Description
Hepatitis B is a viral infection that primarily affects the liver and has the potential to become a chronic, life-threatening disease. The Hepatitis B virus is a global issue. It is transmitted via bodily fluids like blood, saliva, semen, and vaginal fluids. Some routes of transmission include needle-stick injury, sexual intercourse, perinatal transmission (from mother to child), re-use of needles/sharing needles, etc.
Hepatitis B can be present as an acute or chronic infection. Acute infection may not produce any symptoms or can cause acute liver dysfunction and failure. An acute infection is self-limiting, where the treatment is usually supportive in nature. However, Hepatitis B can undergo chronicity and result in liver cirrhosis(scarring of the liver), liver failure, and hepatocellular carcinoma (liver cancer). Chronic infections are serious and require specific treatment. The primary goal of treating Hepatitis B is to prevent progression to severe complications.
The patients with acute Hepatitis may be asymptomatic or experience symptoms like fever, nausea, poor appetite, vomiting, generalised fatigue and tiredness, and abdominal pain. They may or may not have jaundice( yellowing of skin and white of eyes). Severe cases of acute hepatitis can cause symptoms like altered sensorium(Inability to concentrate), alteration of the sleep cycle, tremors(shaking movements), jaundice, abdominal distension, itching, confusion, mood disturbances, gastrointestinal bleeding, black stools, anaemia, coma, etc.
Chronic Hepatitis B can be in a dormant, non-symptomatic phase or can result in symptoms similar to acute hepatitis, along with liver cirrhosis and cancer, and can result in morbidity.
The Hepatitis B virus has a central core and an envelope of proteins surrounding it. The body’s immune cells produce special substances called antibodies which help in fighting infection. One such antibody that is produced is the IgM antibody against the core of the virus, which is called the Anti-Hepatitis B Core Antibody. This antibody is produced by the immune cells within a few weeks of exposure to the virus.
The IgM antibody stays in circulation for around 6 months, following which it is undetectable. This antibody is also elevated during the active phase of chronic infection. This AHBC - IgM test is done to detect this antibody in circulation, which helps diagnose the disease. It is also the only test that can be done during the window period (period in hepatitis infection when neither HBsAg nor its antibody HBsAb can be detected in the blood of the patient).
There is no specific treatment for the acute phase of this disease; management primarily involves supportive care. Chronic Hepatitis B requires targeted treatment with antiviral agents, which may be required to be taken lifelong. Liver cirrhosis and failure may require surgical intervention and even transplantation.
