Hepatitis B – Diagnosis and Treatment
Diagnosis
Doctors use several tests and exams to find out if someone has hepatitis B. They look for signs of liver damage, such as yellowing of the skin (jaundice) or belly pain.
Sometimes, doctors use special tools or lab tests to get a clear answer.
Common ways to check for hepatitis B:
- Blood Tests: Blood tests show if the hepatitis B virus (HBV) is in the body. These tests also help tell if the infection is new (acute) or long-term (chronic).
| Test Name | What It Shows |
| HBsAg (Hepatitis B surface antigen) | Current infection (virus present) |
| Anti-HBs (Antibody to HBsAg) | Immunity to HBV (from past infection or vaccine) |
| HBcAg (Hepatitis B core antigen) | Past or current exposure to HBV |
| HBeAg (Hepatitis B e antigen) | Active infection, higher risk of spreading virus |
| HBV DNA levels | Amount of virus in the blood (viral load) |
- Liver Function Tests: Tests like alanine transaminase (ALT) check how well the liver works. High levels may show liver damage from hepatitis B.
- Liver Imaging: Sometimes doctors order a special ultrasound called transient elastography. This scan looks for scarring or stiffness in the liver.
- Liver Biopsy: In some cases, doctors take a tiny piece of liver tissue with a thin needle. They look at this tissue under a microscope to check for damage.
Checking People Who Seem Healthy for Hepatitis B
Doctors may test people who feel well for hepatitis B. This process is called screening. Screening helps find infections early, before problems start.
People who may need screening include:
- Pregnant people
- Household members and sexual partners of someone with HBV
- Individuals with many sexual partners or a history of STIs
- People living with HIV or hepatitis C
- People who use injected drugs
- People needing dialysis
- Anyone taking medicines that weaken the immune system
- Those born in or connected to regions where hepatitis B is common
- Individuals in correctional facilities
Doctors may also advise screening if a person has unusual liver test results or is at higher risk due to work or lifestyle.
Routine tests for screening often include the triple panel test (HBsAg, anti-HBs, and anti-HBc). This checks for current infection, immunity, and past exposure.
Treatment
Steps to Lower Infection Risk After HBV Exposure
Anyone who has contact with hepatitis B virus (HBV) should see a medical provider right away. The healthcare provider checks vaccination history and reviews the type and timing of exposure.
For post-exposure prevention, a shot of hepatitis B immune globulin gives quick protection against the virus. This medicine works best when given within 24 hours after exposure.
| Medicine | When to Use | Protection Type |
|---|---|---|
| Hepatitis B immune globulin | Within 24 hours | Short-term |
| Hepatitis B vaccine | If unvaccinated | Long-term |
This injection only gives short-term protection. People who have never received the hepatitis B vaccine should also start the vaccination series at the same time.
Care Plans for New (Acute) HBV Infection
Most cases of acute hepatitis B get better without treatment. The immune system usually clears the virus in a few months.
Doctors advise patients to:
- Rest
- Eat healthy foods
- Drink plenty of fluids
- Stay in touch with healthcare providers for regular checkups
In severe cases, or if symptoms are strong, doctors may recommend a short hospital stay. Doctors rarely use antiviral drugs, but may consider them if someone develops liver failure or serious complications.
Common symptoms to watch for:
- Yellow skin or eyes (jaundice)
- Extreme tiredness
- Loss of appetite
- Nausea or vomiting
If symptoms get worse, seek medical help quickly.
Ongoing Treatment Plans for Long-lasting (Chronic) HBV Infection
Doctors aim to lower liver damage from the virus, stop the risk of cirrhosis and liver cancer, and prevent the disease from spreading to others.
Chronic hepatitis B treatment usually uses long-term antiviral therapy. These medicines control the virus, limit liver inflammation, and slow or prevent complications like liver disease and liver failure.
Main treatment choices include:
- Oral Antiviral Medicines: Patients usually take these drugs as daily pills. Sometimes, doctors use a combination of medicines for better results.
- Pegylated Interferon Therapy: This treatment involves the use of injectable interferons given for a certain period. This therapy is often shorter than daily pills, but side effects like nausea, mood changes, and breathing problems are more common. Doctors may choose this therapy for younger patients or those planning a family. It is not advised for people with cirrhosis or severe liver damage.
Doctors consider the following before starting treatment:
- Signs of liver scarring or cirrhosis.
- Co-infection with hepatitis C or HIV.
- Weak immune system from illness or medication.
If hepatitis B has caused end-stage liver damage or liver cancer, doctors may recommend a liver transplant. Surgeons remove the sick liver and replace it with a healthy one from a donor.
Table: Treatment Methods and Their Uses
| Medicine or Method | Used for | Notes |
|---|---|---|
| Antiviral Medicines | Chronic HBV | Oral, long-term therapy |
| Pegylated Interferon Therapy | Chronic HBV | Intermittent, injection, more side effects |
| Liver Transplant | End-stage liver disease | For severe liver failure/cancer |
Doctors adjust treatment based on how well the virus responds and if liver damage improves.
Everyday Steps and Home Care
People can manage hepatitis B at home by taking simple but important actions to protect themselves and others. Practicing safer sex is important.
Anyone who is sexually active should tell partners about their hepatitis B status and always use a new latex condom. This lowers the chance of spreading the virus but does not remove all risk.
Anyone who may have been exposed to hepatitis B, such as sexual partners, should get tested. Avoid sharing personal items like toothbrushes, razors, needles, or syringes since these can carry infected blood.
Table: Key Ways to Lower the Risk of Spread
| Practice | Why It’s Important |
|---|---|
| Use condoms during sex. | Lowers risk of passing the virus. |
| Don’t share sharp items. | Prevents contact with blood. |
| Get tested and vaccinated. | Helps with early protection. |
Encouraging hepatitis B vaccination and completing the full immunization series helps prevent infection in others. Vaccines are effective in reducing the spread of hepatitis B and should be considered for anyone at risk.
Ways to Manage and Find Support
Staying informed about hepatitis B helps people feel more in control.
Building a support system by keeping in touch with friends and family is important. Hepatitis B does not spread through hugs, handshakes, or sharing meals.
Self-care tips:
- Eat a balanced diet.
- Exercise regularly.
- Get enough sleep.
Avoid drinking alcohol and talk to a healthcare provider before starting any new medicines.
Since hepatitis B spreads through blood and can be sexually transmitted, people should take steps to lower the risk of spreading the virus. Doctors may also recommend vaccination against hepatitis A.
Getting Ready for Your Visit
How to Prepare Before Seeing Your Healthcare Provider
Good preparation helps people get the most out of their medical visit.
Before the appointment, these steps can help:
Check for Special Instructions: Some lab tests require fasting or avoiding certain foods and drinks. Call the office and ask about any restrictions before your visit.
Record Problems and Symptoms: Write down all symptoms, such as jaundice (yellow skin or eyes), fever, fatigue, nausea, vomiting, abdominal pain, joint pain, and dark urine. Include symptoms that may not seem related, like tiredness or appetite loss.
Note Major Life Events: Write down any stresses or big life changes.
List All Medications: Prepare a list of all medications, vitamins, and supplements with their doses. This helps spot possible problems or interactions.
Bring Support: Bring a friend or family member to help remember important advice from the healthcare provider.
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Prepare Questions: Write down questions to ask during the visit. Example questions:
- What is causing the symptoms?
- What tests are needed?
- Are there possible complications?
- Is the HBV infection short-term or long-term?
- What treatments are available?
- Are there activity or food restrictions?
- Should family members be tested or vaccinated for hepatitis B?
- How to prevent spreading HBV to others?
| Checklist Before Your Visit |
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Questions Your Healthcare Provider Might Ask
During the appointment, your healthcare provider will likely ask about:
- When symptoms such as fatigue, nausea, vomiting, or jaundice started
- Whether these symptoms are always present or come and go
They may also ask about any recent changes in the color of your urine or stool. Your provider will want to know your vaccination history for hepatitis B.
They might ask if you have ever had liver inflammation or a hepatitis diagnosis. Risk factors like blood transfusions, drug injections, or unprotected sex may also come up.
Your provider may ask about your family history and possible exposure to HBV.
Your healthcare provider will usually perform a physical exam to look for signs such as yellowing of the skin (jaundice), stomach tenderness, or joint pain. They may talk about possible blood tests to check for signs of HBV infection or liver inflammation.
