Hepatitis B, while rare in western nations, is endemic in many countries in south asia.
It can cause acute infection or evolve into a chronic state where it can cause long term damage to the liver. Patients who have chronic Hepatits B infection are prone to liver cirrhosis and liver cancer.
Spread of Hepatitis B
The virus that causes Hepatitis B (HBV) is spread through the exchange of bodily fluids from person to person generally during sexual contact. It is very infectious. According to estimates, it is nearly 100 times more infectious than HIV. The infection is spread by:
- Unprotected penetrative sex with someone who is infectious
- Sharing contaminated needles or other drug-injecting apparatus
- Using non-sterilised equipment for tattooing, acupuncture or body piercing
- Mother to her baby, most commonly during delivery. Immunisation of the baby at birth prevents the transmission of hepatitis B.
- Blood transfusion if the blood is not checked for HBV
Natural History of Hepatitis B infection
While some people with active Hepatitis B infection have no symptoms, others have symptoms of malaise, jaundice etc, similar to infection with Hepatitis A.
If hepatitis B infection is acquired as a baby, e.g. mother to baby transmission, individuals often remain chronic carriers of HBV. However, most adults infected with the hepatitis B virus fully recover and develop life-long immunity. About 2% to 10% of individuals infected as adults will become chronic carriers, which means they will be infectious to others and can develop chronic liver damage. Infected children, especially newborn babies, are much more likely to become chronic carriers. If a person lives with hepatitis B infection for a number of years then they may develop liver cirrhosis and liver cancer.
Nothwithstanding, chronic HBV infection does not usually present with symptoms and hence treatment is not necessary for most chronic carriers. However, they need to be monitored long term for development of cirrhosis and/or liver tumours.
Testing for Hepatitis B
Acute Hepatitis B infection is diagnosed by detecting the presence of Hepatitis B Surface Antigen (HBsAg) in the blood.
Hepatitis B immunisation
In asia, the rate of HBV infection is high and hence immunisation is recommended for the general population at large.Click here to see the full range of our HIV/STD Services
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.