Paging Dr. Frischer: Hepatitis B
The CDC recently issued new vaccine and screening recommendations for hepatitis B. This is an important development; you may be eligible to have the highly effective hepatitis B vaccine.
Hepatitis B is a liver disease caused by the HBV virus. It is highly contagious and spreads through contact with infected blood, semen, or other bodily fluids. Although the virus can be found in saliva, it is not spread through kissing or sharing utensils, nor is it spread through sneezing, coughing, hugging, breastfeeding, food, or water. Those at high risk include medical personnel, front-line workers like police and firefighters, those who have unprotected sex, and those using unsterile needles from drug use.
Acute hepatitis B can lead to chronic hepatitis B, a lifelong infection. That can range from mild to severe and life threatening, requiring hospitalization. The CDC estimates that about 640,000 adults in the United States have chronic hepatitis B, which left untreated can cause liver damage, cirrhosis, liver cancer, and death.
Many of those with hepatitis B do not have symptoms and may not even be aware that they are infected. If there are symptoms, they might include dark urine and clay-colored stool, fatigue, fever, joint pain, loss of appetite, nausea, and jaundice. If symptoms occur during an acute infection, they often begin 90 days after exposure. Although the symptoms of an acute and a chronic infection may be similar, most people with chronic HBV do not have symptoms for years, often decades, following exposure.
The CDC recommends vaccination for all infants, all unvaccinated children and adults under 60, and those who are 60 and older who are at higher risk.
The CDC also recommends that all adults be screened for hepatitis B at least once in their lifetime through a simple blood test. Those who should be tested more often include all pregnant women during each pregnancy, infants born to pregnant women who are infected with HBV, and those with an ongoing risk of exposure.
If a blood test indicates that you have acute or chronic hepatitis B, a gastroenterologist will monitor your liver. If symptoms are mild, the treatment will involve nutrition and rest. You would be vaccinated against hepatitis A, and tested for hepatitis C. You would be advised to limit alcohol consumption (because alcohol is hard on the liver), to follow a healthy diet, to be physically active, and to avoid any prescription or over-the-counter drugs that might affect the liver.
There are no medications for acute hepatitis B, although there are some to help treat chronic hepatitis B. Unfortunately, there is no cure for this disease. I urge you to do everything you can to avoid getting (and spreading) it, including becoming vaccinated.