People can have hepatits B without obvious symptoms. Even without physical symptoms, though, hepatitis B can cause liver damage. A doctor can detect this damage through a blood test that looks for specific viral proteins in the blood. Also, routine laboratory tests for proper liver function may alert your doctor to the possibility of a disguised infection. Liver sampling (biopsy) can usually detect microscopic evidence of damage.
In the acute form, hepatitis B causes sudden liver inflammation and a flu-like illness. Symptoms can include:
- lack of appetite
- joint pain
- yellowing of the skin and eyes (jaundice)
- nausea and vomiting.
- right-sided tenderness under the ribs.
Symptoms may persist for some time, but they usually resolve in less than six months.
In the chronic form, hepatitis B can eventually cause serious liver damage. Symptoms of chronic hepatitis B include:
- ongoing loss of appetite
- muscle and joint pain
- tenderness in the upper right abdomen.
An estimated 10% per year of people with chronic infections do clear the virus from their systems over time. Others do not, and face an increased risk of cirrhosis as well as liver cancer. While it is possible to "carry" the hepatitis B virus for years without serious problems, some carriers relapse into an active infection. This active infection may not cause symptoms, but may cause liver damage anyway.
Sharing needles for injection drug use helps spread the disease. Needles used to create tattoos, if unclean, can also spread the virus. Unprotected sexual intercourse can spread hepatitis B. Both semen and vaginal secretions can spread the hepatitis virus. The hepatitis virus has also been found in saliva. Kissing on the cheek or dry lip kissing will not spread the virus.
People who have day-to-day contact with those who have chronic hepatitis B are at risk for the disease, and should get a hepatitis B vaccine. For example, anyone living with a person with chronic hepatitis B is more likely to come in contact with that person’s blood, a razor, a toothbrush, or any other item that may contain bodily fluids harboring the disease.
Health care workers who have contact with blood are at risk for getting the disease. A needlestick from an infected needle, for example, can spread the virus.
Babies born to mothers with an active hepatitis B infection are at risk for getting the disease. Spread of the virus from mother to child during birth is called vertical transmission, and carries a risk of infection to the newborn that can approach 90%, depending on how active the virus is in the mother.
Patients who are undergoing hemodialysis--a process whereby a person's blood is fed into a machine that filters and purifies it, and then returns it to the body— are at greater risk of catching the virus. Infants and children who emigrate to the US from areas where the disease is common are at risk for chronic infection. According to the Center for Disease Control, chronic hepatitis B infection rates are high (>8%) in all of Africa; Southeast Asia, including China, Korea, Indonesia, and the Philippines; the Middle East, except Israel; south and western Pacific islands; the interior Amazon River basin; and Haiti and the Dominican Republic. The prevalence of chronic hepatitis B infection is intermediate (2% to 7%) in South Central and Southwest Asia, Israel, Japan, Eastern and Southern Europe, Russia, most areas surrounding the Amazon River basin, Honduras, and Guatemala. It is recommended that travelers to these areas be vaccinated for hepatitis B if they will be staying for longer than six months, or if they anticipate having daily physical or sexual contact with the local population. Anyone traveling to such an area who may require medical or dental care should also be vaccinated.
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