What is hepatitis?
Hepatitis is enlargment of the liver due to inflammation, liver’s inflammatory is a condition that may be caused by variuos reasons, as virus and called “viral hepatitis”, alcoholism, high fat intake, increase storage of fats or glycogen in the paranchymal cells of the liver, or the liver may be get inflamed due to attacking of immune cells to the liver cells which called “autoimmune hepatitis”
What is Viral Hepatitis?
Hepatitis is an infection of the liver by a virus, may be called “viral infection”, this viral infection my be caused be an interaction with pre-infected or contaminated source or animal, as many hepatitis viruses transferred in the human blood through various routes such as: hepatitis A virus which is transmits via oral-fecal route, and Hepatitis C virus which transmits by blood transfusion mainly.
What is Hepatitis B virus?
Hepatitis B is a inflammation of the liver due to infection with the hepatitis B virus (abbreviated to HBV) and followed by irritation and swelling of the organ.
What cause Hepatitis B virus?
Many risk factors that lead to the human get infected, may be an injury by needle stick or sharp tools, some infected body fluids blood or urine, stool, semen, vaginal fluids, or salivary liquid transfer the infection to you if any of these get on an open injury of your body’s skin.
How HBV transferred or who is the vulnerable people to HBV infection?
Many jobs are vulnerable to HBV infection such as:
unprotected sex with an infected partner. Receive blood transfusions (not common in the United States). Have contact with blood at work (such as health care workers). Have been on long-term kidney dialysis. Get a tattoo or acupuncture with unclean needles. Share needles during drug use. Share personal items (such as toothbrush, razor, and nail clippers) with a person who has the virus Were born to a hepatitis-B infected mother.
What is the common hepatitis symptoms and signs?
In the beginning of viral infection with HBV you may have no symptoms or you just feel sick for a period of days or weeks, also you may become very ill very quickly (called fulminant hepatitis).
The Hepatitis patient will feel one or more of these symptoms:
Abdominal pain or distention
Breast development in males
Dark urine and pale or clay-colored stools
Fever, usually low-grade
Jaundice (yellowing of the skin or eyes)
Loss of appetite
Nausea and vomiting
Also hepatitis B show with signs:
Enlarged and tender liver
Fluid in the abdomen (ascites)
Yellowing of the skin
What is the carrier people means?
Carrier person is the one who carry the virus B and have no symptoms but it is high contagious and it is an infectious person, means Hepatitis B carrier is the person who carry the infection and spread it even if he not feel any symptoms or show a sign.
Blood test results to diagnose Hepatitis B virus is:
First common test is to carry hepatitis viral panel when a heptitis diseases is suspected, include: HAV, HCV, HBs-Ag, and HIV 1-2 Ab. If HBs-Ag is Positive, then confirmatory tests should be done.
HBV confirmed by Complete HBV antibody and antigen screening test, which includes: (HBs-Ag, HBs-Ab, HBc-Ag, HBc-Ab, HBe-Ag, and HBe-Ab), each test explain the viral timeline, means each antigen and antibody appears in a particular time during viral period which called “viremia” and help physician indicate the appropriate medical descision.
HEPATITIS B SURFACE ANTIBODY results for Unvaccinated will appear negative while Vaccinated will appear positive.
HEPATITIS B SURFACE ANTIBODY by QUANTITATIVE methods
Unvaccinated: <10.0 mIU/mL
Vaccinated: > or =10.0 mIU/mL
What do HBs-Ag, HBs-Ab, HBc-Ag, HBc-Ab, HBe-Ag, and HBe-Ab mean?
HBs-Ag is stands for Hepatitis B surface antigen and appears Positive prior to infection, so it is an important indicator of recent infection.
HBs antigen If positive indicates acute HBV infection while liver enzymes elevated. Or chronic HBV infection with enzymes fluctuate. Or HBV carrier and his enzymes not elevated.
HBs-Ab is abbreviated to Hepatitis B surface antibody and appears positive at the final viremia period and indicate recovery, also it is build in the body slowly during verima until it peaks about 4 weeks after HBsAg disappears.
HBc-Ag is the abbreviation to Hepatitis B core Antigen.
HBc-Ab is stands for Hepatitis B core antibody, and it is appears after HBcAg disappears and last as long life immunity.
HBe-Ag is stands for Hepatitis B extracellular antigen and appears Positive for very short time then disappeared after development if its antibodies “HBeAb”.
HBe-Ab is a word describe the Hepatitis B extracellular Antibodies against HBe antigens.
What is meant by “Hepatitis B Virus is Positive”?
If HBs-Ag is the only Positive: it is means that it is HBV is recent infection which indicate acute hepatitis B virus and Liver function panel should be ordered to define health status of the liver.
Liver tests may be elevated due to HBS virus is (GOT “AST”, and GPT “ALT”) results may be show double the upper normal limit or higher due to damage caused as a result of virus reproduction the matter which require destroy the hepatic cells integrity and pour its components in the blood serum. Bilirubin test in HBV condition is elevated as viremia increase and high DNA count in PCR test of HBV.
Alkaline Phosphatase and GGT tests may be elevated but in severe hepatobiliary damage.
Lab will carry a prothrombin time test because it is the primary analyte get changed or elevated upon liver abnormality is occur. If PT time and INR is elevated, it may be or may be not indicate virus B or other virus infection. Next is to carry PCR test for HBV virus to know the exact count of DNA made up by virus units, high PCR count indicate high load of HBV.
What test results suggest HBV is negative?
HBs-Ag test is a very good indicator to know whether hepatitis B virus is found if the test is Positive or virus not found if the test results is negative.
PCR test for HBV is the strong indicator that the person never infected before or being sick under a virus invasion.
What is the difference between Acute and chronic hepatitis B virus?
As long as the results bieng limited or deceased the patient may be acute heptic B or going to be a carrier person. When the test results elevated to quadret the upper normal limits of liver function tests as well as high DNA load in PCR test, it is the chronic hepatitis B virus and high viremia that a patient will be in.
Your liver function is becoming worse quickly
You develop symptoms of long-term liver damage
You have high levels of the hepatitis B virus in your blood
If you develop rapid liver failure, you may need a liver transplant. A liver transplant is the only cure in some cases of liver failure. Not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor
How I know HBV vaccine coarse is succeful?
the HBV vaccines contain HBS-Ab and induce the increasing in producing HBs-Ab to kill virus kids “DNA”. For this reason HBsAb is the good indicator of recovery and ending of existence of the HB virus.
HBcAb is a long life immunity against HB virus, so it is usefull to utilise HBcAb test as an indicator of either previuos infection or inddicator that the recovery is soon.
Example blood test results for patient suspect HBV infection:
HBsAg is positive
HBsAb is negative
Alkaline Phosphatse: 120
Bilirubin, total: 1.2, normal bilrubin must not exceeds 1.0 mg/dl
Direct Bilirubin: 0.4, elevated
Indirect bilirubin: 0.8, normal indirect bilirubin
Total protien: 8.0, normal Total protien
Albumin: 4.3, normal Total protien
PCR test for HBV: 500.0 unit, this indicate Low viremia
INR value: 1.17, indicate a little elevation
Complete blood count:
WBC count: 11.000 cell/cucm.
RBCs count: 4.5 million cell/cucm.
Platelets: 300.000 cell/cucm.
Color is a little dark yellow
Pus cells: 5 – 6 cell/HPF.
RB cells: 1 – 3 cell/HPF.
Interpretation of HBV results:
HBsAg Positive means the hepatitis B virus is found.
HBsAb Negative means the hepatitis B virus is still found.
Since liver enzymes both SGOT and SGPT is double high with slight elevation in bilirubin and Total Protien, albumin, ALP tests is within normal ranges, in addition to Low viremia count in PCR count for HBV DNA, the exact description is acute hepatitis B virus at a recent infection and may be the incidence was 3 weaks ago. The best medical desicion when HBsAg is Positive to directly head to a specialist in GIT or Liver diseases.
Next step may be vaccination coarse against HBV for a period depends on the status of the petient’s liver and virus count according to medical examinations and lab results.
What is the effective medication for Hepatitis B virus?
List of Approved Hepatitis B vaccines in the United States, all of them once a day or a weak and the drug can cause side effects such as flu-like symptoms, depression, and headaches.
Interferon Alpha (Intron A) is given by injection several times a week for six months to a year. Pegylated Interferon (Pegasys) is given by injection once a week usually for six months to a year. Lamivudine (Epivir-HBV, Zeffix, or Heptodin), Adefovir Dipivoxil (Hepsera) is a pill taken once a day as Entecavir (Baraclude) and Telbivudine (Tyzeka, Sebivo).
Follow up on HBs Ag +ve patients
ALT is the test used to decide whether the patient has active disease that should be
considered for anti-viral therapy.
If the ALT >60 units, it should be repeated in 4 months. If the elevation >60 persists,
the patient should be referred for specialist follow-up.
HBe Ag should also be checked and repeated annually if found to be positive.