's likelihood of clearing the virus with treatment, a person's risk for developing complications of persistent infection, and development of viral resistance with some of the treatments.

On March 29, 2005, the US Food and Drug Administration (FDA) approved Entecavir for the treatment of hepatitis B.

On February 25, 2005, the EU Commission approved PEGASYS for the treatment of hepatitis B making it the first pegylated interferon to be approved for hepatitis B.

Chronic carriers should be strongly encouraged to avoid consuming alcohol as it increases their risk for cirrhosis and hepatocellular carcinoma (liver cancer).

Infants born to mothers known to carry hepatitis B can be treated with antibodies to the hepatitis B virus (hepatitis B immune globulin or HBIg). When given with the vaccine within twelve hours of birth, the risk of acquiring hepatitis B is reduced 95%. This treatment also allows a mother to safely breastfeed her child.

An individual exposed to the virus who has never been vaccinated may be treated with HBIg immediately following the exposure. For instance, a health care worker accidentally stuck by a needle used in a hepatitis B carrier would qualify. Treatment must be soon after exposure, however.