Hepatitis B

Overview
hepatitis B is a potentially dangerous liver contagion caused by the hepatitis B virus ( HBV ). It is a major global health problem. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.
A condom and effective vaccine that offers 98 % to 100 % protective covering against hepatitis B is available. Preventing hepatitis B infection averts the development of complications including chronic disease and liver cancer. The burden of hepatitis B infection is highest in the WHO Western Pacific Region and the world health organization african Region, where 116 million and 81 million people, respectively, are chronically infected. Sixty million people are infected in the WHO Eastern Mediterranean Region, 18 million in the WHO South-East Asia Region, 14 million in the WHO European Region and 5 million in the WHO Region of the Americas.

Reading: Hepatitis B

Transmission

In highly endemic areas, hepatitis B is most normally spread from mother to child at birth ( perinatal transmission ) or through horizontal transmission ( exposure to infected blood ), particularly from an septic child to an uninfected child during the beginning 5 years of life. The development of chronic infection is park in infants infected from their mothers or before the age of 5 years. hepatitis B is besides spread by needlestick injury, tattooing, piercing and exposure to infected lineage and consistency fluids, such as saliva and menstrual, vaginal and germinal fluids. transmission of the virus may besides occur through the recycle of contaminated needles and syringes or acuate objects either in health care settings, in the community or among persons who inject drugs. sexual transmission is more prevailing in unvaccinated persons with multiple sexual partners. hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5 % of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95 % of cases. This is the footing for strengthening and prioritizing baby and childhood inoculation. The hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can calm cause infection if it enters the body of a person who is not protected by the vaccine. The incubation period of the hepatitis B virus ranges from 30 to 180 days. The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B, specially when transmitted in infancy or childhood.

Symptoms

Most people do not experience any symptoms when newly infected. however, some people have acute illness with symptoms that last several weeks, including yellow of the skin and eyes ( jaundice ), dark urine, extreme tire, nausea, vomiting and abdominal pain. People with acute hepatitis can develop acute liver-colored failure, which can lead to death. Among the long-run complications of HBV infections, a subset of persons develops advanced liver diseases such as cirrhosis and hepatocellular carcinoma, which cause high unwholesomeness and deathrate.

HBV-HIV coinfection

about 1 % of persons living with HBV infection ( 2.7 million people ) are besides infected with HIV. conversely, the global prevalence of HBV infection in HIV-infected persons is 7.4 %. Since 2015, WHO has recommended treatment for everyone diagnosed with HIV contagion, regardless of the stage of disease. Tenofovir, which is included in the treatment combinations recommended as first-line therapy for HIV infection, is besides active against HBV.

Diagnosis

It is not possible on clinical grounds to differentiate hepatitis B from hepatitis caused by other viral agents, hence testing ground confirmation of the diagnosis is essential. several rake tests are available to diagnose and monitor people with hepatitis B. They can be used to distinguish acute and chronic infections. WHO recommends that all lineage donations be tested for hepatitis B to ensure blood guard and avoid accidental transmission. As of 2019, 30.4 million people ( 10.5 % of all people estimated to be living with hepatitis B ) were aware of their infection, while 6.6 million ( 22 % ) of the people diagnosed were on treatment. According to latest WHO estimates, the proportion of children under five years of age chronically infected with HBV dropped to just under 1 % in 2019 down from around 5 % in the pre-vaccine era ranging from the 1980s to the early on 2000s.

Treatment

There is no specific discussion for acuate hepatitis B. Therefore, care is aimed at maintaining comfort and adequate nutritional balance, including substitute of fluids lost from vomiting and diarrhea. Most authoritative is the avoidance of unnecessary medications. Acetaminophen, paracetamol and medication against vomiting should be avoided. Chronic hepatitis B infection can be treated with medicines, including oral antiviral agents. treatment can slow the progress of cirrhosis, reduce incidence of liver cancer and improve long term survival. In 2021 WHO estimated that 12 % to 25 % of people with chronic hepatitis B infection will require treatment, depending on setting and eligibility criteria. WHO recommends the use of oral treatments ( tenofovir or entecavir ) as the most potent drugs to suppress hepatitis B virus. Most people who start hepatitis B treatment must continue it for life. In low-income settings, most people with liver cancer die within months of diagnosis. In high-income countries, patient award to hospital earlier in the naturally of the disease, and have access to operating room and chemotherapy which can prolong life for respective months to a few years. Liver transplant is sometimes used in people with cirrhosis or liver cancer in high-income countries, with varying success.

Prevention

WHO recommends that all infants receive the hepatitis B vaccine ampere soon as possible after birth, preferably within 24 hours, followed by 2 or 3 doses of hepatitis B vaccine at least 4 weeks apart to complete the inoculation series. Protection lasts at least 20 years and is credibly lifelong. WHO does not recommend booster vaccinations for persons who have completed the 3-dose vaccination schedule. In accession to infant vaccination, WHO recommends the use of antiviral prophylaxis for the prevention of hepatitis B transmission from mother-to-child. implementation of blood safety strategies and safer sex practices, including minimizing the number of partners and using barrier protective measures ( condoms ), besides protect against transmittance.

WHO response

In May 2016, the World Health Assembly adopted the first Global health sector scheme on viral hepatitis, 2016-2020. The strategy highlights the critical function of universal health coverage and sets targets that align with those of the Sustainable Development Goals. The 74th World Health Assembly in 2021 adopted a former decision of the Executive Board to request that Global Health Sector Strategies on HIV, viral hepatitis and sexually air infections are developed for the period 2022-2030.

To support countries in achieving the global hepatitis elimination targets under the Sustainable Development Agenda 2030, WHO is working to :

  • raise awareness, promote partnerships and mobilize resources;
  • formulate evidence-based policy and data for action;
  • increase health equities within the hepatitis response;
  • prevent transmission; and
  • scale up screening, care and treatment services.

WHO organizes annual World Hepatitis Day campaigns ( as 1 of its 9 flagship annual health campaigns ) to increase awareness and reason of viral hepatitis .

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Category : Health

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