Sexually Transmitted Diseases (STDs in Men) (cont.)

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Hepatitis B

What is hepatitis B and how is it spread?

Hepatitis B is liver inflammation (hepatitis) that is caused by the hepatitis B virus (HBV). HBV is one of several viruses that cause viral hepatitis. Most individuals that are infected with HBV recover from the acute phase of the hepatitis B infection, which refers to the initial rapid onset and short course of the disease. These persons develop immunity to the HBV, which protects them from future infection with this virus. Still, some individuals infected with HBV will develop chronic or long-lasting liver disease. These persons are potentially infectious to others. Moreover, patients with chronic hepatitis B are at risk for developing, over many years, severe and complicated liver disease, liver failure, and liver cancer. These complications at times lead to the necessity of a liver transplant.

Hepatitis B is transmitted in ways that are similar to the spread of HIV. These modes of transmission are primarily through sexual contact, exposure to contaminated blood, such as from sharing needles, or from infected pregnant women to their newborns. Only half of acute hepatitis B infections produce recognizable symptoms.

How can hepatitis B infection be prevented?

A highly effective vaccine that prevents hepatitis B is currently available. It is recommended that all babies be vaccinated against HBV beginning at birth, and all children under the age of 18 who have not been vaccinated should also receive the vaccination. Among adults, anyone who wishes to do so may receive the vaccine, and it is recommended especially for anyone whose behavior or lifestyle may pose a risk of HBV infection. Examples of at-risk groups include:

  1. sexually active men and women;
  2. illegal drug users;
  3. health care workers;
  4. recipients of certain blood products;
  5. household and sexual contacts of persons known to be chronically infected with hepatitis B;
  6. adoptees from countries in which hepatitis B is common, such as Southeast Asia;
  7. certain international travelers who may have sexual or blood exposures;
  8. clients and employees of facilities for the developmentally disabled, infants and children; and
  9. patients with renal failure on hemodialysis.

The vaccine is given as a series of three injections in the muscle tissue of the shoulder. The second dose is administered one month after the first dose and the third dose is given 5 months after the second dose. In the event that a non-immunized individual (who would not have protective antibodies against HBV) is exposed to the genital secretions or blood of an infected person, the exposed person should receive purified hepatitis B immunoglobulin antibodies (HBIG) and initiate the vaccine series.

How is hepatitis B infection diagnosed?

The diagnosis of hepatitis B is made by blood tests for the hepatitis B surface antigen (HBsAg, the outer coat of the virus), hepatitis B surface antibody (HBsAb), and hepatitis B core antibody (HBcAb). If the HBsAb antibodies are in the blood, their presence indicates that the person has been exposed to the virus and is immune to future infection. Furthermore, this person cannot transmit the virus to others or develop liver disease from the infection. The HBcAb antibodies identify both past and current infection with the HBV. If the HBsAg antigen is in the blood, the person is infectious to others. There are also two possible interpretations to the presence of this antigen. In one, the person has been recently infected with HBV, may have acute viral hepatitis, and will develop immunity in the coming months. In the other interpretation, the person is chronically infected with HBV, may have chronic hepatitis, and is at risk for developing the complications of chronic liver disease.

Medically Reviewed by a Doctor on 10/16/2014

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