Hepatitis B

Hepatitis B is caused by Hepatitis B virus.

Hepatitis B virus is found in blood of infected persons.

It is spread by:

1. Sexual contact with an infected person.
2. from a pregnant woman to her child during delivery.
3. transfusion of infected blood and blood products (in Malta blood is screened prior to transfusion for various diseases including Hepatitis B).
4. Sharing of contaminated needles between drug addicts, tattooists or acupuncturists.
5. Percutaneous exposure (when infected body fluids gain entry via inoculation, breaks in skin or by contact with mucous membrane).

Reservoir

Humans

Incubation period

Usually 45-180 days, average 60-90 days. As short as 2 weeks to the appearance of HbsAg, and rarely as long as 6-9 months; the variation is related in part to the amount of virus in the inoculum, the mode of transmission and host factors.

Signs and Symptoms

• Loss of appetite
• Vomiting
• Fever,
• Joint Pain
• Nausea
• Abdominal Pain
• Jaundice (yellowish colour on the skin and eyeballs)

Diagnosis

Blood tests for Acute Hepatitis B:

1. IgM core antibody (anti-HBc IgM) detected in serum usually indicates recent infection.
2. Clinical illness consistent with acute viral hepatitis (jaundice, elevated serum transaminase (a liver enzyme) levels).

Chronic carriers and chronic hepatitis B:

1. Negative anti-HBc IgM.
2. Positive anti-HBc IgG or positive anti-HBc total.
3. No clinical illness consistent with acute viral hepatitis.
4. Presence of HBe antigen (HbeAg) indicates high infectivity of blood and body fluids.

Treatment

No specific medical treatment.

Control and Prevention

Educate patient and family members on disease, possible mode of transmission.

Emphasis on transmission to sexual partners, educate on personal hygiene, hand washing, patient to keep their own belongings. Use of condoms in sexual intercourse, care of open wounds. Toilet facilities can be shared as long as hygiene and cleanliness is observed. Follow up of family members is important and contacts are encouraged to have their blood tested for the presence of HbsAg and to be vaccinated if negative.

Pre-exposure vaccination is recommended for:

1. Health care workers.
2. Household members.
3. Vaccination according to Child Immunisation Schedule.