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Dx Hepatitis B Treatment: Read more..


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Observation:
Hepatitis B

The N.H.S. Choices
states:
"Hepatitis B is a type of virus that can infect the liver. Symptoms can include:
*feeling sick
*being sick
*lack of appetite
*flu-like symptoms, such as tiredness, general aches and pains, headaches *yellowing of the skin and eyes (jaundice)

*It takes between 40 and 160 days for any symptoms to develop after exposure to the virus.
*However, many people don’t realize they have been infected with the virus, because the symptoms may not develop immediately, or even at all.

How does hepatitis B spread?
Hepatitis B can be spread through blood and body fluids such as semen and vaginal fluids, so it can be caught
•during unprotected sex, including anal and oral sex
•by sharing needles to inject drugs such as heroin

*A mother can also pass on the hepatitis B infection to her newborn baby, Hepatitis B in pregnancy, but if the baby is vaccinated immediately after birth (see below), the infection can be prevented.

In England, people who are most at risk of contracting hepatitis B include the following:
*people who inject drugs
*people who change sexual partners frequently

Diagnosis
Hepatitis B is diagnosed by a blood test that shows a positive reaction to hepatitis B surface antigen (the outer surface of the hepatitis B virus that triggers a response from your immune system). A positive result means your body is making antibodies to try and fight the hepatitis B virus.

Your GP may also request a liver function test. This is a blood test that measures certain enzymes and proteins in your bloodstream, which indicates whether your liver is damaged. It will often show raised levels if you are infected with the hepatitis B virus. The Metabolic and Hepatitis Profiles are available On-line.

Stages of infection
*In most cases, the hepatitis B virus will only stay in the body for around one to three months. This is known as acute hepatitis B.
*In around 1 in 20 cases in adults, the virus will stay for six months or longer, usually without causing any noticeable symptoms. This is known as chronic hepatitis B.
*Chronic hepatitis B is particularly common in babies and young children: 9 in 10 children infected at birth and around 1 in 5 children infected in early childhood will develop a long-term infection.
*People with chronic hepatitis B can still pass the virus on to other people, even if it is not causing any symptoms.

Major Health Concerns
**Around 20% of people with chronic hepatitis B will go on to develop scarring of the liver (cirrhosis), which can take 20 years to develop
**Around 1 in 10 people with cirrhosis will develop liver cancer.

Treatment
There is currently no specific treatment for acute hepatitis B, other than using painkillers to relieve symptoms. Treatment for chronic hepatitis B depends on how badly your liver is affected. It can be treated using medications designed to slow the spread of the virus and prevent damage to the liver.

Can it be prevented? There is a vaccine that is thought to be 95% effective in preventing hepatitis B. Because of the relative rarity of hepatitis B in England, the vaccine is not given as part of the routine childhood vaccination schedule. It is routinely given now in the United States.

Vaccination would usually only be recommended for people in high-risk groups, such as:
*people who inject drugs or have a sexual partner who injects drugs
*people who change their sexual partner frequently
*people travelling to or from a part of the world where hepatitis B is widespread
*Pregnant women are also screened for hepatitis B, and if they are infected their baby can be vaccinated shortly after birth to prevent them from also becoming infected. (HBIG) immune globulin is given to the newborn and he/she is vaccinated immediately after delivery."

Who is affected? Hepatitis B is uncommon in England and cases are largely confined to certain groups such as drug users, men who have sex with men and certain ethnic communities (such as South Asian, African and Chinese). [Editor 1 in 12 people from parts of Asia are affected.] There were 5,478 newly reported cases in England during 2011.

In contrast, hepatitis B is common in other parts of the world, particularly East Asia and sub-Saharan Africa. The World Health Organization estimates that hepatitis B is responsible for 600,000 deaths a year worldwide.

Outlook The vast majority of people infected with hepatitis B are able to fight off the virus and fully recover from the infection within a couple of months. The infection can be unpleasant to live with, but usually causes no lasting harm.

*[Editor]It is so important to have the laboratory tests to make sure of both the form of disease and the damage to the liver.See the Hepatitis screen, blood count and metabolic and liver screen tests, On-line.
But for the small minority of people who go on to develop cirrhosis of the liver, and in some cases liver cancer, the outlook is poor.
Therefore it's important to get yourself vaccinated if you fall into one of the high-risk groups for catching hepatitis B."


Medications Used in Treatment:
1. Hepatitis B NRTIs: Viread®/tenofovir, Baraclude®/entecavir, Epivir®Hbv/lamivudine-3TC, Hepsera®/adefovir, Tyeka®/telbivudine
2. Interferon Alphas: Pegasys®/peginterferon alfa-2a:
3. Vaccinations: Engerix®B/hepatitis B vaccine, Twinrix®/Hepatitis A- Hepatitis B, Recombivax®HB/ hepatitis B
4. Interferon Alphas: Intron®A/interferon Alfa-2b
5. Immune Globulin: Hepagam®B, hepatitis immune globulin
6. Glycyrrhiza: licorice root extract for intravenous infusion

*[Editor] Because Japan experienced a large number of transfusion transmission of hepatitis C after World War II, they are most advanced in the treatment of Chronic Hepatitis. The Editor has used the published protocol of intraveous glycyrrhiza to treat elevated liver enzymes from various forms of hepatitis [viral, A, B, and C] with good success at normalizing moderately elevated liver enzymes. The treatment was ineffective in end-stage Hepatitis C when all standard medical therapies including interferon had failed.

Suggested Links:
*Medscape
*Hepatitis B Foundation


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