Disease Fact Sheet Series:
Hepatitis B (formerly known as serum hepatitis) is a liver disease
caused by the hepatitis B virus (HBV). The disease is fairly common; about
50 acute cases and 600 chronic/unspecified cases are reported in Wisconsin
each year.
Who is most likely to get hepatitis B?
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Injection drug users
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Healthcare workers
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Men who have sex with men
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Heterosexuals with multiple partners
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Hemodialysis patients
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Sexual / household contacts of infected people
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Infants born to infected mothers
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Infants / children of immigrants from HBV-endemic
countries
How is the virus spread?
HBV is spread by contact with blood, serum, semen,
vaginal fluids and, rarely, saliva. Direct contact with infected body
fluids; usually by needle stick injury, sharing needles, or sexual
contact, is necessary for spread. HBV is not spread by casual contact
or by respiratory droplets.
What are the signs and symptoms of hepatitis B?
The signs and symptoms of hepatitis B include fatigue,
poor appetite, nausea, vomiting, abdominal discomfort and sometimes
joint pain or rash. Later, urine may become dark and jaundice (a
yellowing of the skin and whites of the eyes) may appear. Many people
do not have typical signs and symptoms of hepatitis; only 10% of
children and 30-50% of adults develop jaundice.
When do symptoms appear?
Symptoms usually appear 2-3 months after exposure
(range: 1½-6 months).
How long can a person spread the virus?
HBV is present in blood and other body fluids several
weeks before symptoms appear and usually persists for about 3 months.
However, the likelihood of complete recovery with elimination of the virus
from the body depends on the age when infection occurs.
Chronic infection occurs in 80-90% of infants infected
during the first year of life, in 30-50% of children infected between 1-4
years of age and in 5-10% of people infected after 6 years of age. People
with chronic hepatitis B may infect others and 15- 25% may die prematurely
of either cirrhosis or liver cancer.
What is the treatment for hepatitis B?
Hepatitis B infected persons should be evaluated by their doctor for
liver disease. There are no medications available for recently
acquired (acute) HBV infection. Hepatitis B vaccine is available for
the prevention of HBV infection. There are antiviral drugs available
for the treatment of chronic HBV infection. Currently five drugs are
used for the treatment of persons with chronic hepatitis B. These
drugs include adefovir dipivoxil, interferon alfa-2b, pegylated
interferon alfa 2-a, lamivudine and entecavir. Additional anti-virals
are under development.
What precautions should a person with acute or
chronic hepatitis B take?
The person should follow standard hygienic practices to protect close
contacts from blood and other body fluids. The infected person must
not share razors, toothbrushes, needles, or any other object that may
have become contaminated with blood. Use of latex condoms during
sexual activity may reduce transmission of HBV among homosexuals and
heterosexuals. The infected person must not donate blood and should
inform dental and medical care providers so that proper precautions
can be followed.
How can hepatitis B be prevented?
Hepatitis B can be prevented either before or right after exposure to
the virus. To prevent disease before exposure, hepatitis B vaccine is
recommended for all infants and children <19 years of age, people
in high risk occupations (e.g., healthcare workers) and people with a
high risk behavior (e.g., injection drug use or multiple sexual
partners). Susceptible sexual and household contacts of people with
chronic hepatitis B should also be immunized and the sexual partners
should be tested for immunity after they complete the 3-dose series.
To prevent disease after exposure, hepatitis B immune
globulin (HBIG) is given along with hepatitis B vaccine.
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Infants of infected mothers. Because these infants are
exposed to the virus during labor and delivery, all pregnant women
should be screened for hepatitis B prenatal. Infants of women who
test positive should receive HBIG and the first dose of hepatitis B
vaccine within 12 hours of birth. The infant should receive the
remaining doses of hepatitis B vaccine at 1-2 months and 6 months of
age.
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Sex partners of a person with acute hepatitis B should
be given HBIG within 2 weeks of the last sexual contact.
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Household contacts of a person with acute hepatitis B
do not need HBIG unless they have had a blood exposure to the case
within the past 2 weeks. Questions about preventing hepatitis B after
other types of exposures should be directed to your physician or local
health department.
For more information, contact your
Local
Public Health Department
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Last Revised: March 20, 2008
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