The Hepatitis B vaccine protects yourself and those you love
- Part 2 -

Salam Ghanapriya *

Simplified diagram of the structure of hepatitis B virus :: Pix - Wikipedia/Dr Graham Beards

What is hepatitis B?

Hepatitis B is the most common serious liver infection in the world. It is caused by the hepatitis B virus (HBV) that attacks liver cells and can lead to liver failure, cirrhosis (scarring) or cancer of the liver later in life. Infection of HBV can be asymptomatic or manifest as either acute or chronic disease. The virus is transmitted through contact with infected blood and body fluids of an infectious person, and is commonly acquired either perinatally (from mother to child at the time of birth), by sexual contact, by non-sexual close contact or by exposure to infectious fluids (sharing of needles, inadequately sterilized skin penetrating instruments, needle stick injury etc).HBV can also survive outside the body for up to 7 days and hence can also be transmitted via contaminated inanimate objects. Other types of Hepatitis are A, C, D & E. Of these Hepatitis B is the most transmissible infection.

How to diagnose Hepatitis B viral infection?

When a person is infected with HBV, the first virological marker detectable in the serum is HBsAg (Hepatitis B surface Antigen). It precedes the elevation of serum aminotransferase and clinical symptoms. In a majority of cases, HBsAg becomes undetectable one to two months after the onset of jaundice and rarely persists beyond six months. During the recovery phase, HBsAg becomes undetectable, while antibodies to HBsAg (Anti-HBs) become detectable in the serum and remain so indefinitely thereafter. In addition, anti-HBs antibody is the only detectable serological marker in those who successfully respond to hepatitis B immunization.

Hepatitis B core antigen (HBcAg) is an intracellular antigen that is not detectable in serum. Antibodies against HBcAg (Anti-HBc), indicate a prior exposure to HBV, irrespective of the current HBsAg status. The anti-HBc is the earliest antibody to develop in response to acute hepatitis B virus (HBV) infection, appearing predominantly as IgM anti-HBc at about 6 to 8 weeks after infection. The anti-HBc typically persists for life, but after about 6 months the total anti-HBc mainly consists of IgG anti-HBc.

Is there a cure for Hepatitis B?

No. Although there are several medicines to help people who have life-long Hepatitis B virus infection, there is no medicine that cures it. The good news is that hepatitis can be prevented by vaccination.

Is there a safe vaccine for hepatitis B?

YES! The good news is that there is a safe and effective vaccine for hepatitis B. More than 1 billion doses have been given around the world. The Hepatitis B vaccine is a subunit vaccine containing hepatitis B surface antigen produced by recombinant DNA technology. This vaccine that protects against a hepatitis B infection can also prevent liver cancer. The vaccine is a series of three shots given over a six-month period that will provide a lifetime of protection. You cannot get hepatitis B from the vaccine – there is no human blood or live virus in the vaccine. The vaccine should be stored at 2ÚC to 8ÚC.

As there is no cure for hepatitis B disease; vaccination is the best means to prevent this disease.

In addition to vaccination, there are other simple ways to stop the spread of hepatitis B:
o Avoid direct contact with blood and body fluids
o Any blood or body fluids spill should be cleaned with dilute bleach solution.
o Practice hand washing after any potential exposure to blood
o Avoid sharing sharps items such as razors, nail clippers, toothbrushes, earrings etc.
o Practice safe sex
o Make sure to use new or sterile needles or sterile equipments for ear/body piercing, tattooing, acupuncture, dental procedures etc

How vaccination is done?
o Dosage depends on age and brand. The manufacturer's guidance should be followed.
o Injections are given intramuscularly in the upper arm or anterolateral thigh. It should not be given into the buttock.
o The standard course of immunization involves three injections at 0, 1 and 6 months.
o An accelerated course of 0, 1 and 2 months is possible - also for combined hepatitis A and B vaccines.
o Adults who need protection very quickly (e.g., within 48 hours of exposure) can have a schedule of 0, 7 and 21 days. Adults and children considered at very high risk should also have an accelerated schedule. After an accelerated course, a booster at one year is recommended.
o The duration of protection provided by the hepatitis B vaccine is still unknown but is believed to be at least 20 years.
o It is quite possible that a course may give lifelong immunity.

Who should be vaccinated against hepatitis B?

All infants should receive the first dose of the vaccine at birth, or before leaving the hospital. We also recommend this vaccine for anyone who lives in close contact with, or is a sexual partner of an infected individual. In addition, the vaccine is recommended to anyone who is at risk of infection through their job, lifestyle choices, or other life circumstances.

Risk factors for hepatitis B are:
o Health care workers and emergency personnel
o Infants born to mothers who are infected at the time of delivery
o Partners or individuals living in close household contact with someone who is infected
o Individuals who have had multiple sex partners
o Individuals who use illegal drugs
o Individuals who received a blood transfusion prior to 1992
o Individuals who get tattoos or body piercings
o Individuals who adopt children from or travel to countries where hepatitis B is common (Asia, Africa, South America, the Pacific Islands, Eastern Europe, and the Middle East)
o Individuals emigrating from countries where hepatitis B is common, or is born to parents who emigrated from these countries.
o Patients with chronic kidney disease or chronic liver disease

Concluded..