A brief introduction to Hepatitis B. Great for giving an overview to a non-medical audience...

1. HEPATITIS B
By
Dr. James, S. U.

3. Outline
• Introduction/Epidemiology
• Transmissions
• Natural History and Chronicity Risk
• Symptoms
• Possible Outcomes of HBV Infection
• Screening
• Symptoms
• Vaccination
• Treatment Options

4. Introduction/Epidemiology
• Viral Hepatitis refers to a group of inflammatory
diseases of the liver caused by viruses with
affinity for the liver.
• Clinically important ones are A,B,C,D and E. Of
which B and C are the most important
• Hepatitis B is a potentially life-threatening liver
infection caused by HBV.
• It can cause chronic infection and also increases
the risk of death fromCirrhosis and liver cancer.

5. Epidemiology
• More than 200 million carriers of the HBV
worldwide
• About 1 million people die each year from
Hepatitis B and it’s complications
• It is a major indicator in liver cirrhosis and
cancer.
• HBV is 50 – 100 times more infectious than HIV

7. Transmission
• Parenteral: IV drug abusers, health workers are
at increased risk
• Blood transfussion
• Sexual: Sex workers and homosexuals are at
higher risk
• Perinatal: From mother to infant
• NB: It is not transmissible by holding hands,
sharing eating utensils or drinking glasses,
kissing, hugging, coughing or breastfeeding

8. • Low prevalence areas: New Zealand, Australia,
USA, Canada and Western Europe
• Intermediate prevalence areas: Japan, Middle
East, Latin and South America, Central Asia
• High Prevalence Areas: China, Indonesia, Pacific
Islands, South East Asia, Sub-Saharan Africa
• About 70% of Nigerians has had a past HBV
infection

10. Natural History and Chronicity Risk
• The virus can survive outside the human body
for at least 7 days and up to 15 years (at 20°C)
• Incubation period is 30-180 days. The virus
becomes detectable 30-40 days post infection
• NB: About 90-95% of adults recover fully within
6 months of infection
• Infants (70-90% chronicity), children (30-50%
chronicity), adults and adolescents (1-3%
chronicity), Elderly (25% chronicity)

11. Possible Outcome of HBV

12. Screening
• Every person should be screened, especially those
who are at higher risk
• It should be included in pre-school, pre-insurance,
pre-employment, pre-blood donation
• Pre-marital screening and pregnancy
• Sexual history, STI
• Illegal drug users, chronic alcoholics
• Health care and allied workers
• All HIV patients
• Transfused patients, etc

13. Symptoms
• Anorexia, nausea, vomiting, headache, body
aches, mild fever, dark urine, jaundice and
possibly itchy skin
• NB: 50% of cases are asymptomatic

14. Vaccination
• The HBV vaccine has been available since 1982
and about 95% effective.
• In Nigeria, the vaccine was introduced into the
National Program on Immunization (NPI) in
2004.
• It is given at birth, 6 weeks and 10 weeks of life
• Unvaccinated adults will take 3 doses, the
second dose 1 month after the first and the third
6 months after the second dose
• A booster dose in 10 years

15. Treatment Options
• Acute HB infection does not usually require
treatment as most adults clear the infection
spontaneously
• Treatment in Chronic infection is to reduce the
risk of Cirrhosis and liver cancer .
• None of the currently available drugs clear the
infection, they can stop the virus from
replicating, thus minimizing liver damage.
• Antivirals, Immune system modulators

17. References
• https://www.slideshare.net/gantugstanan/hepatitis-b-
infection-hbv-47364892
• https://www.researchgate.net/figure/Possible-outcome-
of-hepatitis-B-virus-infection_fig2_8672566
• https://www.hhs.gov/immunization/diseases/hepatitis-
b/index.html#:~:text=All%20adults%20aged%2019%20
through,months%20after%20the%20second%20dose.
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC48856
99/#:~:text=In%20Nigeria%2C%20the%20vaccine%20
was,of%20routine%20immunization%20in%20children.
• Hepatitis B by Oladele S.