Hepatitis B: the causes, symptoms, complications and prevention

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Disease is war with the laws of our being, and all war, as a great general has said, is hell.
~ Lewis G. Janes

Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B virus. It is a major global health problem. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.
Hepatitis B is spread mainly by exposure to infected blood or bodily secretions. In infected individuals, the virus can be found in the blood, semen, vaginal discharge, breast milk, and saliva. Hepatitis B is not spread through food, water, or by casual contact. Additionally, hepatitis B can be transmitted through sharing toothbrushes and razors contaminated with infected fluids or blood.

Most people do not experience any symptoms during the acute infection phase. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and right upper abdominal pain (due to the inflamed liver).

A small percentage of persons with acute hepatitis can develop acute liver failure, which can lead to death. In some people, the Hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer. Some individuals with chronic Hepatitis B remain symptom free for many years or decades.

Chronic HBV infection can lead to serious complications, such as scarring of the liver (cirrhosis), liver cancer, liver failure and other conditions such as kidney disease and anemia. In patients with advanced cirrhosis, the liver begins to fail and this is life-threatening condition. Several complications occur in advanced cirrhosis:
• Confusion and even coma (encephalopathy) results from the inability of the liver to detoxify certain toxic substances.
Increased pressure in the blood vessels of the liver (portal hypertension) causes fluid to build up in the abdominal cavity (ascites) and may result in engorged veins in the swallowing tube (esophageal varices) that tear easily and may cause massive bleeding.
• Portal hypertension can also cause kidney failure or an enlarged spleen (splenomegaly) resulting in a decrease of blood cells and the development of anemia, increased risk of infection and bleeding.
• In advanced cirrhosis, liver failure also results in decreased production of clotting factors. This causes abnormalities in blood clotting and sometimes spontaneous bleeding.
• Patients with advanced cirrhosis often develop jaundice, because the damaged liver is unable to eliminate a yellow compound, called bilirubin.

Prevention
• The Hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. The incubation period of the Hepatitis B virus is 75 days on average, but can vary from 30 to 180 days. The virus can be detected within 30 to 60 days after infection and can persist and develop into chronic Hepatitis B.
• Get vaccinated (if you haven’t already been infected).
• Use condoms every time you have sex.
• Wear gloves when you clean up after others, especially if you have to touch bandages, tampons, and linens.
• Cover all open cuts or wounds.
Don’t share razors, toothbrushes, nail care tools, or pierced earrings with anyone.
• Don’t share chewing gum or pre-chew food for a baby.
• Make certain that any needles for ear piercing, or tattoos or tools for manicures and pedicures are properly sterilised.

* Saara Nelao Shikufa is an enrolled nurse/midwife and a medical student at Belarusian State Medical University, Minsk, Belarus. nshikufa@gmail.com

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