Blood test for hepatitisHEPATITIS  B

A little background

Hepatitis B is a potentially life-threatening disease caused by the Hepatitis B Virus - HBV. This disease is a major and global medical problem. This department is moving into a chronic phase, putting the patients at risk of death due to its complications such as cirrhosis of the liver and/or liver cancer . The vaccine against this infection has existed since 1982. Its effectiveness in preventing the disease is estimated to be 95% effective. In the Middle East, the prevalence of this disease is 3.3% of the adult population.
 

key facts

• Hepatitis B or hepatitis B is caused by a viral contaminant that can cause both an acute disease now and a chronic disease that lasts for more than six months

• Infection occurs through exposure of a person to the blood and/or other bodily fluids of a contaminated person

• According to recent estimates, there are approximately 257 million people in the world who are infected with the hepatitis B virus (HBV)

• In 2015 hepatitis B caused approximately 887,000 deaths, mainly through the complications of the disease such as cirrhosis or liver cancer

• Hepatitis B is an important occupational risk for healthcare workers

• Despite all this, the disease can be prevented through an effective and safe vaccine

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ways of transfer

The hepatitis B virus can survive outside the human body for over 7 days. During this time it is still possible to contract the disease if there is exposure to the pollutant by an unvaccinated person.
The incubation time (from the moment the contaminant enters the body until the symptoms of the disease appear) of Hepatitis B is on average 75 days, but can range from 30 to 180 days. The virus can be detected in the human blood after 30 to 60 days from the day of infection, and there is a possibility of the disease transitioning into a chronic state.

In endemic areas (areas with a high rate of infection) this disease is often passed from mother to newborn at birth (perinatal infection), or due to exposure to contaminated blood (horizontal transmission) mainly in the first 5 years of life, when there is exposure to the blood of a contaminated child from uncontaminated children. The development of a chronic disease is very common among toddlers who are infected from the mother and/or in the first 5 years of their lives.

The hepatitis B virus is also transmitted through skin exposure and through contact that contaminates human mucous membranes due to exposure to various body fluids, such as saliva and semen, vaginal fluids.

Transmission of the disease during sexual intercourse can take place, especially when it comes to intercourse with unvaccinated males, sexual life with many partners or sexual intercourse with sex service providers. Infection in old age causes chronic disease in less than 5% of cases.

Another way of transmission is the reuse of needles and/or syringes in the medical services or among a population that consumes drugs by injection. In addition, infection can happen during surgical medical procedures, dental treatments, getting tattoos, using razors or other objects that have the potential to be contaminated with contaminated blood. You can read aboutViral diseasesmore

 

symptoms

Most people do not experience any symptoms during a current acute illness. Although some people can present a picture of jaundice (yellowing of the eyes and skin), dark urine, extreme fatigue, abdominal pain, nausea and vomiting. A small proportion of patients can develop acute liver failure, which can even cause death.

In some patients, type B hepatitis can cause the disease to transition into a chronic condition that over time can develop into liver cirrhosis (scarring of the liver causing the loss of its function) and liver cancer.

Who is at risk of developing a chronic disease?

The chance of Hepatitis B becoming chronic depends on the age at which the person was infected. Children infected with hepatitis B have the highest risk of getting sick in its chronic form as well.

            Among toddlers and children:

80-90% of infants infected in the first year of their lives will develop chronic hepatitis B

30-50% of the children infected up to the age  years 6 will develop a chronic disease as well

            Among adults:

Less than 5% of people who are healthy except for hepatitis B will develop chronic hepatitis B

20-30% of adults with chronic hepatitis B will develop cirrhosis or liver cancer.

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Co-infection with hepatitis B and HIV

About 1% of the people infected with HBV (hepatitis B virus), which make up around 2.7 million people in the world, were also found to be infected with HIV. In contrast, among HIV patients the frequency of HBV patients is 7.4%. As a result, since 2015, the World Health Organization (WHO) recommends drug treatment for all HIV patients, regardless of the stage of their disease. This is because initial treatment for HIV also helps against HBV infections.

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diagnosis

  It is not possible based on clinical data to distinguish hepatitis B from another type of viral hepatitis, therefore, the diagnosis must be verified   against the results of laboratory tests. There are several blood tests that are used to diagnose and monitor the condition of patients with hepatitis B. These tests can also be used to differentiate whether the patient has an acute or chronic disease.

These laboratory tests focus on identifying the hepatitis B virus envelope antigen HBsAg (a foreign receptor that belongs to the outer part of the virus. This is the first part of the virus that the human immune system encounters). The World Health Organization recommends testing all blood donations with these laboratory tests in order to prevent accidental infection of people who receive blood products.

 

• An acute HBV infection is characterized by the presence of HBsAg and immunoglobulin M (IgM, a type of antibody that the immune system produces at the beginning of the immune response to infection) to the virus core antigen HBcAg. In the initial stages of infection, HBeAg antigens can also be detected, which indicate the high culture rate of the virus, their presence indicates a high infectious potential of blood and/or other body fluids of this person to infect others. 

• Chronic disease is characterized by the presence of HBsAg in tests continuously for a period of more than 6 months (with or without the presence of HBeAg). Remaining HBsAg for this long period indicates a chance of developing the hepatitis complications described above later.

 

care

  There is no unique treatment for viral hepatitis B in its acute state. Therefore, supportive care is focused on maintaining a nutritional balance and returning fluids that a patient loses during vomiting and diarrhea. Chronic disease can be treated with drugs, including antiviral drugs. The treatment can slow down the development of liver cirrhosis, reduce the incidence of liver cancer and thus improve long-term survival rates.

  WHO recommend oral treatment (pills) using the drugs Tenofovir, Entecavir because of their high potency (strength of effect) in suppressing the virus. Unlike other drugs, it is rare for a drug-resistant virus to develop under their treatment. In addition, a treatment regimen including taking 1 pill a day and a relative minority of side effects requires less strict monitoring. As of 2018, both drugs should end their patent periods.

  When it comes to the complications of the disease such as cirrhosis and cancer, these are serious diseases. This type of cancer develops quickly, and since the treatment options are limited, in most cases the results are generally not good. Especially when it comes to low social conditions, most people with liver cancer die within months of diagnosis. Under better conditions, surgical treatments and chemotherapy allow life to be extended by several years. Sometimes treatment with a liver transplant is possible in severe cases of cirrhosis with variable success rates.

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prevention

The main prevention of hepatitis B is done through vaccinations. WHO recommends vaccinating infants as soon as possible, preferably during the first 24 hours of life. A significant decrease in the incidence of viral liver disease type B in its chronic form is attributed to the widespread use of the vaccine in question. This prevalence decreased in 2015 to 1.3% worldwide as opposed to 4.7% before the use of these vaccines. In Israel, the vaccine is given in 3 stages: at birth, at the age of one month and at the age of 6 months.

 The vaccination causes the production of a sufficient level of antibodies in over 95% of the cases. The protection that develops through this vaccine is sufficient for at least 20 years and potentially can be sufficient for life. Therefore, it is not officially recommended to add booster vaccines to those who received the vaccine in the 3-step way. This vaccine has been shown to be safe and effective. Since 1982, more than a billion doses of the vaccine have been used. In many countries where the percentage of children who were sick with hepatitis B was 8-15%, it dropped to less than 1% after the start of using vaccines. Other ways to prevent infection are checking the blood samples for carriers, a safer sex life, including reducing the number of partners and using condoms.

 

Specific laboratory tests

During the performance and interpretation of the laboratory tests related to the hepatitis B disease, protein inventions from different parts of the virus (antigens) and unique antibodies that the body produces against these antigens are tested.

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Hepatitis B surface antigen (HBsAg) - a protein from the envelope of the HBV virus. found at a high level during acute or chronic hepatitis B. The presence of this protein indicates that this person can infect others. The body during a normal immune response produces antibodies against this antigen. This protein is used during vaccine production.

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Hepatitis B surface  antibody (anti-HBs) - an antibody produced by the body against HBsAg. Their presence in the blood generally signifies recovery from illness and the development of protection against HBV infection. These antibodies are present even after successful vaccination.

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Total hepatitis B core antibody (anti-HBc)-  Total antibodies against a protein from the core of the HBV virus. Appears during an acute illness and remains in the human blood for life. The presence of these antibodies Indicates patients with hepatitis B now or sometime in the past.

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IgM antibody to hepatitis B core antigen (IgM anti-HBc) - a type of antibody against a virus core protein, which was first formed as part of the body's immune response to HBV. Over time, it is replaced by other types of antibodies. Their presence indicates infection in less than 6 months, and indicates an existing disease at this moment.

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Hepatitis B tests can be performed with us. The answers are given within 48 hours, except for special tests.
A doctor's referral is not necessary.

The test is confidential and anonymous, it is not in the POS databases.
 

You can enter the full list of viral diseases and additional blood tests.

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