Hepatitis B is a viral infection of the liver that affects over 200 million people worldwide. It can cause both acute and chronic infection and increases the risk of cirrhosis and liver cancer. The virus is transmitted through contact with infectious blood or body fluids and can be prevented through vaccination. While many acute cases resolve spontaneously, chronic infection puts people at high risk of serious liver diseases and requires treatment to control the virus and reduce liver damage. Regular screening is important for at-risk groups.

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.