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Sex and Hepatitis B

What is Hepatitis B?

Hepatitis B is inflam- mation of the liver caused by Hepatitis B Virus (HBV), a lifelong infection that could lead to cirrhosis (scarring) of the liver, hepatoma (cancer of the liver), liver failure and death.

How does one catch Hepatitis B?

HBV is transmitted by unprotected sexual contact with a person with the infection, by receiving blood transfusion from a donor infected with the HBV, by using HBV contaminated needles among patients, or by sharing HBV-contaminated needles or drugs among drug addicts, and by maternal-fetal (mother to baby, during birth) transmission.

How about food, water, etc?

No, the Hepatitis B virus is not spread through water, food, eating utensils, pots and pans, sneezing, coughing, holding hands, hugging, kissing, or by casual contact. Unsafe sexual practices is one of the most common causes, and mode of spread, of this viral infection.

How prevalent is HBV infection?

There are 360 million HBV chronic carriers worldwide, 78 percent in Asia, 16 percent in Africa, 3 percent in South America, 3 percent in Europe, North America and Oceana combined. The prevalence in the Philippines, evidenced by HBsAG positivity is in the range of 2 to 16.5 percent, averaging about 12 percent, translating to about 10.5 percent Filipinos. Mass HBV vaccination in many Asian countries showed the EPI (Extended Program on Immunization as a public program) has led to a drastic reduction in the prevalence of HBV infection. Notwithstanding these great strides, HBV infection rate in this region of the world is still the highest. In the USA, in 2003 alone, there were 73,000 people infected with HBV, and about 5,000 Americans die each year from the infection or its complications.

How is the diagnosis made?

Only a blood test can confirm for sure if a person has hepatitis B infection or not. After a person is exposed to the HBV, it takes about 4 weeks (range: 1-9 weeks) for the blood test (HBsAg) to show if a person has acquired the HBV infection.

How soon after the exposure do symptoms occur?

After exposure to HBV, the symptoms, if they occur, will manifest on the average of 12 weeks (9 to 21 week range). Only 70 percent of patients will have symptoms, the 30 percent will be symptom-free although infected. Adults are more likely to show clinical symptoms than children.

When is the HBV patient infectious?

About half of the persons with hepatitis B will no longer be infectious (not "contagious") seven weeks after the onset of their symptoms. The other half will still be able to spread the infection even after 7 weeks. All patients with HBV who do not stay chronically infected will test negative for HBsAg 15 weeks after the start of their first symptoms.

What symptoms do HBV patients have?

Not all patients develop symptoms, especially among adult and older patients. One might have hepatitis B infection and spread it around without even knowing he/she had the infection. If symptoms show up, they might include: jaundice (yellow discoloration of the skin and the whites of the eyes), anorexia (loss of appetite), fatigue (tiredness), nausea, vomiting, arthralgia (joint pains), abdominal discomfort, chalky-white bowel movements, dark yellow urine.

What are the risk factors for HBV?

You have a higher risk of getting HBV infection if you: (1) have sex with a person infected with HBV, (2) have sex with multiple partners, (3) shoot drugs, (4) are a homosexual, (5) have a housemate(s) who has chronic (long term) HBV, (6) have hemophilia, (7) work with, and in contact with, human blood, (8) live in a home for the developmentally disabled, (9) travel to countries where HBV infection is common, (10) have parents who were born in Southeast Asia, the Amazon Basin in South America, Sub-Saharan Africa, the Pacific Islands or the Middle East.

Who should be vaccinated?

The following should be vaccinated: all babies, at birth; all children up to 18 years who have not been vaccinated before; and people of any age whose job or behavior puts them at a high risk for HBV. Since prevention of this potentially serious infection is most essential, it is prudent to discuss this issue with your physician.

Is there an oral treatment for chronic Hep-B?

On August 20, 1998, drug maker Glaxo Wellcome received from the Bureau of Food and Drugs in the Philippines the first regulatory approval for the world’s first oral anti-viral treatment for chronic hepatitis B, called Zeffix (lamuvudine). According to an article in the New England journal of Medicine a month before, Zeffix (100 mg per day) led to 98 percent reduction in hepatitis B DNA (a marker of viral replication) and a very high rate of seroconversion (predictor of long lasting remission). Today, there are at least 5 anti-viral dugs available for the treatment of chronic hep-B (Adefovir, dipivoxil, interferon alfa-2b, pegvlated interferon alfa-2a, lamivudine and entecavir), but there is no drug that prevents hepatitis B infection, or treats recently acquired (acute) hep-B infection. The best strategy is still prevention, especially for hepatitis B which could lead to liver cancer, liver failure, and death.

The main objective of this column is to educate and inspire people to live a healthier lifestyle to prevent illnesses and disabilities, and achieve a happier and more productive life. Any diagnosis, recommendation, or treatment in our articles are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who is familiar with your condition and your best ally when it comes to your health.

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