Hepatitis B is caused by infection with the hepatitis B virus (HBV). Although 90 per cent of the people infected with hepatitis B are cleared of the infection, about ten per cent go into the chronic phase .Hence the outcome of the disease is different for different people.
- After the infection, in the first 6 months the person has acute hepatitis – hence this phase is known as the acute phase. During the acute phase the person suffers from fever, nausea, loss of appetite and yellow discolouration of the skin called jaundice. The symptoms may range from mild to severe in different people
- Fulminant hepatic failure (FHF) or acute liver failure (ALF) is caused when there is massive acute damage to the liver leading to the failure of its synthetic capacity and detoxifying capacity. This leads to hepatic encephalopathy. Hepatitis B is the most common infective cause of fulminant hepatic failure (FHF)
- In 90% of patients with hepatitis B, the infection is limited by the immune system of the body and the virus is cleared in approximately 6 months. Following this infection antibodies to hepatitis B develop and the person is immune to the infection lifelong. In 10%, of the infected persons, the virus is not cleared and hepatitis B infection continues beyond 6 months,. This persistent condition is known as chronic hepatitis B.
- In these 10 % of patient who develop chronic hepatitis B, there is constant damage, inflammation and scarring of the liver. This fibrosis or scarring of the liver causes cirrhosis of the liver and may lead to hepatocellular cancers. In fact hepatitis B infection is the most important cause of liver cancer.
- In infants who develop Hepatitis B infection there is a reversal of the ratios and almost 90 % develop chronic hepatitis
- It is therefore most important to visit a gastroenterologist and start treatment for hepatitis B.
- Once the patient is on treatment the success of the treatment can be measured by quantitative PCR of the blood for measuring the number of viral copies in the blood. These viral copies should keep reducing in patients who are on treatment.
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