Thomas Jefferson University Hospital
 
CANCERCARE AT JEFFERSON HOSPITAL

Hepatitis B

What is hepatitis B?
Hepatitis B is a liver disease caused by the hepatitis B virus. Most infections of hepatitis B clear up within one to two months without treatment. However, when the infection lasts more than six months, it can develop into chronic hepatitis B. Chronic hepatitis B can in turn lead to:

  • Chronic inflammation of the liver
  • Cirrhosis (scarring of the liver)
  • Liver cancer
  • Liver failure
  • Death (every year, 5,000 people die as a result of liver disease caused by HBV)

What causes hepatitis B?
The hepatitis B virus causes this liver disease. You can contract the virus through contact with an infected person’s body fluids – including blood, semen, vaginal fluids and saliva. A woman infected with hepatitis can pass the virus on to her baby during childbirth.

What are the risk factors for hepatitis B?
Coming in contact with the blood or other body fluids of someone infected with hepatitis B increases your risk for infection. Unlike the hepatitis A virus, hepatitis B virus is not spread through contaminated food or water.

Your risk of getting hepatitis B may increase due to the following factors:

  • Having sex with someone infected with hepatitis B or who is a carrier of hepatitis B
  • Your mother had hepatitis B when you were born
  • Injecting illicit drugs, especially with shared needles
  • Having more than one sexual partner
  • Being a man who has sex with men
  • Living in the same house with someone who is infected with hepatitis B, and sharing items such as toothbrushes or razorblades
  • Having a job that involves contact with body fluids; such jobs include:
    • First aid or emergency workers
    • Funeral directors
    • Medical personnel
    • Dentists
    • Dental assistants
    • Firefighters
    • Police personnel
  • Having a sexually transmitted disease at the time you come in contact with hepatitis B
  • Traveling to areas where hepatitis B is common, such as China, southeast Asia and sub-Saharan Africa
  • Receiving a blood transfusion prior to 1975 (the year a test to screen blood was developed)
  • Receiving multiple transfusions of blood or blood products, as hemophiliacs do (risk is greatly reduced with careful blood screening)
  • Working or being a patient in a hospital or long-term care facility
  • Working or being incarcerated in a prison
  • Being bitten so that the skin is broken by someone whose saliva contains the virus
  • Being a hemodialysis patient

Note: It is very important that all pregnant women get a blood test for hepatitis B early in their pregnancy, since a woman who has hepatitis B can spread the virus to her baby during birth.

How is hepatitis B diagnosed?
Symptoms usually appear within 25 to 180 days following exposure to the virus. The most common symptoms are:

  • Yellowing skin and eyes (jaundice)
  • Fatigue that lasts for weeks or even months
  • Abdominal pain in the area of the liver (upper right side)
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain
  • Low-grade fever
  • Dark urine and light-colored stool
  • Widespread itching
  • Rash

The doctor will ask about your symptoms and medical history and perform a physical exam. Hepatitis B is diagnosed with blood tests, which are also used to monitor its effects on the liver. For chronic cases, a liver biopsy may be needed. A biopsy is the removal of a sample of liver tissue for testing.

What are the treatment options for Hepatitis B?
The symptoms of hepatitis B can be treated with medication. Patients with uncomplicated cases can expect to recover completely. Patients with chronic hepatitis B are treated with medication to reduce the activity of the virus and prevent liver failure.

Medications include:

  • Interferon alfa-2b (Intron A) injection
  • Lamivudine (Epivir-HBV) oral medication

Chronic hepatitis B patients should avoid anything that can further injure the liver, such as alcohol, certain medications, dietary supplements and herbs (discuss these substances with your doctor before taking them).

Chronic hepatitis B patients should prevent the spread of their infection by:

  • Telling their doctors, dentists and sexual partner(s) that they have hepatitis B
  • Never donating blood, organs or tissue
  • Discussing their hepatitis B status with their doctor during pregnancy or before becoming pregnant to ensure the baby receives treatment

How can you prevent hepatitis B?
Hepatitis B can be prevented through vaccination, which consists of three injections over a six-month period. Protection is not complete without all three injections. Anyone at increased risk for hepatitis B should be vaccinated.

In addition, to prevent the transmission of hepatitis B:

  • Use condoms or abstain from sex
  • Limit your number of sexual partners
  • Do not inject drugs. If you use IV drugs, get treatment to help you stop. Never share needles or syringes.
  • Do not share personal items that might have blood on them, such as:
    • Razors
    • Toothbrushes
    • Manicuring tools
    • Pierced earrings
  • If you get a tattoo or body piercing, make sure the artist or piercer properly sterilizes the equipment. You might get infected if the tools have someone else’s blood on them.

In addition, to prevent the transmission of hepatitis B:

  • If you are a healthcare or public safety worker, get vaccinated against hepatitis B, and always follow routine barrier precautions and safely handle needles and other sharp instruments.
  • Wear gloves when touching or cleaning up body fluids on personal items, such as:
    • Bandages
    • Tampons
    • Linens
    • Cover open cuts or wounds
  • Use only sterilized needles for drug injections, blood testing, ear piercing and tattooing

It is important to remember that you cannot spread HBV by:

  • Sneezing or coughing
  • Kissing or hugging
  • Sharing eating utensils or drinking glasses
  • Breast feeding
  • Food or water
  • Casual contact (such as an office setting)

If you are pregnant, have a blood test for hepatitis B. If you are diagnosed as positive, you should be sure that your baby gets a shot called H-B-I-G and the first dose of hepatitis B vaccine within 12 hours of birth. Your baby should get the second dose of hepatitis B vaccine at one to two months old and the third dose at six moths old. Your baby should also get a blood test at nine to 15 months old to be sure your baby is protected.

Contact us
To schedule an appointment with a Jefferson physician call 1-800-JEFF-NOW or click here.

To contact the Liver Tumor Program team at the Kimmel Cancer Center at Jefferson, please call 215-503-8752 and/or fax your records to 215-503-8755. We aim to schedule your first clinic visit within two weeks of your diagnosis being made and records being received.