Hepatitis B
Hepatitis B is a liver infection caused by the hepatitis B virus. In the Netherlands, this virus is primarily transmitted through sexual contact. It enters the body through the mucous membranes of the genitals and then spreads via the bloodstream to the liver. There, the virus settles in the liver cells and causes inflammation. The severity of the symptoms varies. Sometimes there are no symptoms at all, but in the long term, permanent liver damage can occur. Often, the body controls the virus within six months, and the infection is then gone. This can be confirmed with blood tests. The virus has then disappeared from the blood, and the body has produced antibodies. A person is then no longer contagious and is also protected against a possible new infection with the hepatitis B virus. Sometimes the body cannot fight the virus, resulting in a chronic hepatitis B infection. Someone with a chronic infection (also called a "carrier") is still contagious to others. The chance of becoming a "carrier" is greater if the infection is contracted at a young age. The longer you are infected with the virus as a carrier, the greater the risk of permanent liver damage. Ultimately, liver cancer can even develop.
Hepatitis B is highly contagious. The virus is present in the blood, but also in other bodily fluids, such as semen, saliva, and vaginal fluids.
HOW DO YOU GET HEPATITIS B?
A person can become infected with hepatitis B in several ways. For example, through:
Sexual contact.
This primarily involves unprotected sexual contact with penetration (penis in vagina and penis in anus). Transmission occurs through contact of semen and vaginal fluid with the partner's mucous membranes. Damage to the mucous membranes, which are often invisible to the naked eye, increases the risk of infection. Therefore, anal sex carries the greatest risk of contracting hepatitis. Mucous membranes around and in the anus are more easily damaged.
Mucous membrane damage can also result from other STIs. For example, having an STI increases the risk of contracting hepatitis B. The risk of contracting hepatitis B during sexual contact is higher during menstruation. Unprotected oral sex (fellatio and oral sex) carries only a small risk of hepatitis B transmission. Although the hepatitis B virus is also present in saliva, French kissing is not the primary route of infection.
Blood-to-blood contact:
Infection can occur through contaminated blood. For example, by sharing needles and other equipment such as straws for drug use, using contaminated instruments or administering contaminated blood products in hospitals, and accidental needle stick injuries by healthcare personnel. Infection also occurs through unhygienic acupuncture, tattooing and piercing, or by sharing razors and toothbrushes. During childbirth:
If the mother has the hepatitis B virus in her blood, there is a high risk of passing the virus to her child during pregnancy or childbirth.
Other forms of transmission:
Transmission of the hepatitis B virus also occurs between family members in a shared household or among people in an institution. This form of transmission is possible through sharing razors and toothbrushes and possibly also through unknowing blood-to-blood contact. A person can also become infected if bitten by someone with hepatitis B.
WHAT ARE THE COMPLAINTS?Hepatitis B infection usually goes unnoticed and is asymptomatic. A minority of infected individuals do experience symptoms. Common symptoms include fatigue, fever, muscle and joint pain, lethargy, nausea, and upper abdominal pain. Skin abnormalities and joint inflammation also occur. These symptoms are sometimes followed by a period of jaundice: yellowing of the whites of the eyes and skin, combined with dark urine (like old tea), and sometimes discolored stool (putty-colored). Symptoms typically develop two to three months after infection and last from several weeks to a maximum of six months. Even after all other symptoms have disappeared, a person can remain tired for months.
POSSIBLE CONSEQUENCES OF HEPATITIS B:
In chronic active hepatitis B, the hepatitis B virus causes long-term (chronic) inflammation in the liver. This chronic infection can eventually have serious consequences because scar tissue forms in the liver (cirrhosis). With cirrhosis, the liver functions less effectively, which can cause a variety of symptoms. There is also an increased risk of liver cancer.
TREATMENT
No medication is given for acute hepatitis B. The disease usually resolves on its own within six months. It is recommended to rest as much as possible. Alcohol and poorly tolerated foods (such as fat and coffee) are discouraged.
Medication is prescribed for chronic hepatitis B. In 40 percent of infected individuals, this inhibits the virus. In 10 percent of cases, the virus disappears from the blood.VACCINATIONIn the Netherlands, groups at increased risk for hepatitis B are vaccinated free of charge. These include prostitutes, drug users, and men who have sex with men. The vaccine used for this purpose is safe and effective.
The vaccination consists of three injections, the second administered one month after the first and the third five months after the second. A vaccinated person is protected against hepatitis B for long periods. It is also possible to administer antibodies against hepatitis B if someone has come into contact with the virus, such as through a needle stick injury or unprotected sexual contact with someone infected with hepatitis B. This is only useful shortly after the potential infection, preferably within 24 hours (up to a maximum of seven days). Babies whose mothers have hepatitis B receive antibodies immediately after birth. They then receive a full vaccination against hepatitis B at the same time as the DTaP injection. If the father is known to be a carrier of the virus and the mother is not, full vaccination of the baby is also recommended. In that case, administering antibodies after birth is not necessary.ADVICE REGARDING SEXUAL PARTNER(S), FAMILY MEMBERS AND HOUSEMATESIf someone knows they are a carrier of the hepatitis B virus, it is recommended that their regular (sexual) partner, family members, and housemates be vaccinated against hepatitis B. This vaccination is covered by the AWBZ (Long-Term Care Act) and administered by the Municipal Health Service (GGD).OTHER FORMS OF VIRAL HEPATITISHepatitis A
This form of hepatitis is caused by the hepatitis A virus. This virus enters the liver through the mouth and gastrointestinal tract, where it causes inflammation. The symptoms of a hepatitis A infection are the same as those of hepatitis B. In children, the infection usually goes unnoticed. Hepatitis A resolves spontaneously within a few weeks, usually without complications. Hepatitis A does not lead to cirrhosis or liver cancer. In some cases, hepatitis A is sexually transmitted, for example, by licking the anus of an infected person ("rimming").
Hepatitis C
Hepatitis C is the term for liver inflammation caused by infection with the hepatitis C virus. Transmission occurs primarily through contact with contaminated blood, for example, among drug users who share equipment such as straws or syringes. In recent years, sexual transmission of hepatitis C has been increasingly observed among a specific group of infected individuals, namely HIV-positive gay men. It is not yet entirely clear how the virus is transmitted during sexual contact. This requires further research. Hepatitis C infection usually goes unnoticed. It sometimes causes symptoms of fatigue and jaundice. Without treatment, the infection becomes chronic in most infected individuals. This can eventually lead to complications such as cirrhosis and liver cancer (as with hepatitis B).PARTNER WARNINGIn the case of acute hepatitis B, it is important that sexual partners are informed and also get tested. This applies to all partners in the six months prior to diagnosis. For chronic carriers, this period may be longer. Others in the community who may have been at risk, such as housemates or people with whom drug paraphernalia has been shared, should also be tested. |
