Hepatitis B is an inflammation of the liver caused by the Hepatitis B virus. It was originally known as “serum hepatitis” and has caused epidemics in parts of Asia and Africa. It is said that up to a third of the world’s population have been exposed to the virus, although 3 to 6% have become affected.
Symptoms of the acute illness caused by the virus include liver inflammation, vomiting, jaundice, and, rarely, death. Chronic hepatitis B may cause liver cirrhosis, which may lead to liver cancer.
Hepatitis B is largely transmitted through exposure to bodily fluids containing the virus, including unprotected sexual contact, blood transfusions, and re-use of contaminated needles and syringes. The diseases can also be passed from a pregnant mother to her child in the womb.
During infection the host immune response is responsible for both hepatocellular damage and viral clearance. While the innate immune response does not play a significant role in these processes, the adaptive immune response, particularly cytotoxic T lymphocytes (or CTL), contributes to nearly all of the liver injury associated with hepatitis B virus (HBV).
Hepatitis B virus infection may either be acute or chronic. People with acute or self-limited infection get well within weeks to months. The greater a person’s age at the time of infection, the greater the chance their body will clear the infection. However, when the infection is not cleared, one becomes a chronic carrier of the virus.
Acute infection with hepatitis B virus is associated with acute viral hepatitis—an illness that begins with general ill-health, loss of appetite, nausea, vomiting, body aches, mild fever, dark urine, and then progresses into development of jaundice. It has also been noted that itchy skin all over the body has been an indication as a possible symptom of all hepatitis virus types. The illness lasts for several weeks and then gradually improves in most of the affected people. A few patients may have more severe liver disease and may die because of it. Hepatitis B may also infect a person and show no signs of symptoms at all, thereby becoming unrecognized.
Meanwhile, chronic infection with hepatitis B virus may be either asymptomatic or may be associated with a chronic inflammation of the liver, which leads to cirrhosis over a period of several years. This type of infection dramatically increases the incidence of liver cancer.
There are currently several treatment available for chronic hepatitis B that can increase a person’s chance of clearing the infection. Examples of which are antivirals like lamivudine and adefovir and immune system modulators such as interferon alpha.
There are several other antivirals under investigation. Roughly, all of the currently available treatments, when used alone, would equally work well in your body. However, some individuals are much more likely to respond than others. It does not appear that combination therapy offers any advantages. In general, each works by reducing the viral load by several orders of magnitude thus helping a body’s immune system clear the infection.
Treatment strategies should be individualized by a doctor and patient. Considerations include the risks associated with each treatment, a person’s likelihood of clearing the virus with treatment, a person’s risk for developing complications of persistent infection, and development of viral resistance with some of the treatments.
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