A person with acute hepatitis may need treatment in a hospital if he or she is dehydrated or unable to eat, or if liver function becomes poor.
People with acute hepatitis should seek medical attention if they become confused, very sleepy, or bruise easily. These symptoms may signal the onset of fulminant hepatitis, a rare but serious form of liver failure.
Bed rest and a good diet may be helpful in the early stages of recovery. Some people experience nausea later in the day, so it may be best to eat a low-fat diet early. In general, people are allowed to start their normal activities after they have the energy to do so.
Avoid alcohol and other substances that can damage the liver. Some common drugs (e.g., acetominophen) are also toxic to the liver. Because the hepatitis B virus causes liver damage, it is important to avoid placing a toxic burden from alcohol or drugs on the organ while you are in recovery.
Your doctor is the best source of information on the drug treatment choices available to you.
A liver sample (biopsy) may help determine if the hepatitis virus is actively damaging tissues. The sample is taken with a hollow needle through the skin. The pathologist will look for areas of dead cells (necrosis) or other evidence of damage such as cell abnormalities or fibrosis (scarring).
Infants born to mothers with hepatitis B stand a high chance of being infected by the virus themselves. Once infected, they have a very high chance of going on to develop chronic hepatitis. In cases where the mother is known to be infected, immunoglobulin therapy given immediately after birth can help to decrease the chances of an infant contracting hepatitis B.
Most cases of adult hepatitis B will resolve by themselves. Less than 10% of adults go on to become chronic carriers of the virus. In children, the hepatitis virus is more likely to cause long-term illness. Infants who contract the virus during delivery are much more likely to develop chronic hepatitis. Up to 90% of infants who are infected with the hepatitis B virus will go on to develop a chronic infection; of those, it is estimated that up to a quarter may eventually die of liver-related disease. Among adults infected with hepatitis B virus, only 5% to10% will go on to become chronic carriers.
If untreated, chronic hepatitis B can cause serious health problems. The ongoing damage caused to the liver by chronic infection with hepatitis B (particularly if the virus is actively reproducing itself) results in scarring, cell death (necrosis), liver failure (cirrhosis), and liver cancer.
It is estimated that those with chronic active hepatitis will develop cirrhosis at rates as high as 12% per year. Liver cancer is thought to develop in those with chronic hepatitis at a rate of about 0.5% to 2.5% per year.
Follow-up for hepatitis B depends on the disease course. Doctors will follow up routinely with exams and blood tests to ensure that the virus has been cleared in someone who has an acute episode of hepatitis B.
A person treated for chronic disease with interferon alpha or another drug will be followed much more closely.
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