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Sexually Transmitted Diseases
Hepatitis B
Description
- Hepatitis refers to an inflammation of the liver. Hepatitis B is a specific type of hepatitis caused by the hepatitis B virus, which is usually transmitted by blood products, or sexually. Hepatitis B can cause an acute infection or a chronic (persistent) one.
Risk Factors
- Homosexual behavior
- Intravenous drug abuse
- Medical professionals
- Hemodialysis workers
- Infants of mothers with hepatitis B
Symptoms
First phase (lasts 2-3 weeks):
- Fatigue
- Not "feeling well"
- Loss of appetite
- Nasal discharge
- Sore throat
- Skin rashes
- Joint pain
- Fever or chills
- Nausea/vomiting
- Abdominal pain
- Diarrhea or constipation
Second (Icteric) phase (occurs 5-10 days after first phase):
- Yellow skin or eyes
- Usually other symptoms improve
- Third (convalescent) phase:
- Continued steady improvement
- Chronic persistent hepatitis:
- May have none
- Fatigue
- Loss of appetite
- Chronic active hepatitis:
- May have none
- Fatigue
- Yellow skin or eyes may be present
Diagnosis
- Skin-yellow skin or eyes
- Liver tenderness
- Spleen tenderness
- Elevated AST, ALT, and total bilirubin
- Hepatitis B antibody testing to confirm diagnosis
- Acute: positive HBsAg, HbeAg, Anti-HBc IgM
- Chronic persistent: positive HBsAg, positive Anti-Hbe IgG
- Chronic active hepatitis: positive HBsAg, Anti HBc IgG (& low levels IgM), HbeAg
- Liver biopsy to diagnose chronic forms
Similar Conditions
- Mononucleosis
- Hepatitis A
- Hepatitis C
- Cytomegalovirus
- Q fever
- Drug-induced liver disease
- Secondary syphilis
- Cholecystitis
- Alcoholic hepatitis
- Autoimmune hepatitis
Complications
- Infection with delta agent. This is a secondary agent on top of the infection with hepatitis B. It can make the infection much more severe. Diagnosis is made by checking for anti-HDV in the blood.
- Hepatocellular (liver) cancer-patients who have been infected with hepatitis B are at much higher risk of developing liver cancer
- Liver cirrhosis
Treatment
- Acute hepatitis:
- Avoid Tylenol and alcoholic beverages. Bed rest as needed. No medical treatment.
- Chronic active hepatitis:
- Alpha-Interferon
- Lamivudine
Prevention
- Hepatitis B vaccine:
- Hepatitis B vaccine now exists and is routinely given during childhood immunizations. It is also given to high-risk adults, e.g., medical professionals.
- Hepatitis B immune globulin immunization for pregnant mothers
- Universal blood precautions
- Condoms may reduce or eliminate the chances of contracting hepatitis B from sexual relations.
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