Hepatitis B is present in roughly 3% of the general population, i.e. 3 out of 100 persons we see daily. Most (95%) of the infected persons are not aware that they are infected. It can cause chronic (long-term, usually lifelong) infection and can put the person to risk of death from cirrhosis or cancer. It is usually detected incidentally during routine health check-up for any reason, workup for the cause of deranged blood test (liver function test), cirrhosis (scarring) of liver or liver cancer. What is hepatitis B? Hepatitis B is an infection of the liver caused by hepatitis B virus (HBV) which causes liver cell injury and can lead to acute infection, chronic infection (i.e. hepatitis B surface antigen HBsAg is positive for more than 6 months), cirrhosis (scarring) of liver and liver cancer.
Hepatitis B infection occurs by contact with body fluids of infected person e.g. blood, semen, vagina fluid, menstrual fluid or saliva. This is usually acquired from infected mother to child during delivery, by having sex without condom with infected person, sharing infected needle/syringe used for drug injection, getting tattoo or piercing from infected needle and sharing razor, nail clipper or toothbrushes. All blood available in blood banks is routinely screened for hepatitis B along with other infectious organism (hepatitis C, HIV, etc.)
If HBV infection occur at birth from infected mother or in childhood (<5yr age) from infected person, it usually persists for many years in form of chronic hepatitis B (i.e. 90% and 30% respectively). These patients usually remain symptom free till patients develop advanced disease like cirrhosis or cancer. Infection in adult age usually last for short duration (acute hepatitis B) but can last for many years (chronic hepatitis B in 5%). Acute hepatitis B can present with symptoms like fever, bodyache, tiredness, weakness, abdominal (tummy) pain, nausea, vomiting, decrease appetite, dark color urine or yellow color eyes (jaundice). Jaundice usually appears once other symptoms starts to disappear. These patients usually clear virus in 1-6 months but it can persist for long in form of chronic hepatitis B (if HBsAg is positive after 6month) in 5%. If person present in advanced disease then he/she can have jaundice, abdominal distension, blood vomiting, black or red color stool, altered sensorium, decrease appetite, weight loss, etc.
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