Hepatitis B: What You Need To Know
Prevention and Treatment More than 1 million Canadians have been infected with hepatitis B at some point — though many of them do not know it.
With new antiviral therapies, chronic hepatitis B can now be treated more effectively than ever before – but only if those at risk get tested and diagnosed.
The hepatitis B virus, transmitted through contact with infected blood and bodily fluids, attacks the liver and causes inflammation, however those infected often do not exhibit signs of infection until significant liver damage has occurred.
“Most people will have no symptoms at all because their liver function is still strong and normal,” says Dr. Scott Fung, a hepatologist at Mount Sinai Hospital. “So patients feel well and they’re often quite surprised when the blood test comes back showing evidence of either chronic infection or previous exposure to hepatitis B.”
In Canada, 111,800 people are infected with hepatitis B according to a 2011 Statistics Canada study. Approximately 1.1 million people tested showed evidence that they had been infected with hepatitis B at some point, whether they knew it or not.
Who’s at risk?
According to Fung, there is a misconception that hepatitis B can be passed through hugs, handshakes, or kissing, but this is not the case. The virus is only transmitted through contact of body fluids with infected bodily fluids, such as blood, saliva, semen, or vaginal secretions.
“Patients feel well and they’re often quite surprised when the blood test comes back showing evidence of their chronic infection or previous exposure to hepatitis B.”
“It’s not readily transmissible through casual contact,” he says.
One of the most common ways that it is transmitted is from mother to child. Those who are infected at birth are also at an increased risk of developing a lasting infection, referred to as chronic hepatitis B.
“The majority of patients that we are seeing are patients who were born with hepatitis B or contracted the virus very early in life,” says Fung. “Areas like Southeast Asia, Eastern Europe, the Mediterranean, and sub-Saharan Africa are hotbeds of maternal to child transmission of hepatitis B.”
The virus can also be spread through drugs that are snorted or injected, unprotected sex or sex with multiple partners, and contaminated medical, hygiene, tattoo, or piercing equipment.
How is it treated?
The majority of adults infected with hepatitis B will recover naturally within six months and develop the necessary antibodies to protect themselves against the virus in the future. However, five percent of adults are unable to clear the virus on their own and will instead develop chronic hepatitis B — a condition that, if left untreated, can lead to liver cirrhosis and cancer.
Hepatitis B can be detected through a simple blood test. If a patient is diagnosed with hepatitis B, Fung explains that, depending on the extent of liver damage, physicians will either monitor the infection or recommend treatment.
“Nowadays we have oral antiviral treatments which are very successful in shutting down replication of the virus,” says Fung. He adds that unlike hepatitis B therapies used in the past, these treatments are taken as a daily pill and result in little to no side effects.
While antiviral treatment will not necessarily cure chronic patients, Fung says he has seen it change lives for the better: “The liver enzymes normalize, the amount of scarring gets better, and we even think the risk of developing cirrhosis and liver cancer also decreases with long-term antiviral treatment.”