What is hepatitis B?

Hepatitis B is a serious liver infection caused by the hepatitis B virus. It is important to find because this disease can lead to liver cancer, liver failure, or cirrhosis, a condition that causes scarring of the liver. After infection, most people clear the virus after an acute (short-term) illness, but some can have a chronic (long-term) infection, lasting for more than 6 months and possibly for the rest of their lives. This disease is deserved immediate attention because it can be prevented with a vaccine; is easily diagnosed with blood tests, and treatments are available for people with this infection.

How common is hepatitis B in Vietnam, and who is at risk?

In Vietnam and all of Asia, hepatitis B is more common than in other countries around the world.  In Vietnam, especially, as high as 10% to 20% of the population may be infected with hepatitis B.  Therefore, everyone should be tested for this disease as part of their routine health care.  However, certain groups of people are at even higher risk for having hepatitis B, including those who have unprotected sex with multiple partners or someone with hepatitis B; shares needles during intravenous (IV) drug use; is a man who has sex with men; lives with someone with hepatitis B infection; was born a mother with infection; or has a job with blood exposure.

How do I get hepatitis B and what symptoms would I have?

Hepatitis B is spread by sexual contact; sharing needles and needle sticks among health care workers; or from mother to child during pregnancy. Symptoms range from mild to severe, usually starting a month after infection. Symptoms include abdominal pain, fever, yellowing of skin and eyes (jaundice), weakness or fatigue (low energy), fever, and dark urine. In many cases, there are no symptoms for many years until the liver is completely scarred (cirrhosis) and symptoms of liver failure develop. Also, this disease puts people at risk for developing liver cancer, even when there is no more infection.

What tests are there for hepatitis B?

To diagnose hepatitis B, blood tests can check whether a person has the infection and whether it is acute or chronic. There are several blood tests for this disease, including testing the amount of virus in the blood; a person’s immune system’s response to infection (antibodies); and testing for specific parts of the virus in your blood (antigens). It is not possible to diagnose hepatitis B infection without blood tests.

I am diagnosed with hepatitis B, what happens next?

Your doctor may need more blood tests to see if other infections are present; for example, your doctor may have to test your kidney and liver functions; recommend radiology tests to better see the liver; or perform a liver biopsy to see if there is any scarring present. These tests are important because this information helps your doctor decide if you would be someone who needs treatment soon, or if monitoring would be safe.

If your doctor determines that you have a short-term (acute) hepatitis B infection, then you may not need treatment and the infection would go away on its own. In this case, you may only need vaccine shots for the acute hepatitis infection (you would want this for hepatitis A as well) and good nutrition for healing.

What treatments are available for hepatitis B?

There are several treatments for long-term (chronic) hepatitis B. The treatment choice and doses of medications may differ depending on your age and kidney function.

Medications include:

– Antiviral medications: these attack the virus to prevent liver damage from happening, and include lamivudine (Epivir), adefovir (Hepsera), telbivudine (Tyzeka) and entevacir (Baraclude). Your doctor can help to figure out which medication is the best option.

– Interferon alfa-2b (Intron A) is a treatment using a substance similar to one produced by the body to fight off infections.

If your liver has severe scarring, then a liver transplant may be an option.

Note: Anyone with hepatitis B infection should also get a vaccine for hepatitis A, another virus that causes liver infections and is common in Vietnam.

My doctor said I should consider being in a “clinical study.” What is a clinical study?

Scientists work to cure diseases, and new medications are being developed to treat hepatitis B infection. A clinical study is a research using human volunteers; it is intended to add to medical knowledge and can involve 1) only collecting information over time (observational) or 2) a medication or other treatment (interventional or experimental). For some people, the current medications may not be an option (or the best choice), so clinical studies may help allow access to other treatments. If this is an option being considered, then talk to your doctor and the study developers to learn more about the clinical study design and whether it is right for you.

Medical syringe isolated over a white background.

Can I prevent hepatitis B?

The best way to avoid this infection is to avoid being exposed to it; avoid sex with people who have hepatitis B, and/or using drugs with needles. If you were exposed, call your doctor right away because getting a shot of antibodies against hepatitis B (immune globulin) within 12 hours may protect you from developing an infection. Also, there is an effective vaccine that can help prevent hepatitis B infection. The vaccine works by causing your body to produce its own protection (antibodies) against this disease.

Notes

Links which may be useful:

  • Review Vietnamese-American article: link
  • Clinical Trials website, learn about clinical studies: link
  • National Library of Medicine Resources (Vietnamese): link