Hepatitis B is a notifiable inflammation of the liver caused by a viral infection that can be manifested by upper abdominal pain, a characteristic yellowing of the skin, poor performance, tiredness, nausea, vomiting or diarrhea. The liver can enlarge and react painfully to pressure impulses.
What is hepatitis B?
In most cases, hepatitis B is not recognized as such immediately after the first symptoms appear. When making a diagnosis, a distinction must also be made as to whether hepatitis B is chronic or acute and how far the inflammation has progressed or has healed.
90% of those infected suffer from an acute infection with hepatitis B, which heals and can be overcome within six months, 10% of the cases of the disease are chronic and can either develop from a previous acute infection with hepatitis B or right at the beginning. In this case, the disease lasts for a period of six months.
The younger a patient infected with hepatitis B, the greater the risk that the disease will become chronic.
According to abbreviationfinder, Hepatitis B is many times more contagious than the AIDS pathogen HIV. It can be transmitted when open skin or body openings come into contact with bodily fluids such as blood or saliva from someone who is already infected. A large number of hepatitis B infections are transmitted through sexual intercourse.
Even a small amount of body fluid contaminated by the virus carries a high risk of infection.
Globally, it has been assumed that around five to seven percent of people are chronically infected with hepatitis B, with newborns being able to contract hepatitis B from their mother at birth and likely to suffer a chronic course of the disease due to their young age.
Symptoms, Ailments & Signs
The symptoms of hepatitis B infection are not clearly defined in the majority of cases. The majority of those who are ill – that is around two thirds – either have no symptoms at all or have a vague feeling of being ill.
After an incubation period of around two to four months, symptoms such as tiredness, joint pain, headaches, loss of appetite, weight loss or muscle problems appear. Many patients complain of fever. A more obvious sign of hepatitis B infection is a feeling of pressure in the upper right abdomen.
Only about a third of those infected develop jaundice symptoms after the onset of hepatitis B. In these cases, the urine turns dark to very dark. The stool, on the other hand, takes on a light color. However, the most obvious sign is yellowing of the skin and whites of the eyes.
Only in very rare, particularly severe cases does hepatitis B take on a particularly severe course of the disease. Then the liver is so badly damaged by the infection that liver failure occurs and the patient falls into a coma. In chronic forms of hepatitis B, which are also rare, the liver values are permanently elevated, which can lead to bleeding in the throat area, among other things.
Hepatitis B has a relatively long incubation period of at least one and up to six months after transmission of the virus pathogen. Hepatitis B disease may have the symptoms described above, but in some cases the disease is acute without any specific symptoms.
If the disease is acute, it will heal on its own after a period of no more than six months; if it is chronic, the symptoms persist over this period and it is referred to as chronic hepatitis B. This can be diagnosed if there is no improvement in the symptoms after the six-month period Symptoms, healing or the formation of antibodies against recurrence of hepatitis B can be detected.
In some cases, chronic hepatitis B can cause liver cirrhosis or other serious liver diseases such as cancer, in which case the liver tissue is attacked and destroyed over the long term.
Hepatitis B can, but does not have to, heal spontaneously. In some cases, approximately five percent of cases with hepatitis B develop chronic hepatitis, which can lead to cirrhosis of the liver. The probability of developing liver cirrhosis is also increased if an additional infection with the hepatitis D virus takes place.
This leads to a more than 90 percent probability of a severe course of the disease. Liver cirrhosis caused by the hepatitis B virus increases the risk of developing liver cancer more than 100-fold. Life expectancy is severely reduced.
In cirrhosis of the liver, all of the liver’s functions fail, including the liver’s synthesis function and its detoxification function. As a result, the necessary proteins for the blood are no longer produced, so that no oncotic pressure can build up, which results in edema. The coagulation proteins are also missing, and the bleeding time is prolonged.
Furthermore, due to the lack of detoxification, the ammonia is no longer properly broken down, which can enter the brain and thus lead to a life-threatening hepatic encephalopathy. The virus is also dangerous for expectant mothers, as the pathogen can be transmitted to the child. There is a high probability that this will lead to chronic hepatitis in the child.
When should you go to the doctor?
If you have hepatitis B, you need to see a doctor or go to a hospital immediately. This can prevent further infection. Early diagnosis usually has a very positive effect on the course of the disease. A doctor should be consulted if the person suffers from jaundice. This is the main symptom of the disease. Jaundice is also accompanied by high fever and severe weakness and fatigue.
A doctor should also be informed if the person has been in an area affected by hepatitis B in the last few months, as the incubation period is at least one month. Furthermore, weight loss also indicates hepatitis B and must be examined by a doctor.
In the worst case, the disease can lead to the death of the person affected or cause cancer. The treatment and examination takes place in a hospital. Since the disease cannot be completely cured, those affected are dependent on long-term therapy.
Treatment & Therapy
In its acute form, hepatitis B usually does not need to be treated with medication and heals on its own after a period of up to six months. If acute hepatitis B disease poses a long-term risk of damage to the liver, a liver transplant may be necessary in rare cases.
Chronic hepatitis B disease can be treated either by boosting the immune system with weekly injections of interferons, or by taking nucleoside tablets daily to stop the virus from multiplying in the body.
Both forms of therapy cannot cure chronic hepatitis B, but they can counteract many long-term effects and symptoms. Only in rare cases is the body’s own immune function reactivated in such a way that it can initiate a late healing of chronic hepatitis B.
Outlook & Forecast
Most patients with hepatitis B have a good prognosis. In over ninety percent of those affected, early diagnosis and rapid initiation of therapy result in a favorable course of the disease and recovery. After a few weeks of medical care, the disease usually heals completely and without further sequelae.
The probability of a chronic progression of the disease is given with hepatitis B. Complications and other illnesses occur in up to ten percent of patients. After about ten years, cirrhosis of the liver and liver cancer are possible diseases that contribute to a worsening of the favorable prognosis.
Shrinkage liver is diagnosed in about twenty percent of cases. The patient is in a life-threatening condition. Often only an organ transplant can help to alleviate the symptoms and the consequences of death.
Without medical treatment, the risk of a chronic course of the disease is very likely. If children are born with hepatitis B or become infected at birth, chronic liver inflammation develops in almost all patients. In very rare cases, an infection with hepatitis D occurs in addition to hepatitis B. This increases the likelihood of severe disease and liver failure.
Preventing hepatitis B is possible with a vaccine, the administration of which is now part of the standard vaccinations that are recommended for infancy and early childhood and prevent infection with hepatitis B.
If you have been vaccinated in childhood, the immune protection against hepatitis B pathogens lasts into adulthood, if you are only vaccinated at an advanced age, three injections are required to ensure long-lasting protection of up to ten years.
In addition to vaccination protection, appropriate contraception can also be an important factor in preventing possible infection with hepatitis B during sexual intercourse and in protecting yourself and others from transmission.
One of the aims of follow-up care is to prevent hepatitis B from recurring. Patients generally achieve this through vaccination. After an initial infection, no further treatment is usually necessary. Because 90 percent of those affected heal hepatitis B completely. Some patients do not even notice the disease. The prognosis is therefore extremely favourable.
The situation is different for adults with a weakened immune system and children. In almost all cases, the disease takes on a chronic course. This requires constant treatment. Medical support aims to enable those affected to lead a symptom-free life. Medications are to be taken daily. They lower the amount of virus in the blood. This reduces the risk of liver cirrhosis or liver cancer.
The doctor treating you arranges regular check-ups in which blood is drawn. The test allows conclusions to be drawn from direct and indirect evidence. An ultrasound scan and biopsy may also be ordered. The structure of the liver can be determined as part of the imaging procedure. Liver biopsy records the extent of tissue damage. Doctors can thus clearly document the progression of the hepatitis B disease.
You can do that yourself
Hepatitis B can be effectively treated with prompt medical examination. In addition to medical treatment, those affected should inform friends and family members to reduce the risk of infection. Immediate vaccination reduces the risk of spread and often also counteracts possible late effects of the virus infection.
In the case of liver problems, it is advisable to drink a lot and use liver wraps. An effective natural remedy is the milk thistle cure, in which appropriate capsules are taken regularly or milk thistle tea is drunk.
Dandelion, tormentil, burnet, wormwood and club moss are also said to have a soothing effect. Acute pain can be counteracted with dark chocolate and foods that contain a lot of bitter substances. An effective acupressure grip for the liver: place fingers together and rub palms until hot.
A chronic hepatitis B disease can be treated independently by strengthening the immune system. Regular exercise and a healthy, balanced diet can effectively counteract the symptoms and long-term effects, but cannot completely cure the disease itself. This is why medical treatment is always required, which complements the self-measures mentioned and enables those affected to live a symptom-free life with the disease.