Hepatitis B virus (HBV) infection, recognised nearly 40 years ago with the identification of the Australia antigen, remains a global health problem. It is estimated that 2 million people worldwide have been infected with HBV. 350 million are chronically infected and 50 million new cases are diagnosed annually. HBV remains the leading cause of cirrhosis (destruction of the liver) and Hepatocellular carcinoma (HCC). Of those chronically infected 15 to 25 per cent will die of sequale related to HBV infection. If routine infant HBV vaccination with three doses is given to the population then 68 per cent of HBV related deaths could be prevented.
*Risk factors* The virus is transmitted via various routes. HBV is ubiquitous in body fluids including blood saliva, sweat, breast milk, tears, vaginal secretions, semen and menstrual blood. Viral transmission can be mother to child (vertical or perinatal transmission) and by percutaneous of mucosa exposure to infectious bodily fluids. After any person who is infected by any one of the following mentioned above routes of transmission, the incubation period of the virus ranges from 45-160 days (mean 120 days). There are various tests available to check if one is infected or not. In areas of low prevalence of HBV infection, transmission is more commonly via unprotected sexual intercourse, IV drug abusers or occupational exposure to blood or blood products like in the case of paramedical workers. In underdeveloped countries, reuse of medical instruments, contamination of multiple dosing vials and reuse of disposable needles remains a risk of infection. Today, most hospitals in Mumbai follow very strict guidelines. Disposable needles need to be disposed off according to infection control guidelines. Contamination of dialysis equipment is also a source of transmission if isolation of infected patients and strict adherence to infection control measures are not practiced. Percutaneous routes of exposure include transmission of blood or blood products, contaminated health related paraphenelia or needle sticks. Less commonly, tattooing which has now become a fashion statement, and acupuncture have also been implicated in HBV transmission. We commonly see barbers on the roadside shaving and cutting hair. People in the low socioeconomic strata can get infected through this route. In areas of high endemicity of HBV, vertical transmission remains to be the predominant mode of transmission. Pregnant woman in the third trimester or in the post partum period will more likely lead to infection of the infant. *Symptoms * Once infected, it can lead to acute Hepatitis B or then progress to chronic Hepatitis B. Chronic Hepatitis B is the more dangerous one and that can lead to cirrhosis (destruction) and then to cancer of the liver. Once infected, the body clears the virus on its own in around six months. If the virus persists beyond that time, then one can say that the individual is a chronic Hepatitis B infected person. In acute Hepatitis B, one can develop symptoms like yellow discoloration of eyes (jaundice), generalized weakness, loss of appetite / weight, nausea, vomiting, pain in abdomen and fever. If severe, bleeding disorders can be seen .If very severe then the person can become comatose but this is not very common. In chronic hepatitis B infected people, they can have liver related complications like vomiting of blood (haematemesis), black tarry stools (malena), loss of consciousness (hepatic encephalopathy), fever (because of low immunity), distension of abdomen (ascites), swelling of the legs (pedal edema). *Diagnosis * There are routine blood tests available and can be done in any reputed laboratory. There are specialized test also available and have to be done if the person is chronic infected. *Treatment * If there is accidental exposure to the virus then injection immunoglobulin is used. Vaccines are available and recommended. There is treatment for Hepatitis B chronic infection. There are various drugs available. These tablets have to be taken according to the dosing schedules. There are injections available as well. Interferon therapy treatment remains the benchmark of antiviral treatment with stable, sustained response to a 12-month course in about 15 – 25 per cent of patients. Liver transplant is also an option for people with cirrhosis of liver and have liver related complications. Liver transplant is being done in Mumbai. If the individual consumes alcohol with concurrent Hepatitis B virus infection, then the liver damage is accelerated. If the person has co-infection of HIV then the clearance of the virus is delayed. The treatment for acute Hepatitis B infection is mainly supportive since it resolves without chronic sequale. -- ~--~---------~--~----~------------~-------~--~--- Connect your World with Us join Now - http://groups.yahoo.com/group/dimpill_gang/join Affiliated group from dimpill_gang for Only Adult Mails - http://groups.yahoo.com/group/fantazies/join Affiliated group from dimpill_gang for Only Health and Food Mails - http://groups.yahoo.com/group/Health_and_Gourmet/join -~----------~----~----~----~------~----~------~--~
