Hepatitis B Virus Infection

Hepatitis B Signs and Symptoms

Hepatitis B virus infection is severe than most other virus infections. Primarily it affects the liver but other organs are also affected. The disease can last from 1-6 months. Patients with acute hepatitis usually recover within 1-2 months of onset but it takes about 6 months to completely eliminate the virus from the body. Death is rare.

Cirrhosis of the liver is the foremost symptom. A person may become weak, fatigues and prone to infections. Abnormal digestion leads to weight loss. Jaundice, dark urine and clay colored stools are present.

In advanced cirrhosis patient suffers from portal hypertension (portal hypertension is the increased pressure in the portal venous system). Portal hypertension leads to retention of fluid and gastrointestinal bleeding. Ankles and abdomen become swollen due to retention of the fluid.

Hyperspleenism (Enlarged spleen) is another complication found in chronic cases of hepatitis B virus infection. Blood cell count decreases leading to anemia, infections and thrombocytopenia (Impairment in the clotting of blood).

Other organs are also affected during hepatitis B virus infection. Hepatitis B virus immune complexes are formed by binding of hepatitis B antibody and hepatitis B virus antigen. These complexes stuck in small arteries resulting in a condition called as polyarteritis nodosa. Large number of symptoms such as skin ulcers, muscle weakness, fever, abdominal pain and kidney failure are produced due to this condition.

Diagnosis

Diagnosis of hepatitis B is made on the basis of blood tests. Detection of hepatitis B surface antigen (HBsAg) in the blood is the first marker of hepatitis B virus infection. Presence of HBsAg indicates the presence of active hepatitis B virus infection.

Hepatitis B core antigen (HBcAg) is not detected in the blood but antibody to HBcAg (anti-HBc) is present in the blood which can be found a week or two after the detection of HBsAg.

Hepatitis B e antigen (HBeAg) is detected in the blood along with its antibody (anti-HBe) which indicates active viral replication. In the same way presence of HBV DNA in the blood also indicates active viral replication and infectivity.

Treatment of Hepatitis B

  • For acute HBV infection no definite treatment is available. Acute HBV infection goes away with the course of time.

  • Interferon alpha and lamivudine are two drugs recommended for the treatment of chronic hepatitis B virus infection.

  • Liver transplantation is recommended for patients with liver failure and advanced cirrhosis caused by the acute infection of hepatitis B virus.

References

Centers for Disease Control and Prevention, National Institutes of Health, HIV Medicine Association/Infectious Diseases Society of America. Treating Opportunistic Infections Among HIV-Infected Adults and Adolescents . MMWR Recomm Rep. 2004 Dec 17; 53(RR15);1-112. Available online at aidsinfo.nih.gov/Guidelines/GuidelineDetail.aspx?GuidelineID=14. Accessed May 19, 2006.

Keeffe E. Clinical Care Options Management Series: Diagnosis, Treatment, and Chronic Care Options for Hepatitis B . Accessed February 7, 2006.

Soriano V, Puoti M, Bonacini M, et al. Care of patients with chronic hepatitis B and HIV co-infection: recommendations from an HIV-HBV International Panel . AIDS. 2005 Feb 18;19(3):221-40.