Hepatitis B Program at Mount Sinai

The liver disease experts at The Mount Sinai Hospital offer the most advanced diagnostic and treatment procedures for patients with hepatitis B. Our multidisciplinary hepatitis B team is comprised of physicians, nurses, dieticians, and psychologists. As part of one of the nation’s premier academic medical centers, our outstanding faculty, scientists, and staff utilize the extensive research facilities at the Icahn School of Medicine at Mount Sinai and interact with nonprofit research organizations and commercial enterprises, enabling them to be on the forefront of drug discovery and translational biotechnology. Additionally, our physicians have a vast amount of experience in molecular virology and antiviral drug research and are authors or coauthors of several primary research papers and many peer-reviewed journals.

About Hepatitis B

An inflammatory liver disease, hepatitis B is caused by an infection with the hepatitis B virus (HBV). Acute hepatitis B occurs approximately six weeks after exposure to the virus and most people fight off the infection themselves. However, approximately 5-10 percent of those people who are infected with the virus will progress to chronic liver disease. Chronic hepatitis B is an infection that lasts longer than six months. Once the infection becomes chronic, it may never go away completely and can lead to cirrhosis and possibly liver cancer.

Prevalence of Hepatitis B

Hepatitis B is one of the most frequently reported, vaccine-preventable diseases in the United States. It is estimated that approximately 46,000 infections occur each year and an estimated 1.4 million people have chronic hepatitis B. According to the World Health organization (WHO), the prevalence of Hepatitis B is estimated to be 8-20 percent of the population in parts of China, Southeast Asia, and tropical Africa. In Eastern Europe and the Mediterranean, the prevalence of HBV is estimated to be 1-7 percent.

Transmission

The hepatitis B virus can be transmitted through blood and body fluid exposure, such as blood, semen, vaginal secretions, or saliva. Infants may also develop the disease if they are born to a mother who has the virus and was not treated during pregnancy. Infected children often spread the virus to other children if there is frequent contact or a child has many scrapes or cuts. However, in approximately 30-40% of cases the method of transmission is unknown.

Risk for Hepatitis B

One in 20 people in the U.S. will develop hepatitis B at some time during their lives. The following describe those who are at risk for developing hepatitis B:

  • Children born to mothers who have hepatitis B ,or mothers who have immigrated from a country where hepatitis B is widespread, such as southeast Asia and China
  • Individuals who live in households or long-term care facilities where another member is infected with the virus
  • Persons who may participate in high-risk activities such as intravenous (IV) drug use and/or unprotected heterosexual or homosexual sexual contact
  • Those who have a job that involves contact with human blood
  • Persons who received blood transfusions or blood products before the early 1990s

Vaccine Prevention

Hepatitis B can be prevented with a safe and effective vaccine. To be fully protected a series of three injections are required. Hepatitis B vaccination injections are recommended for all newborns, infants, teenagers and all persons with diabetes. Injections may be given at any age. This vaccine provides immunity for most people for at least five years and possibly lifetime.

Symptoms of Hepatitis B

Hepatitis B has a wide range of symptoms. It may be mild without symptoms, it may cause chronic hepatitis, or in some cases, hepatitis B can lead to full-blown liver failure and death.

Symptoms develop within 30-180 days of exposure to the virus. The symptoms are often compared to flu. Most people think they have flu and never think about having HBV infection.

The following are the most common symptoms of hepatitis B, however, each individual may experience symptoms differently.

  • Appetite loss
  • Fatigue
  • Nausea and vomiting
  • Itching all over the body
  • Skin rashes
  • Joint paint
  • Pain over the liver
  • Jaundice with yellowing of the skin and eyes
  • Dark colored urine
  • Stools are pale in color (grayish or clay colored)

Diagnosis

Since many people with hepatitis B do not have symptoms, they often do not know they have the disease. Hepatitis B is often discovered accidentally when you see your health care provider for another reason. Blood tests done for an annual check-up, insurance purposes, or before surgery may show abnormalities in the liver blood test results. Testing for hepatits B is not routine. If your health care provider determines that you may be at risk for contracting hepatitis, you will have blood drawn and tested for liver function and hepatitis viruses.

In addition to a complete physical examination and laboratory tests for blood and urine, diagnostic procedures for hepatitis B may involve an abdominal ultrasound, a CT scan, or MRI to screen for liver cancer. A FibroScan or a liver biopsy can determine a level of liver fibrosis (scarring).

Treatment

Acute hepatitis B usually goes away by itself and does not require medical treatment. If very severe, symptoms such as vomiting or diarrhea may require treatment to restore fluids and electrolytes. There are no medications that can prevent acute hepatitis B from becoming chronic. If you have chronic hepatitis B, you should see your health care provider regularly. Most often, treatment includes oral therapy, taking just one pill daily with continuous follow up every two to three months.

In chronic HBV infection, the primary goal of therapy is to achieve continuous suppression of the hepatitis B virus which improves inflammation, reduces progression to cirrhosis and/or liver failure and reduces the risk of liver cancer. Currently, there is no cure for hepatitis B and prevention is crucial.


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