Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). The virus can cause acute (which is self-resolving) or chronic hepatitis (which can progress to liver cirrhosis or cancer). The disease in many cases is a short-term illness in adults. Approximately less than 5% of adults and 90% of children with the virus will develop a chronic hepatitis B. The World Health Organization estimates that up to 257 million people are living with hepatitis B virus infection. In 2015, the disease reportedly resulted in 887,000 deaths with most of them due to complications such as cirrhosis and hepatocellular carcinoma (WHO, 2018).
Transmission
Transmission of the virus occurs through contact with blood or any other bodily fluids with a person infected with the virus. Therefore, the transmission can easily occur through improper sharing or reuse of needles and syringes. The disease mainly spreads through mucosal or percutaneous exposure such as saliva, vaginal, menstrual and seminal fluids (Davis, 2017). Sexual transmission occurs if in contact with an unvaccinated particular among heterosexuals with many partners, contact with sex workers and among men who have sex with men.
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Incubation and Diagnosis
The virus can survive out of the body for almost a week during which it can cause infection upon entry to a body of a person not vaccinated. Its incubation period is on average 75 days with detectability period ranging between 30-60 days post infection. Diagnosis will involve a doctor examining the patients to determine indications of liver damage, typical signs include yellowing skin or belly pain. Tests can then be conducted which includes a blood test to detect the virus or its complications and ascertain whether the disease is acute or chronic. The blood test can also help to determine whether the individual has immunity. A liver transient elastography or biopsy can be done to assess the level of damage (Mayo Clinic, 2017).
Medication
In order to prevent infection post-exposure to the hepatitis B virus and an individual is not sure of having vaccinated, giving an immunoglobulin injection within 12 hours of exposure may help prevent falling ill with hepatitis B. However, the treatment only provides short-term protection and a simultaneous vaccination is necessary. Acute Hepatitis B does not need treatment. Nevertheless, rest, proper nutrition and plenty of fluids are recommended to help the body fight the infection. Antivirals or a stay at the hospital may be used in severe cases to prevent complications. For chronic Hepatitis B, lifetime treatment is recommended to help reduce the risk of liver disease and transmitting infection to others. Treatment may involve the use of oral antivirals such as entecavir (Baraclude), tenofovir (Viread), lamivudine (Epivir), adefovir (Hepsera) and telbivudine (Tyzeka) (Mayo Clinic, 2017).
Hepatitis B in the Elderly
Due to ageing and liver changes, the elderly face an increased risk of major cirrhosis and hepatocarcinoma. However, the disease is symptomatic with the presentation being greatly enhanced. Vaccination if often less efficient (Loustaud‐Ratti, Jacques, Debette‐Gratien, & Carrier, 2016). Moreover, elderly institutions face a higher risk for HBV spread. Hence, health professionals have to take steps to prevent spread and promptly managing the disease in the elderly to avoid complications.
Patient Education
Patient education is critical to the effective management of the infection and preventing spread. For instance, people leaving with the disease need to be informed of the modes of transmission such as sharing contaminated needles, sexual contact and mother to infant to ensure steps are taken to prevent the spread of Hepatitis B. The public should be informed about not sharing needles and following safe sexual practices to prevent infection (Davis, 2017).
Conclusion
Hepatitis B is a common infection with many people at risk of developing the infection. With a significant mortality rate, health professionals need to take steps towards reducing spread including the use of patient education. Hepatitis B among the elderly needs to be managed more effectively due to the greater risk of spread and developing complications.
References
Davis, K. (2017). Everything you need to know about hepatitis B. Retrieved April 28, 2019, from https://www.medicalnewstoday.com/articles/306288.php
Loustaud‐Ratti, V., Jacques, J., Debette‐Gratien, M., & Carrier, P. (2016). Hepatitis B and elders: an underestimated issue. Hepatology Research , 46 (1), 22–28.
Mayo Clinic. (2017). Hepatitis B. Retrieved April 28, 2019, from https://www.mayoclinic.org/diseases-conditions/hepatitis-b/diagnosis-treatment/drc-20366821
WHO. (2018). Hepatitis B. Retrieved April 28, 2019, from https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
