Hepatitis B

Hepatitis B is spread throughout the world. The disease is the most prevalent in Central and South America, Southeast Asia and certain countries of Eastern Europe.

The virus is found in all body fluids, and the most important in terms of transmission of infection are the blood, saliva and semen of infected persons. The infection is most commonly transmitted through contact with infected blood, through sexual intercourse and from mother to child during pregnancy or birth. It is also possible to become infected through tattooing, ear piercing and acupuncture. There is a high risk of infection among intravenous drug users who share their accessories, and inhalant users.

The HBV can survive for several months in a serum at 4oC, up to six months in a surveillance culture at temperatures between 30 and 32oC and several years at -20oC. Boiling water destroys the virus in 10 minutes, dry heat at 160oC in 2 hours, 1% sodium hypochlorite in 30 minutes and 40% formaldehyde in 12 hours.

According to some estimates, there are more than 350 million people in the world who are chronically infected with hepatitis B, and the blood of as much as a third of the global population shows signs of past or fresh infection with hepatitis B. There are approximately four million new acute cases each year, and approximately a million people die of chronic effects of cancer and liver cirrhosis.

Almost one in a hundred Slovenians carry the hepatitis B virus but do not experience any problems. Experts estimate that there are approximately twenty thousand chronic carriers of the virus in Slovenia, many of which are chronic liver patients. The symptoms and consequences of liver inflammation depend on the properties of the virus, the organism’s defensive capabilities and certain external factors. The risk of liver cancer for a person who is chronically infected with the hepatitis B virus is ten times greater than the risk of lung cancer for a smoker.

In 90 percent of adults, acute infection leaves no consequences, but in 10 percent of infected adults, 25 percent of infected children and 80 percent of infected newborns, the disease becomes chronic, and the viral infection lasts for a minimum of 6 months and is reflected by abnormal results of liver function tests, and changes in liver tissue. In a few years, chronic patients can get liver cirrhosis or liver cancer. Liver failure due to chronic hepatitis B infection occurs in more than half a million people per year and constitutes the reason for 5 to 10 percent of all liver transplants.

Risk for HBV transmission through unprotected sexual intercourse

Sexual intercourse with a person with:

• acute HBV: the risk of transmission is 20-40%;

• if the sexual partner is a chronic carrier and it is a long-term relationship, the risk of transmission is in excess of 70%;

• 30-40% of all infections as yet lack an etiological explanation.

Vaccination against hepatitis B is mandatory for people with an increased risk of infection, and since 1998 all children in Slovenia are vaccinated against hepatitis B before starting school. More at http://www.drustvo-bpnb.si/index.php/english-articles/203-vaccination-against-hepatitis-b.

Vaccination against hepatitis B is recommended to anyone travelling to countries where the disease is widespread, as well as to those with an increased risk of infection due to their habits. Vaccination with vaccine against hepatitis A and hepatitis B (bivalent recombinant vaccine) protects against both types of hepatitis. More at http://www.drustvo-bpnb.si/index.php/english-articles/204-vaccination-against-hepatitis-a-and-hepatitis-b.