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Hepatitis B Virus Infection

Hepatitis B virus infection

It is the leading cause of chronic hepatitis, cirrhosis and liver cancer in Thailand. About half of chronic liver disease cases in Thailand are caused by hepatitis B infection. The prevalence of hepatitis B infection in the Thai population is approximately 5-7% of the total population.

Causes, Risk Factors, and

Transmission Hepatitis B is transmitted through blood, the most common form of transmission being mother-to-child transmission. and is the main cause of chronic hepatitis B Sharing needles, syringes or sharp objects including exposure to blood or blood products contaminated with the virus (Currently screening for hepatitis B and C in all blood bags Therefore, the chances of this transmission are very low) and sexually.

Symptoms and complications of the disease

Hepatitis B virus infection, If infected as an adult with a relatively strong immune status, the infection is most likely to clear itself with usually no symptoms at all or mild symptoms. In a minority with severe symptoms, patients will develop symptoms of acute hepatitis including fever, nausea, vomiting, fatigue, and inability to eat. There may be jaundice, yellow eyes. also known as jaundice And in some patients with pre-existing liver impairment, symptoms can be severe and even lead to liver failure. which the patient will have symptoms of lethargy, confusion due to congestion of waste products in the body Including various complications, especially complications that can lead to life-threatening infections In adults, after recovery from an acute infection, most patients develop immunity to hepatitis B. and often does not progress to chronic hepatitis B infection in the future.

On the other hand, if the hepatitis B virus was infected while infancy, which was passed through the mother at birth. Most of the patients will become chronic hepatitis B infection. The hepatitis B virus is present in the body for many decades until adulthood. and can divide the infection into different stages according to the rate of replication of the virus and inflammation of the liver that occurs Inflammation of the liver is caused by the body’s immune defenses against the virus causing injury to the liver tissue known as hepatitis. chronic and the formation and accumulation of fibrosis or scars according to the principle of inflammation eventually leading to cirrhosis and liver cancer Some patients were unaware that they had hepatitis B because they had no symptoms. but came to know when he was in the stage of cirrhosis that was already very which will show symptoms such as jaundice, yellow eyes ascites Gastrointestinal bleeding from high intra-abdominal arterial pressure. or feel the liver cancer lump in the abdomen, etc.

In chronic hepatitis B, there is usually a remission stage. Also known as hepatitis B virus carriers. But in reality, the word carrier might be a very inaccurate word. Because the implication of the word carrier means that the infected person is not affected by the presence of the virus. but can only pass it on to others In fact, even in that state of remission The presence of hepatitis B virus in your body also has the potential to increase your risk of developing cirrhosis. including liver cancer in the future There is also a risk of recurrence of hepatitis B virus.

All patients diagnosed with hepatitis B should see a doctor. to assess how much liver damage or fibrosis has accumulated including assessing the infection situation of the virus and check the number of viruses and screening for liver cancer as well

In addition, in those whose spouses have hepatitis B virus. This includes people with a family history of cirrhosis or liver cancer of unknown cause. They should also be tested for hepatitis B. However, since Thailand is a country with a relatively high prevalence of hepatitis B virus. Therefore, it is recommended that in Thai people who have never been tested for hepatitis B before A baseline examination should be performed at least once.

Diagnosis

Hepatitis B infection is easily diagnosed and diagnosed by detecting hepatitis B virus in the bloodstream. Initially, screening is performed by detecting the so-called surface antigen and counting the viral load in the bloodstream if detected.

Goals of treatment

Treatment for hepatitis B is aimed at preventing complications. These include cirrhosis and liver cancer. In addition, treatment aims to reduce the transmission of the infection in order to cut the cycle of transmission, especially the transmission of the infection from mother to child.

Additional examinations for treatment

The current drugs used to treat hepatitis B, although effective in suppressing the virus, are effective. But the chance of decisively eliminating the virus from the body may not be very high. Therefore, further testing is needed to classify patients who are in need of antiretroviral therapy. Hepatic fibrosis must be measured to assess liver damage caused by hepatitis B infection. together with the viral load count to take into account the consideration of treatment

The current measurement of liver fibrosis can be performed using a probe called transient elastography (Fibroscan®) , a tool that sends sound waves through the skin to measure the reflexes of the liver without pain. Or maybe checked from a blood test to calculate liver fibrosis as well.

Treatment guidelines

Patients with indications for treatment, including patients with cirrhosis. who have high liver fibrosis high viral load or liver cancer should be considered for treatment The main treatment is an oral medication. By taking one tablet a day reduces the amount of virus in the body and less damage to the liver than it is. Oral medication is very effective in reducing the number of viruses. But the rate of elimination of the virus from the body is so low that it may take the drug for many years. or maybe lifelong

In some patients with positive factors that may respond favorably to injectable ARVs, the physician may consider individual injectable drugs, since even if the injectable drug only lasts for a period of time, it may not be effective. Lifelong medication is not required. But it has more side effects. and the rate of cure from infection is not very high

Results and expectations of treatment

Treatment for chronic hepatitis B This is to prevent and limit liver damage so that it doesn’t progress to cirrhosis. and reduce the chance of liver cancer including preventing the recurrence of the virus Therefore, patients starting treatment should take the drug regularly. to prevent future drug resistance. Including making the drug effective in reducing the virus as best as possible

In addition, patients with chronic hepatitis B should be screened for liver cancer by initial screening, including a hepatocellular carcinoma marker (AFP) test, along with upper abdominal ultrasound every six months. in patients with liver cirrhosis or patients with immature liver, but males over 40 years old and females over 50 years old, including those with a family history of liver cancer.

An exacerbation of hepatitis B is also something to be cautious about. because it is a condition that may occur and sometimes life-threatening if severe exacerbations The risk of hepatitis B relapse depends on your liver function. If liver fibrosis is present, a relapse of hepatitis B can lead to severe hepatitis and liver failure. Therefore, if a person with chronic hepatitis B is required to receive certain immunosuppressants, such as high-dose steroids, chemotherapy, or immunotherapy. It is important to always tell your treating physician that you have hepatitis B. to consider antiviral therapy for hepatitis B relapse prevention