Hepatitis B.

Hepatitis B. is a reportable inflammation of the liver caused by a viral infection, which can be manifested by pain in the upper abdomen, a characteristic yellowing of the skin, poor performance, tiredness, nausea, vomiting or diarrhea. The liver can enlarge and react painfully to pressure impulses.

What is hepatitis B?

In most cases, hepatitis B is not recognized as such immediately after the first symptoms appear. When making a diagnosis, a distinction must also be made between chronic or acute hepatitis B disease and how far the inflammation has progressed or has healed again.

90% of those infected suffer from an acute infection with hepatitis B, which heals and can be overcome within six months, 10% of the cases are chronic and can develop either from a previous acute infection with hepatitis B or right at the beginning. In this case, the disease lasts for six months.

The younger a patient infected with hepatitis B, the greater the risk of the disease becoming chronic.

causes

Hepatitis B is many times more contagious than the AIDS pathogen HIV. It can be transmitted through contact with open skin or orifices with body fluids such as blood or saliva from someone who is already infected.

Even a small amount of body fluid contaminated by the virus carries a high risk of infection.

Worldwide, around five to seven percent of people chronically infected with hepatitis B are assumed, whereby newborns can be infected with hepatitis B when their mother is born and, due to their young age, will probably also suffer a chronic course of the disease.

Symptoms, ailments & signs

Symptoms of hepatitis B infection are not clearly outlined in the majority of cases. The majority of the sick - around two thirds - either have no symptoms at all or an indefinite feeling of illness arises.

After an incubation period of around two to four months, symptoms such as fatigue, joint pain, headache, loss of appetite, weight loss or muscle problems occur. Many patients complain of a fever. A more obvious sign of hepatitis B infection is a feeling of pressure in the area of ​​the upper right abdomen.

Symptoms of jaundice only appear in about a third of those infected after the outbreak of hepatitis B. In these cases the urine turns dark to very dark. The stool, on the other hand, takes on a light color. However, the most obvious sign will be yellowing of the skin and whites of the eyes.

Only in very rare, particularly severe cases does hepatitis B take a particularly serious course. Then the liver is so badly damaged by the infection that liver failure occurs and the patient falls into a coma. In chronic forms of hepatitis B, which are also rare, the liver values ​​are permanently elevated, which can lead to bleeding in the throat area, among other things.

course

Hepatitis B has a relatively long incubation period of at least one and up to six months after the virus is transmitted. If you have hepatitis B, you may experience the symptoms described above, but in some cases an acute illness has no specific symptoms.

If the disease is acute, it heals on its own after a period of no more than six months, if it is chronic, the symptoms persist during this period and this is called chronic hepatitis B. This can be diagnosed if there is no relief from the Symptoms, a healing or the formation of antibodies against a recurrence of hepatitis B can be determined.

In some cases, chronic hepatitis B can cause cirrhosis of the liver or other serious diseases of the liver such as cancer, the liver tissue is attacked and destroyed over the long term.

Complications

Hepatitis B can, but does not have to, heal spontaneously. In some cases, around five percent of cases with hepatitis B, develop chronic hepatitis, which can result in cirrhosis of the liver. The likelihood of developing liver cirrhosis is also increased if an additional infection with the hepatitis D virus occurs.

This leads to a more than 90 percent probability of a severe course of the disease. Cirrhosis of the liver caused by the hepatitis B virus increases the risk of developing liver cancer by more than a hundred times. Life expectancy is severely restricted.

In cirrhosis of the liver, all functions of the liver fail, including the synthesis function and the detoxification function of the liver. As a result, the proteins required for the blood are no longer produced, so that no oncotic pressure can build up, which leads to edema. The coagulation proteins are also missing, the bleeding time is prolonged.

Furthermore, due to the lack of detoxification, the ammonia is no longer properly broken down, which can pass into the brain and thus lead to life-threatening hepatic encephalopathy. The virus is also dangerous for expectant mothers, since the pathogen can be transmitted to the child. This is very likely to lead to chronic hepatitis in the child.

When should you go to the doctor?

If you have hepatitis B, you must see a doctor or hospital immediately. This can prevent further infection. As a rule, an early diagnosis has a very positive effect on the course of the disease. A doctor should then be seen if the person has jaundice. This is the main symptom of the disease. Jaundice is also accompanied by a high fever and severe weakness and fatigue.

A doctor should also be informed if the person has been in an area affected by hepatitis B in the past few months, as the incubation period is at least one month. Weight loss also indicates hepatitis B and must be examined by a doctor.

In the worst case, the disease can lead to death or cancer. The treatment and examination takes place in a hospital. Since the disease cannot be completely cured, those affected are dependent on permanent therapy.

Doctors & therapists in your area

Treatment & Therapy

In acute form, hepatitis B usually does not require medication and heals on its own after a period of up to six months. If acute hepatitis B disease poses a long-term damage to the liver, a liver transplant may be necessary in rare cases.

Chronic hepatitis B disease can be treated either by strengthening the immune system through weekly injections of interferons or with the help of daily nucleoside tablets, which are intended to curb the replication of the viruses in the body.

Both forms of therapy cannot cure chronic hepatitis B, but they can counteract many long-term effects and symptoms. Only in rare cases is the body's immune function reactivated in such a way that it can initiate a late healing of chronic hepatitis B.

Outlook & forecast

Most patients with hepatitis B have a good prognosis. In over ninety percent of those affected, an early diagnosis and a rapid start of therapy lead to a favorable course of the disease and a recovery. After a few weeks of medical care, the disease usually heals completely and without any further sequelae.

The likelihood of a chronic course of the disease is given in hepatitis B. Complications and other diseases occur in up to ten percent of patients. After about ten years, liver cirrhosis and liver cancer are possible long-term consequences that contribute to a worsening of the favorable prognosis.

Shrunken liver is diagnosed in approximately twenty percent of cases. The patient is threatened with a life-threatening condition. Often only an organ transplant can help alleviate the symptoms and the result of death.

Without medical treatment, the risk of developing a chronic disease is very likely. If children are born with hepatitis B or if they are infected at birth, almost all patients develop chronic inflammation of the liver. In very rare cases, in addition to hepatitis B, an infection with hepatitis D occurs. This increases the likelihood of severe disease and organ failure of the liver.

prevention

Preventing hepatitis B is possible with a vaccine, the administration of which is now one of the standard vaccinations that is recommended for infants and small children and prevents infection with hepatitis B.

If you have already been vaccinated in childhood, the immune protection against hepatitis B pathogens lasts into adulthood, if you only vaccinate at an advanced age, three injections are required to ensure long-term protection for up to ten years.

In addition to vaccination protection, adequate contraception can also be an important factor in preventing possible infection with hepatitis B during sexual intercourse and in protecting yourself and others from transmission.

Aftercare

One of the goals of follow-up is to prevent hepatitis B from recurring. Patients generally achieve this through vaccination. After the initial infection, no further treatment is usually necessary. Because in 90 percent of those affected, hepatitis B heals completely. Some patients do not even notice the disease. The prognosis is therefore extremely favorable.

It is different for adults with a weakened immune system and children. With them, the disease takes a chronic course in almost all cases. This requires long-term treatment. Medical support aims to enable those affected to lead a symptom-free life. Medicines are to be taken daily. They lower the amount of virus in the blood. This avoids the risk of liver cirrhosis or the development of liver cancer.

The attending physician will arrange regular check-ups during which blood will be drawn. The sample allows conclusions to be drawn from direct and indirect evidence. An ultrasound examination and a biopsy can also be arranged. The structure of the liver can be determined as part of the imaging procedure. The liver biopsy records the extent of tissue damage. Doctors can thus clearly document the progress of the hepatitis B disease.

You can do that yourself

Hepatitis B can be treated effectively with a prompt medical examination. In addition to medical treatment, those affected should inform friends and family members to reduce the risk of infection. Immediate vaccination reduces the risk of spreading and often counteracts possible long-term effects of the virus infection.

If you have liver problems, we recommend drinking plenty of fluids and using liver compresses. An effective natural remedy is the milk thistle cure, in which appropriate capsules are taken regularly or milk thistle tea is drunk.

Dandelion, bloodroot, beaverfly, wormwood and bear moss are said to have a soothing effect. Acute pain can be counteracted with dark chocolate and foods that contain many bitter substances. An effective acupressure grip for the liver: interlock your fingers and rub the heels of your hands until they get hot.

A chronic hepatitis B illness can be treated independently by strengthening the immune system. Regular exercise and a healthy, balanced diet can effectively counteract the symptoms and long-term effects, but cannot completely cure the disease itself. Therefore, medical treatment is always necessary, which complements the self-measures mentioned and enables those affected to live a symptom-free life with the disease.