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Guide line

Conclusion
Acute hepatitis B infection does not usually require treatment and most adults c
lear the infection spontaneously Early antiviral treatment may be required in fe
wer than 1% of people, whose infection takes a very aggressive course (fulminant
hepatitis) or who are immunocompromised. On the other hand, treatment of chroni
c infection may be necessary to reduce the risk of cirrhosis and liver cancer. C
hronically infected individuals with persistently elevated serum alanine aminotr
ansferase, a marker of liver damage, and HBV DNA levels are candidates for thera
py. Treatment lasts from six months to a year, depending on medication and genot
ype.
Although none of the available drugs can clear the infection, they can stop the
virus from replicating, thus minimizing liver damage. As of 2008, there are seve
n medications licensed for treatment of hepatitis B infection in the United Stat
es. These include antiviral drugs lamivudine (Epivir), adefovir (Hepsera), tenof
ovir (Viread), telbivudine (Tyzeka) and entecavir (Baraclude), and the two immun
e system modulators interferon alpha-2a and PEGylated interferon alpha-2a (Pegas
ys). The World Health Organization recommended a combination of tenofovir and en
tecavir as first line agents. Those with current cirrhosis are in most need of t
reatment.
The use of interferon, which requires injections daily or thrice weekly, has bee
n supplanted by long-acting PEGylated interferon, which is injected only once we
ekly. However, some individuals are much more likely to respond than others, and
this might be because of the genotype of the infecting virus or the person's he
redity. The treatment reduces viral replication in the liver, thereby reducing t
he viral load (the amount of virus particles as measured in the blood).[67] Resp
onse to treatment differs between the genotypes. Interferon treatment may produc
e an e antigen seroconversion rate of 37% in genotype A but only a 6% seroconver
sion in type D. Genotype B has similar seroconversion rates to type A while type
C seroconverts only in 15% of cases. Sustained e antigen loss after treatment i
s ~45% in types A and B but only 25 30% in types C and D

Guide line in viral hepatitis B Thereby


Treatment to prevent hepatitis B infection after exposure
If you know you've been exposed to the hepatitis B virus, call your doctor immed
iately. If you haven't been vaccinated or aren't sure whether you've been vaccin
ated or whether you responded to the vaccination, receiving an injection of hepa
titis B immune globulin within 12 hours of coming in contact with the virus may
help protect you from developing hepatitis B. You should be vaccinated at the sa
me time.
Treatment for acute hepatitis B infection
If your doctor determines your hepatitis B infection is acute
meaning it is shor
t-lived and will go away on its own you may not need treatment. Instead, your do
ctor might recommend rest and adequate nutrition and fluids while your body figh
ts the infection.
Treatment for chronic hepatitis B infection
If you've been diagnosed with chronic hepatitis B infection, you may have treatm
ent to reduce the risk of liver disease and prevent you from passing the infecti
on to others. Treatments include:
Antiviral medications. Several antiviral medications
including lamivudine (Epivi
r), adefovir (Hepsera), telbivudine (Tyzeka) and entecavir (Baraclude)
can help
fight the virus and slow its ability to damage your liver. Talk to your doctor a
bout which medication might be right for you.
Interferon alfa-2b (Intron A). This synthetic version of a substance produced by
the body to fight infection is used mainly for young people with hepatitis B wh
o don't want to undergo long-term treatment or who might want to get pregnant wi

thin a few years. It's given by injection. Side effects may include depression,
difficulty breathing and chest tightness.
Liver transplant. If your liver has been severely damaged, a liver transplant ma
y be an option. During a liver transplant, the surgeon removes your damaged live
r and replaces it with a healthy liver. Most transplanted livers come from decea
sed donors, though a small number come from living donors who donate a portion o
f their livers.
Lifestyle and home remedies
If you've been infected with hepatitis B, take steps to protect others from the
virus.
Make sex safer. If you're sexually active, tell your partner you have HBV and ta
lk about the risk of transmitting it to him or her. Use a new latex condom every
time you have sex, but remember that condoms reduce but don't eliminate the ris
k.
Tell your sexual partner to get tested. Anyone with whom you've had sex needs to
be tested for the virus. Your partners also need to know their HBV status so th
at they don't infect others.
Don't share implements. If you use IV drugs, never share needles and syringes. A
nd don't share razor blades or toothbrushes, which may carry traces of infected
blood.
Prevention
The hepatitis B vaccine is typically given as three or four injections over six
months. You can't get hepatitis B from the vaccine.
The hepatitis B vaccine is recommended for:
Newborns
Children and adolescents not vaccinated at birth
Anyone who has a sexually transmitted infection, including HIV
Developmentally disabled people who live in an institutional setting and staff
Health care workers, emergency workers and other people who come into contact wi
th blood
Men who have sex with men
People who have multiple sexual partners
People with chronic liver disease
People who inject illicit drugs
People who live with someone who has hepatitis B
People with end-stage kidney disease
Sexual partners of someone who has hepatitis B
Travelers planning to go to an area of the world with a high hepatitis B infecti
on rate
Take precautions to avoid HBV
Other ways to reduce your risk of HBV include:
Know the HBV status of any sexual partner. Don't engage in unprotected sex unles
s you're absolutely certain your partner isn't infected with HBV or any other se
xually transmitted infection.
Use a new latex or polyurethane condom every time you have sex if you don't know
the health status of your partner. Remember that although condoms can reduce yo
ur risk of contracting HBV, they don't eliminate the risk.
Stop using illicit drugs. If you use illicit drugs, get help to stop. If you can
't stop, use a sterile needle each time you inject illicit drugs. Never share ne
edles.
Be cautious about body piercing and tattooing. If you get a piercing or tattoo,
look for a reputable shop. Ask about how the equipment is cleaned. Make sure the
employees use sterile needles. If you can't get answers, look for another shop.
Ask about the hepatitis B vaccine before you travel. If you're traveling to a re
gion where hepatitis B is common, ask your doctor about the hepatitis B vaccine
in advance. It's usually given in a series of three injections over a six-month
period.

Introduction
Hepatitis B is a virus that infects the liver . Most adults who get it have it f
or a short time and then get better. This is called acute hepatitis B.
Sometimes the virus causes a long-term infection, called chronic hepatitis B. Ov
er time, it can damage your liver. Babies and young children infected with the v
irus are more likely to get chronic hepatitis B.
You can have hepatitis B and not know it. You may not have symptoms. If you do,
they can make you feel like you have the flu. But as long as you have the virus,
you can spread it to others.
It's caused by the hepatitis B virus. It is spread through contact with the bloo
d and body fluids of an infected person.
You may get hepatitis B if you:
Have sex with an infected person without using a condom.
Share needles (used for injecting drugs) with an infected person.
Get a tattoo or piercing with tools that weren't sterilized.
Share personal items like razors or toothbrushes with an infected person.
A mother who has the virus can pass it to her baby during delivery. Medical expe
rts recommend that all pregnant women get tested for hepatitis B. If you have th
e virus, your baby can get shots to help prevent infection with the virus.
You cannot get hepatitis B from casual contact such as hugging, kissing, sneezin
g, coughing, or sharing food or drinks.
Many people with hepatitis B don't know they have it, because they don't have sy
mptoms. If you do have symptoms, you may just feel like you have the flu. Sympto
ms include:
Feeling very tired.
Mild fever.
Headache.
Not wanting to eat.
Feeling sick to your stomach or vomiting.
Belly pain.
Diarrhea or constipation.
Muscle aches and joint pain.
Skinrash.
Yellowish eyes and skin (jaundice). Jaundice usually appears only after other sy
mptoms have started to go away.
Most people with chronic hepatitis B have no symptoms.
A simple blood test can tell your doctor if you have the hepatitis B virus now o
r if you had it in the past. Your doctor also may be able to tell if you have ha
d the vaccine to prevent the virus.
If your doctor thinks you may have liver damage from hepatitis B, he or she may
use a needle to take a tiny sample of your liver for testing. This is called a l
iver biopsy.

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