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Hepatitis B
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What is Hepatitis B ?
 Hepatitis B is a contagious liver disease that results
from infection with the Hepatitis B virus.
 Hepatitis B is a stealthy virus that can cause severe
liver damage.
There is no cure, but drugs can keep the virus in
check.
Source CDC, 2011 and medecinenet.com
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 The incubation period from the time of exposure to
onset of symptoms is 6 weeks to 6 months.
 HBV is found in highest concentrations in blood and
in lower concentrations in other body fluids (e.g.,
semen, vaginal secretions, and wound exudates).
 It spreads through contact with blood and other body
fluids.
Source CDC, 2011 and medecinenet.com
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Source: medecinenet.com
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Symptoms and Pathogenesis
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 Incubation period: 45 to 160 days (average: 120 days)
 Among persons with chronic HBV infection, the risk
for premature death from cirrhosis or hepato-cellular
carcinoma is 15%–25%.
 Chronic Hepatitis B virus infection is a long-term
illness that occurs when the Hepatitis B virus remains in
a person’s body.
Source CDC, 2011 and medecinenet.com
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 Hepatitis B can be either “acute” or “chronic.”
 Acute Hepatitis B virus infection is a short-term illness
that occurs within the first 6 months after someone is
exposed to the Hepatitis B virus. Acute infection can (but
does not always) to chronic infection.
 Chronic Hepatitis B virus infection is a long-term illness
that occurs when the Hepatitis B virus remains in a
person’s body.
Source CDC, 2011 and medecinenet.com
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Symptoms of acute Hepatitis B, if they appear, can include:
 Fever
 Fatigue
 Loss of appetite
 Nausea
 Vomiting
 Abdominal pain
 Dark urine
 Clay-colored bowel movements
 Joint pain
Source CDC, 2011 and medecinenet.com
 Jaundice (yellow color in the skin or the eyes)
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 Chronic infection can lead to liver cirrhosis and liver
cancer.
 Many people have no symptoms for years.
 Chronic Hepatitis B is a serious disease that can
result in long-term health problems, including liver
damage, liver failure, liver cancer, or even death.
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Source : DermNetNZ.org
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Source: CDC
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Epidemiology
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 About 2 billion people worldwide infected with the virus
 About 350 million worldwide live with chronic infection.
 An estimated 600,000 persons die each year due to the
acute or chronic consequences of hepatitis B.
 About 25% of adults who become chronically infected
during childhood later die from liver cancer or cirrhosis
caused by the chronic infection.
Source WHO
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 Estimated 43,000 new infections in 2007
 Estimated 1.2 million people with chronic HBV
infection
 Estimated 3,000 persons in the United States die
from HBV-related illness per year.
 Approximately 2,000–4,000 people die every year
Source CDC, 2011 and medecinenet.com
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*Adjusted for underreporting.
Source: National Notifiable Diseases Surveillance System (NNDSS)
Source: National Notifiable Diseases Surveillance System (NNDSS)
239
Injection-drug use
1854
42
Men who have
sex with men¶
182
875
925
284
Multiple
sex partners
0
*A total of 3,371 case reports of hepatitis B were received in 2009.
† More than one risk behavior may be indicated on each case report.
§ No risk data reported.
¶A total of 2,038 hepatitis B cases were reported among males in 2009.
Source: National Notifiable Diseases Surveillance System (NNDSS)
§
1814
18
Household
contact
No
Missing
68
Sexual
contact
Yes
1,278
609
500
2428
2428
2478
1000
1500
Number of cases
2000
2500
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Risk factors
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 HBV is efficiently transmitted by percutaneous or
mucous membrane exposure to infectious blood or
body fluids that contain blood.
 The primary risk factors that have been associated
with infection among adolescents and adults are
unprotected sex with an infected partner, unprotected
sex with more than one partner, MSM, history of other
STDs, and illegal injecting-drug use.
Source CDC, 2011 and medecinenet.com
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 People can become infected with the virus during activities like:
 Birth (spread from an infected mother to her baby during
birth)
 Sex with an infected partner
 Sharing needles, syringes, or other drug-injection
equipment
 Sharing items such as razors or toothbrushes with an
infected person
 Direct contact with the blood or open sores of an infected
person
 Exposure to blood from needlesticks or other sharp
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 Populations at increased risk of HBV infection:
 Infants born to infected mothers
 Sex partners of infected persons
Sexually active persons not in a long-term, mutually monogamous
relationship
 Men who have sex with men
 Injection drug users
 Household contacts of persons with chronic HBV infection
 Healthcare and public safety workers at risk for occupational exposure
to blood or blood-contaminated body fluids
 Hemodialysis patients
 Residents and staff of facilities for developmentally disabled
 Travelers to countries with intermediate or high prevalence of HBV
Source CDC, 2011 and medecinenet.com
infection
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Prevention
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 The best way to prevent Hepatitis B is by getting vaccinated.
 Prevent perinatal HBV transmission
 Routine vaccination of all infants
 Vaccination of children in high-risk groups
 Vaccination of adolescents
 All children up through age 18
 Vaccination of adults in high-risk groups
Source CDC, 2011 and medecinenet.com
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 All children should get their first dose of Hepatitis B
vaccine at birth and complete the vaccine series by 6–
18 months of age.
 All children and adolescents younger than 19 years
of age who have not yet gotten the vaccine should also
be vaccinated. "Catch-up" vaccination is recommended
for children and adolescents who were never vaccinated
or who did not get the entire vaccine series.
Source CDC, 2011 and medecinenet.com
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 Infants and children: 3 to 4 doses given over a 6- to
18-month period depending on vaccine type and
schedule
 Adults: 3 doses given over a 6-month period
Source CDC, 2011
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Treatment
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 No specific therapy is available for persons with
acute hepatitis B; treatment is supportive.
 Persons with chronic HBV infection should be
referred for evaluation to a physician experienced in the
management of CLD.
Source CDC, 2011 and medecinenet.com
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Comparison between HIV and HBV
HIV
HBV
Transmission
Sex, bloody fluid
Sex, blood ,body fluids
Pathogen
Virus
Risks factors
Unprotected sex,
multiple partners,
other STDs, injectingdrug use, MSM
Treatment
No treatment but
medications slow
down destruction of
the immune system
Vaccine
No vaccine
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Virus
Unprotected sex,
multiple partners,
other STDs, injectingdrug use, MSM
No treatment
Very efficient vaccine
TRANSMISSION
HIV
HBV
Cuts or breaks in the skin
Yes
Yes
Breast milk
Injections or needle stick
No style
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Yes
Yes
Deep kissing
No
No
Sex
Yes
Yes
Breathing in droplets
No
No
Blood transfusion
Yes
Yes
Saliva
No
No
Dry blood (1week old)
No
Yes
Birth to an infected mother
Yes
Yes
Sharing items such as razors
or toothbrushes with infected
Yes
Yes