Hepatitis B

Hepatitis B disease is caused by infection with the Hepatitis B virus. The WHO estimates that nearly 300 million people are living with this hepatitis B infection. The Hepatitis B virus is a hepadnavirus that is transmitted majorly through contact with bodily fluids like saliva, semen, blood, and others. Infection can be acute or chronic, and symptoms may include nausea, vomiting, joint pain, fever, abdominal pain as well as fatigue.

Acute infections are new infections and may or may not be with symptoms. For someone with an acute infection, a blood test after six months of the first diagnosis of the disease would be negative if carefully managed.

If a person is unable to completely get rid of the virus after six months, it can lead to a chronic infection. A chronic infection is more severe and can lead to other complications like liver cirrhosis or hepatocellular carcinoma if not managed properly.

There are different stages of chronic infection; the immune tolerant phase is when an individual has a high viral load but with normal liver enzymes and no damage to the liver. In this phase, the immune system is tolerant of the virus and has not yet been activated to fight it. This phase can last for many years. The inactive phase is when the individual’s viral load is low or undetectable and liver enzyme levels are normal with no liver inflammation or complication. Here, the immune system has been able to overcome the virus. In the active phase, the immune system is not able to launch an attack against the Hepatitis B e antigen that is strong enough to seroconvert, therefore, viral load is high, accompanied by heightened liver enzymes and liver inflammation. All these phases can last varying times within an individual and constant monitoring of your viral load is crucial at least every six months to know what stage you are at and to be managed accordingly. Without this constant monitoring, the infection can go unchecked and proper management may not be administered which can gradually lead to various liver complications including liver cancer.