Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis
Hepatitis is an inflammation of the liver. There are at least five virus types that cause the disease. One of the types of viruses is the B virus. More than
1 million individuals are carriers of the hepatitis B virus in the United States. About 200,000 individuals contract this disease each year. Certain racial and ethnic groups have higher rates of infection, including blacks, Asians, Pacific Islanders, Hispanics, and Native Americans. Hepatitis B is more infectious than the human immunodeficiency virus (HIV). The main ways the hepatitis B virus is transmitted is by sexual contact with an infected individual, receiving contaminated blood, or from using nonsterile needles or syringes. Hepatitis B can also be transmitted from an infected mother to her newborn. It is transmitted through infected blood and other body fluids (seminal fluid, vaginal secretions, breast milk, tears, saliva, and open sores). As with other types of hepatitis, the method of transmission in many patients is unknown. Hepatitis B is detected by a blood test that is positive for the antibody to the virus. Liver function tests are abnormally elevated, often to very high levels. About 90% of the individuals who get hepatitis B recover within a few months, and they will never get hepatitis B again. However hepatitis B is a serious disease. Approximately 1% of patients die during the acute stage of the disease. Other individuals infected with hepatitis B become carriers of the disease or become chronically infected. This occurs in about 10% of adults, 25% to 50% of young children, and 70% to 90% of infants.

Living With Your Diagnosis
Hepatitis B has a long incubation period, occasionally taking up to 6 months to become apparent. The first symptoms may be a variety of rashes, joint pains, and other “flulike” symptoms. Ultimately jaundice, a yellow color to the skin or whites of the eyes, may be noted. The jaundice is caused by the excess bilirubin in the blood. The excess bilirubin can also lead to other symptoms such as pale or claycolored stools, dark urine, and generalized itching. If the acute infection does not resolve, the symptoms can vary. Some individuals will remain well and just be a carrier of the virus. Others will have severe and persistent liver inflammation. This may eventually lead to cirrhosis and liver failure. Cirrhosis is scarring of the liver. The scarring does not allow the liver to do its job of removing toxic substances from the blood. Cirrhosis can lead to additional complications, including accumulation of fluid in the body (ascites) or bleeding from veins in the esophagus (varices). If the liver is chronically scarred, hepatocellular cancer can develop.

There is no specific treatment for hepatitis B. Most individuals can be cared for at home. Proper amounts of rest for 1–4 weeks after the diagnosis of hepatitis B is made is important. Intimate contact with other individuals should be avoided during this time. The diet should include foods that are high in protein. Individuals who have come into contact with the patient should be given temporary immunization with hepatitis B immune globulin plus
immunized with hepatitis B vaccine. This must be given within 2 weeks of exposure. This combination should also be given to newborns of infected mothers.

The DOs
• Bed rest may be necessary until the jaundice disappears and appetite returns.
• A well-balanced diet with plenty of fluids is essential.
• Make sure you properly wash your hands if you have hepatitis or are caring for someone with the disease. This is particularly important after contact with blood or other body fluid.
• An individual with hepatitis B should use separate or disposable eating and drinking utensils.
• A latex condom should be used. It may prevent transmission of the virus.
• If exposed to blood and body fluids on the job, use proper protective equipment such as gloves and eye protection to lessen the chance of accidental exposure.
• If you are in a high-risk group, you should receive the hepatitis B vaccine. High-risk groups are health workers, homosexual men, and household contacts of carriers.
• All newborns and children should be immunized with hepatitis B vaccine.

The DON’Ts
• Avoid any substances that may be harmful to the liver. The avoidance of alcohol is key.
• Fatty foods may not be well tolerated in individuals with hepatitis B and should be avoided.
• Avoid sexual contact with an individual infected with hepatitis B.
• Avoid contact with blood or blood products.
• If you have had hepatitis B, you should not donate blood. All blood is screened for the hepatitis B virus.
• Women who have had hepatitis B or have chronic hepatitis B should not breast-feed their babies.
• If you are an intravenous drug addict, do not share needles and other equipment because they can be contaminated with the hepatitis B virus or another virus.

When to Call Your Doctor
• If symptoms of hepatitis B develop.
• If hepatitis B symptoms do not resolve in 2 or 3 weeks, or if new symptoms develop.
• If you belong to a high-risk group for hepatitis B and have not yet been vaccinated against the disease.