Hepatitis is an inflammation of the liver. It can be caused, amongst other things, by infection with various hepatitis viruses (hepatitis A, B, and C, D, E viruses). The different forms of hepatitis have different characteristics and different routes of infection.

The hepatitis B virus is found particularly in body fluids (saliva, semen, vaginal mucus, blood or plasma). Hepatitis B is therefore transmitted particularly by sexual contact and is highly contagious. The virus needs only microscopically small skin lesions to allow it to enter the bloodstream. An infected pregnant woman can also pass on the infection to her child.

The disease can also be transmitted by contact with infected blood or blood products.

Symptoms and signs

Some people have hepatitis B without being aware of it. Acute infections begin with loss of appetite, aversion to certain foods, nausea, mild fever and muscle and joint pain. In the second phase of the disease jaundice develops, that is the skin, mucous membranes and eyes turn yellow. The feces lose their color and the urine becomes dark. The disease usually lasts four to six weeks. After this the patient recovers.

A possible complication is chronic hepatitis which can be symptom-free or characterized by tiredness, joint pain, aching muscles and occasional discomfort under the right costal arch. Patients with longstanding chronic hepatitis B have a considerably increased risk of developing liver cirrhosis or liver cancer.

Diagnosis

The doctor will take your history and ask you about your symptoms. Imaging procedures (e.g. ultrasound) may be used to assess the size and texture of the liver. A blood test provides information about liver function and allows detection of the virus. If chronic hepatitis is suspected a liver biopsy (removal of a sample of liver tissue) may be necessary.

Prevention and treatment

There is a very effective vaccination against hepatitis B. It consists of three doses of vaccine and provides protection lasting at least five years. There is also a combined hepatitis A/hepatitis B vaccine.

In addition, safer sex should always be practiced.

If you develop acute hepatitis the doctor will order symptomatic treatment in the form of bed rest, abstinence from alcohol or discontinuation of all drugs that place a burden on the liver. There is no causal treatment for hepatitis B.

When the acute liver inflammation has subsided the hepatitis B usually clears up and no further treatment is necessary.

If chronic hepatitis B has been diagnosed (six months after onset of the acute liver inflammation at the earliest) drug treatment is given, e.g. with interferon (an antiviral drug).

If the chronic hepatitis B has progressed to liver cirrhosis liver transplantation is often the only option.

Patients with longstanding chronic hepatitis B should have regular medical check-ups so that serious complications such as liver cancer can be detected as early as possible.