Hepatitis B

What is Hepatitis B?

This is another form of hepatitis, and many believe it may be similar to hepatitis A, but in a more prolonged form. This also is caused by a virus, but instead of the virus having been discovered, the antigen has been isolated. If this is discovered in the blood, it is presumptive evidence that the virus is there also. This is referred to as the hepatitis B surface antigen, or HBsAg for short. The antigen has a surface component and a central core, and the surface portion is involved with hepatitis B.

It is of interest to note that this was first discovered in an Australian Aborigine. For some years it was referred to as the Australian Antigen or AuAg. However, the name was later changed. For many years hepatitis B was known and referred to as serum hepatitis, for it occurred when infected needles from a hepatitis patient (usually unrecognized) transmitted it to others not suffering from the disorder. It was also transmitted in blood transfusions. Today, stringent screening measures arc used on blood from recipients to rule out this possibility. However, it seems the HBsAg is present in a large number of fluids and secretions in those affected. It may be transmitted by contact with these, although this is not fully understood.

Besides being in the blood, it may be present in saliva, breast milk, urine, vaginal secretions, seminal fluid. It is common in prostitutes, and this seems a common way of it being disseminated. The exact role of kissing, sexual intercourse and breastfeeding is not fully known, but there would appear to be inherent risks.

Hepatitis B Causes

Tattooing, ear-piercing and the use of unsterile needles by drug addicts (or indeed by anyone having regular injections) are other common methods of spread, for good hygiene may be lacking. The use-once disposable needles are recommended and usually used for all injections today.

Ear-piercing should be done using totally sterile equipment, and this is now readily available. Tattooing in any form should be banned. In certain Australian states it is illegal for those under a certain age, and this is as it should be.

Hepatitis B is much more common in dental surgeons, probably due to their close contact with saliva in many patients, including those who are infected. It has been a wide problem in hemodialysis units in major hospitals and where open-heart surgery is carried out, for large volumes of blood arc used, and it has been easy for the virus to be involved.

However, with major screening processes and very sensitive radio-immunoassay tests for picking the HBsAg, it has now largely been eliminated in many major hospitals, particularly in the UK, which has an amazing record for having almost conquered the disease in its larger units. Hepatitis B is a serious disease, for it may come on six to 12 months or even longer after initial exposure. It runs a chronic prolonged course. The mortality rate in some series has been given as 10 – 20 per cent, which is extremely high, and a marked variation from the almost always innocuous hepatitis A.

Diagnosis usually depends on HBsAg being detected in the blood, for this is conclusive. Other tests similar to those for hepatitis A may also be carried out. Hepatitis B is closely related to HIV, the virus responsible for AIDS. In fact, the two diseases are transmitted in almost exactly the same way, and many patients suffer from both diseases. It is much more common in homosexual couples, and the greater the number of partners, the higher the risk. It is commonly transmitted by the use of infected needles, which usually means it is related to the use of illicit drugs. It is present in the heterosexual community; but more commonly when one partner is bisexual (i.e. has relations with both male and female partners). It is also present in the prostitute community; where many partners, requiring a variety of sexual practices, are encountered. Transmissions by infected blood products, infected instruments, and anal intercourse, seem to be common ways in which the germ is transmitted. People living a normal heterosexual life, or with one stable non-infected partner, have little to fear of contracting hepatitis B.

The risks of acquiring it from blood medicinal products or blood transfusions today are minimal. Strict screening measures are now widely used, and any potentially infected blood is discarded, and the donor usually followed up for treatment.

Hepatitis B Treatment

Hepatitis B vaccination, consisting of three injections (now, then one month, six months), gives excellent protection, and lasts at least five years, when a booster may be required. Treatment is with interferon, but other drugs will inevitably be developed. Contacts may gain some protection with hepatitis B immunoglobulin injection. Avoidance of the virus is the simplest and best advice. Commonsense is essential.