Hepatitis B

Hepatitis B is an infection of the liver caused by a virus.

It is estimated that over 350 million people are infected worldwide (WHO data). In the UK, it is thought that around 1 person in 350 has chronic (persistent) hepatitis B infection. The hepatitis B virus can live outside the body for up to one week.

The illness

The incubation period of acquiring the infection to developing symptoms ranges from 40-160 days. The symptoms tend to be mild and are similar to influenza. Jaundice (yellowing of the skin) can occur as can pain to the upper abdomen. The acute illness usually lasts around 1-3 months with most people clearing the virus from the body.

About 1 in 20 adults will not clear the virus and have persisting infection for life. They are known as chronic carriers and most remain well without symptoms, although they can still pass the virus on to other people. Of those who are chronic carriers, approximately 20% will go on to develop chronic liver disease and cirrhosis (scarring of the liver). 1 in 10 of those that develop cirrhosis will develop liver cancer.
Diagnosis

There are various tests to diagnose hepatitis B. The initial screen is the Hepatitis B surface antigen (outer coat of the virus), which is present from around 3 weeks and is the first marker of infection. Antibody testing and looking at viral levels can be performed if the surface antigen test is positive.

Treatment

There is no specific treatment available for the acute stage of the disease. For people with chronic disease, antiviral drugs can be used to slow down replication of the virus and prevent liver damage from occurring. A liver specialist will determine whether treatment is required.

Sexual intercourse should be avoided until the patient is no longer infectious or their partner has completed the vaccination course.

There is an effective and well tolerated vaccine available for preventing hepatitis B.