Hepatitis B Pathogenesis and Treatment

Introduction

Hepatitis B is a common infectious disease that affects over 350 million people worldwide. The disease results in approximately one million deaths annually, making it the 10th leading cause of death worldwide. The deaths occur since the disease causes inflammation on the liver which results in cirrhosis and liver failure. Because HBV is a very common infection in the general population, this paper will set out to conduct concise yet informative research on the disease. The paper will begin by providing a brief history of the disease and continue to highlight the symptoms of the disease. Current treatments for the disease will also be discussed and ongoing research on the disease highlighted.

Brief Overview of Hepatitis B

Hepatitis B is a common infectious disease caused by the Hepatitis B virus (HBV). The infection results in the inflammation of the liver which is caused by the special cells released by the body as it attempts to fight off the virus once it is detected. There are over 400 million carriers of HBV worldwide, but the infection rate of the disease is endemically high in; Africa, parts of Asia, and parts of South America with up to 15% of those populations having the virus (Dwyre et al 93).

Hepatitis B can be acute and or chronic. Acute illness resolves itself fairly fast in adults and does not cause any lasting damage to the liver. The chronic illness lasts for over six months and is associated with cirrhosis, complete liver failure, and even death in the patient. Research indicates that chronic HBV infection is “a strong risk factor for hepatocellular carcinoma” (Sorrell et al. 107). Hepatocellular carcinoma has a very high mortality rate for patients who do not obtain liver transplantation.

Detection of hepatitis B is through the screening for Hepatitis B surface antigen which is detectable in the blood after 4 to 10 weeks after the infection has occurred. The incubation period for the disease is 3 months but it may take up to 6 months before the first symptoms of the disease are observed.

Symptoms

While most people’s bodies can eliminate HBV from the bloodstream, the virus persists in some people, and this is chronic hepatitis B. Individuals with chronic hepatitis B may not show any of the symptoms of the disease. Hicks asserts that about 33 percent of acute hepatitis B have no symptoms. However, these individuals are still carriers and can therefore transmit the virus to others.

There are several notable symptoms of hepatitis B and they begin to manifest themselves three months after infection for the remaining two-thirds of the infected. 33 percent of acute hepatitis B sufferers experience mild symptoms from the disease. These symptoms include general weaknesses and fatigue, mild headaches, loss of appetite, nausea, jaundice, and fever (Hicks). The final 33 percent suffer from severe symptoms which can go on for many months. Their symptoms include severe abdominal pains, severe diarrhea, and jaundice.

Transmission of Disease

Hepatitis B is a very infectious disease, and the HBV is transmitted through infected blood or body fluids that get into someone’s body via wounds, mucous membranes, or injection. HBV is also transmittable through sexual contact with a person infected with the virus or by prenatal exposure (Sorrell et al. 106). The following groups of people are especially prone to acquiring hepatitis B: men who have sex with men (MSM), injection drug users, and heterosexuals with a recent history of a sexually transmitted disease or multiple sex partners. The risk of developing chronic hepatitis B is increased in persons who are also infected with hepatitis C or hepatitis D viruses. After infection with HBV, the HBV DNA is the first marker to be present in the blood

Treatment

Treatment of hepatitis B infection depends on whether it is Acute or Chronic. With Acute hepatitis B, most adults’ bodies can produce special cells to fight off the disease. As such, for a majority of adult patients, acute hepatitis B requires no treatment since the body can counter the infection on its own. However, there are several treatments for chronic infection to reduce the risk of liver failure and cirrhosis. Treating chronic hepatitis B is necessary to reduce the adverse impacts on the liver that the disease may cause.

A number of treatments have been approved for adults suffering from chronic HBV and this includes; “interferon-α, pegylated interferon-α, lamivudine, adefovir dipivoxil, entecavir, telbivudine, and tenofovir disoproxil fumarate” (Sorrell et al 104). For children, only interferon-α and lamivudine are currently approved in the US. With chronic hepatitis infection, there is no cure and anti-HBV treatment is meant to decrease the risks of the patient developing liver cancer or cirrhosis by suppressing the virus. Anti-HBV treatment is aimed at limiting the development of progressive liver disease and therefore prevents death from these. This is because chronic hepatitis B infections predispose the person to liver cirrhosis and even liver cancer.

While treatment for chronic HBV mono-infection has continued to be improved over the past decade, immunization with the hepatitis B vaccine remains to be the most effective means of preventing HBV infection. The HBV vaccine has resulted in a significant decrease in the number of new infections as well as cases of acute hepatitis B in the US (Sorrell et al 104).

Prognosis

For a majority of the adults infected with HBV, recovery occurs completely after the body generates antibodies and therefore clears the Hepatitis B surface antigen from the blood. Hepatitis B usually disappears within 2 to 3 weeks and the liver regains its previous health within 4 to 6 months in the majority of the patients. However, children are less likely to clear the infection and research indicates that 50% of all children who are infected with HBV and all newborns that get the virus from their mothers go on to develop chronic hepatitis B (Sorrell et al. 106). This is in contrast to the marginal 5% or less of adults who go on to develop chronic hepatitis.

Prevention

As with many other diseases, the best way of dealing with hepatitis B is by preventing it from occurring in the first place. Research indicates that the most effective form of prevention is vaccination and children, as well as people who are at high risk of contracting the virus, should receive a hepatitis B vaccine to safeguard themselves from HBV. Practicing safe sex also decreases the chances of being infected with HBV since it is sexually transmitted (Hicks).

Infectious disease testing on donated blood is of great importance in the reduction in risk for HBV infection. Dwyre et al propose that countries and even communities should come up with pre-donation screening processes that eliminate infected donors from the donor pool and therefore reduce the risk of HBV infection (93).

Future of Hepatitis B

Much progress has been made in the prevention of hepatitis B and managing chronic hepatitis B within the last 2 decades and new cases of HBV infection have dramatically increased across the US since the 1990s. Developments ineffective vaccines remain to be the most effective way of dealing with hepatitis B. Progress is also being made in antiviral drugs, known as nucleoside analogs, to reduce the side effects that the drugs on the patient and also counter cases of the HBV virus becoming resistant to the drugs (Hicks). Advanced technologies are being developed to improve donor screening and therefore reduce the risk of HBV transfusion transmission. Research is underway to ensure that the goal of zero risk is achieved when testing donor blood for HBV infection (Dwyre et al 92).

Conclusion

This paper set out to discuss hepatitis B which is a common infectious disease. The paper has shown that certain groups of people are at higher risk of contracting the Hepatitis B virus. Once acquired, recovery from hepatitis B depends on whether it is acute or chronic. Acute Hepatitis B does not require treatment and the patient makes full recovery without medical intervention. Chronic hepatitis B requires treatment with interferon or nucleoside analogs to reduce risks to the liver. The research had demonstrated that while HBV is highly infectious, Hepatitis B is preventable through vaccination and avoiding contact with infected bodily fluids.

Works Cited

Dwyre, Daniel, Fernando Leo, and Holland Prince. “Hepatitis B, hepatitis C and HIV transfusion-transmitted infections in the 21st century”. Vox Sanguinis 100.1 (2011): 92–98. Print.

Hick, Rob. “Hepatitis B”. BBC. 2009. Web.

Sorrell, Michael, Belongia Edward, Costa Jose, Gareen Ilana, Grem Jean, Inadomi John, et al. “National Institutes of Health Consensus Development Conference Statement: Management of hepatitis B”. Ann Intern Med 150.2 (2009): 104-110. Web.

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NerdyRoo. (2022, April 30). Hepatitis B Pathogenesis and Treatment. Retrieved from https://nerdyroo.com/hepatitis-b-pathogenesis-and-treatment/

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NerdyRoo. 2022. "Hepatitis B Pathogenesis and Treatment." April 30, 2022. https://nerdyroo.com/hepatitis-b-pathogenesis-and-treatment/.

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