Hepatitis B virus is a common cause of hepatitis infection in our
population. It is a serious illness that can cause inflammation and scarring of
the liver which can be long-lasting.
It can cause acute liver failure where it severely disturbs the liver functions, thereby requiring hospital
admission and management which sometimes may include referral for liver transplant.
Chronic infection carries the risk of cirrhosis (scarring of liver), liver failure
and liver cancer.
If acquired in infancy and childhood, it is more likely to become chronic (long-lasting). Not everyone who acquires
the chronic infection needs treatment but a regular follow up with hepatologist (a doctor with expertise in dealing
with the liver problems) is warranted.
Sometimes, hepatitis B can co-exist with another virus called hepatitis D virus causing
co-infection which needs different treatment and management.
The main modes of transmission are by:
Symptoms and Signs
Depending upon the mode of presentation, hepatitis B can be asymptomatic (no
symptoms at all) or may manifest as:
Vaccination is an important strategy to prevent the infection. An effective
and safe vaccine exists for hepatitis B. It is usually given in three doses over
a period of 6 months and should be given to every non-infected individual
including children. It is a usual part of birth vaccination schedule.
Hepatitis B vaccine and immunoglobulins are given at birth to children born
to mothers with positive hepatitis B virus. It is best to know your hepatitis B
status before travelling. If a partner is affected, it is imperative to screen
the other one, followed by vaccination if found negative for the virus.
Similarly, if one of the parents is affected, the whole family should be
screened out, followed by vaccination if found negative for the virus and not
already given before.
Vaccine gives lifelong protection so don’t miss the chance of getting
vaccinated for hepatitis B if not received before.
Pakistan remains a high zone for hepatitis B and C. Avoiding high risk behaviours, propagating the culture of
vaccination and screening are some of the ways which can help eliminate these viruses.
Safe oral drugs are available for hepatitis B that can effectively suppress the virus.
They are usually given in patients with chronic (long-lasting) hepatitis B and are to
be taken for a long period of time because the virus may show up again despite
effective suppression if treatment stopped without consulting the doctor. Once
started, treatment should be taken on regular basis without any gap.
Not all patients require drug therapy as most have the virus in an inactive phase
which requires frequent monitoring. Hepatitis B patients under follow-up spend a
normal life and unnecessary restrictions should not be imposed like avoid sharing
meals. Avoid risk factors such as sharing needles and shaving kits etc.
Those cases who develop hepatitis B associated cirrhosis (scarring of liver) require
different management steps along with antivirals. They may also require liver
transplant at some point and should strictly follow up with their doctor.