Hepatitis B is an infectious disease transmitted through body fluids such as blood or semen. In Germany, the majority of infections are caused by unprotected intercourse. The disease first manifests itself as nonspecific symptoms such as tiredness, fever and nausea. Later, jaundice may occur. Acute hepatitis need only be treated if it is severe. If the infection becomes chronic, therapy must be given in any case. With a vaccine you can safely protect yourself from the hepatitis B virus.
Causes of infection
Hepatitis B is one of the most prevalent infectious diseases in the world. Infection with the hepatitis B virus (HBV) causes liver inflammation. The virus is transmitted through bodily fluids such as blood, saliva, breast milk, tears or sperm.
In Germany and other industrial nations more than half of the infections are due to sexual contacts. In addition, above all, the infection via blood plays a role. Due to the good hygienic conditions in Germany, the risk of getting infected as part of a blood transfusion is extremely low. More risky are contaminated items such as tattoo instruments, ear piercers, shared toothbrushes or razors. In drug addicts, infection can also be done on multiply used syringes and cannulas.
Symptoms of Hepatitis B
After the infection with the hepatitis B virus can take between one and six months pass before the first symptoms. Typically, fatigue, tiredness, fever, headache, body aches, nausea, and diarrhea may occur. In about every third affected person also the typical symptoms of jaundice become noticeable: the skin and the inside of the eyes turn yellowish. In addition, the chair becomes lighter and the urine darker.
In about one in ten patients, chronic acute hepatitis develops from an acute one. In the chronic stage, the disease can lead to serious complications. Among other things, it can then lead to cirrhosis. In addition, the risk of developing liver cancer increases.
Hepatitis B in pregnancy
Pregnant women who have hepatitis B can transmit the virus to the child at birth. In Germany, however, this rarely happens because pregnant women are tested for hepatitis B and if necessary preventive measures are initiated. A passive active vaccine against the virus is performed on the newborn child within 12 hours after birth. In addition, the baby is given special antibodies, so that the risk of infection decreases to about five percent. Preventing infection is important because many infected infants develop chronic hepatitis.
Acute and chronic course
For most infected people, hepatitis B heals within four to six weeks. After that you are immune to the virus for life - so you can only get sick once in a lifetime. In very rare cases, the infection can lead to such severe damage to the liver that subsequent liver transplantation is necessary.
If the hepatitis is still not cured after half a year, it is called a chronic course. This occurs in about every fifth to tenth adult, but affects 90 percent of all infants who were infected by her mother with the virus.
Chronic hepatitis can manifest itself in a variety of ways. In some, despite infection, no symptoms show, in others, chronically elevated liver enzymes develop. In some cases, the liver inflammation is so aggressive that it leads to severe changes to the organ and eventually to cirrhosis of the liver. Overall, about every third cirrhosis of the liver is caused by hepatitis B. In addition, the risk of developing liver cancer increases.
Therapy of hepatitis B
In order to prove that an infection with the hepatitis B virus is present, a blood test is carried out. Increased liver values - such as an elevated GPT value - already point to liver inflammation. However, to safely diagnose the infection, certain virus components as well as specific antibodies to the virus in the blood must be detected.
If there is a suspicion of an infection, the attending physician must report this to the health department. The actual detection of the disease as well as the death of an indexed patient are also notifiable. The health department must be informed about the infection even if no symptoms occur in the patient.
An acute hepatitis B infection often heals itself. Because of this, in most cases, only the symptoms that occur must be treated. Only in very severe cases are drugs used to inhibit the multiplication of the virus. It is important that the affected people take care of themselves and avoid foods that put a heavy strain on the liver. That's why alcohol must be avoided if you have a hepatitis B infection.
Treatment of a chronic infection
If there is a chronic inflammation, the disease is usually treated with drugs. Frequently then antiviral drugs are used, which inhibit the multiplication of viruses. The antivirals include substances such as tenofovir and entecavir. These drugs are relatively commonly used as they rarely lead to resistance. When the treatment starts with the antivirals depends on the amount of virus present in the body.
In addition to antivirals, interferon may also be used for a second space of a maximum of twelve months. Taking the medicine can cause side effects such as weight loss, hair loss and flu-like symptoms. However, the side effects disappear after the end of the intake.
If liver failure occurs in the context of chronic hepatitis B - rarely even in acute infections - liver transplantation is the only way to save the patient's life.
Vaccination is the best protection
To protect yourself against hepatitis B, a vaccine against the virus is recommended. Since 1995, the vaccine has been among the standard vaccinations for children recommended by the Standing Vaccination Commission (STIKO). The vaccine stimulates the body to produce antibodies against the virus, so that in case of infection, the virus can be quickly rendered harmless.
Unvaccinated adults should be vaccinated if they belong to one of the following groups:
- Travelers who stay in a country with a high risk of hepatitis B for an extended period of time.
- People who are privately exposed to an increased risk of infection, somewhat because they live in a household with a person who suffers from chronic hepatitis B disease, or because of their sexual behavior.
- Doctors, nurses, nursery and children's nurses and any other person who regularly comes into contact with blood or other bodily secretions.
- People with immunodeficiency or certain illnesses whose course would have an infection with hepatitis B would have a particularly unfavorable.
Combination of hepatitis A and B vaccine
Hepatitis B can be either a single vaccine or a combination vaccine, which also protects against hepatitis A, are performed. The single vaccine, like the combination vaccine, is first administered twice at intervals of four weeks. For long-term protection, a third vaccination should be given six months later.
After that, you are protected from hepatitis B for at least 10 years. If there is no increased risk of exposure, adult vaccination will not be considered necessary.
Further protective measures
If you are not vaccinated against hepatitis B, you should take the following measures to prevent infection:
- Use condoms during intercourse. Not only can you prevent hepatitis B, you can also protect yourself from other sexually transmitted diseases such as AIDS.
- Do not use items such as razors, nail clippers, nail files or toothbrushes with a person infected with hepatitis B.
- In countries with low hygienic standards, you should only use a supply of blood in an emergency. Even syringes or cannulas used in hospitals can be contaminated.