Henry is an avid traveller. He loves experiencing the cultures of various countries. On his last trip to Thailand, he had gotten a tattoo as a result of losing a bet with some friends. He thought nothing of it until a few months later.
Over a couple of days, Henry had gotten progressively tired, with yellowing of his eyes and pain in the tummy. He was worried and rushed over to see his family doctor.
After Henry mentions his symptoms and his recent travels, the doctor suspects that he might have contracted a Hepatitis B infection.
What is a Hepatitis B infection?
Hepatitis B infection is caused by the Hepatitis B Virus (HBV) which can cause liver damage. The virus can cause acute symptoms like that experienced by Henry. It can also progress to the “chronic” stage where it remains in the liver, causing long-term damage and leading to diseases like cancer. It is estimated that over 1% of mostly older adults in Malaysia have it.
It is commonly spread through contaminated blood and fluids. As in the story of Henry, a contaminated tattooing needle may have been the source of his infection.
Who gets an HBV infection?
Drug users
Many needles that are used by drug addicts are unclean and not sterilized. Some who practice needle sharing may contract the infection from another drug addict. This is one of the common ways a person can get an HBV infection in Malaysia.
Mother to a newborn baby
Before the advent of HBV screening and vaccination, mothers who have HBV infection without symptoms may unknowingly pass it on to their children. This is especially common in communities with high rates of HBV.
Unprotected sex
Since HBV can be spread via body fluids, having unprotected sex can increase the risk of contracting the virus. For this reason, it is recommended to wear condoms consistently to minimize the risk of contracting the infection.
Tattoos or body piercings
Tattooing involves many injections of tiny drops of ink into the skin via tiny needles. This increases the risk of transmitting infections by blood like HBV. The risk is greatest when performed in unsanitary conditions or prisons. Therefore, it is important to select a professional who will properly sterilize the equipment before usage.
Healthcare workers
Healthcare workers like nurses and doctors come into contact with patients infected with HBV from time to time. If a needlestick injury occurs – as when a healthcare worker is pricked by a needle that was used on an infected patient – there is a risk of the healthcare worker contracting HBV infection.
What are the symptoms of HBV infection?
Tiredness
As the body is trying to fight off the infection, the individual may feel unusually tired throughout the day.
Aches and pains
Our immune system will react to viral infections such as that by HBV.
While it fights the virus, it may also cause joint and muscle pains.
Yellowing of skin and eyes (Jaundice)
Damage to the liver can interfere with its normal processes. One example is the processing of a substance called unconjugated bilirubin to be excreted.
When the liver is damaged, this substance accumulates and leads to the yellow colour seen.
Loss of appetite
Ongoing inflammation or damage to parts of the body like the liver can trigger the release of factors that may reduce our appetite.
Tummy pain
Discomfort or pain may be felt on the right side of the tummy below the ribs, where the liver is located.
This may be due to ongoing liver damage.
How to treat HBV infection?
Henry let out nervous laughter as he thinks about how he got infected. He then asks the doctor if there is any cure for the infection?
The doctor reassures Henry. “Since you have mild symptoms, you do not require hospitalization or any specific treatment.”
Acute HBV infection
For this type of infection, there is no specific treatment.
Doctors will advise the patient to get plenty of rest and provide paracetamol for tummy pain.
People will generally recover from the illness within a couple of months.
However, if the individual begins to vomit or show signs of dehydration, he or she should be sent to the hospital.
“Oh, great! So, can I be free of this illness once it passes?” Said Henry to the doctor. The doctor shook his head in disagreement.
Chronic HBV infection
Unfortunately, some individuals infected with HBV virus go on to develop “chronic” HBV infection. In this stage, the virus multiplies and causes damage to the liver over time, leading to a host of complications like liver cirrhosis and cancer.
After this acute phase, Henry needs to follow up with the doctor for routine tests. This is to determine if the virus is eliminated from his body.
Henry is curious as to what type of routines tests he will need to take and asks the doctor. The doctor explains:
Liver function tests (LFTs)
Over time, HBV can multiply and cause long-term damage to the liver. If not carefully monitored, permanent damage in the form of liver scarring may occur.
LFTs such as AST and ALT reflect the degree of liver damage and can be used by the doctor to monitor the progression of the illness. This will be done with a simple blood test.
Hepatitis B serologic markers
There are certain markers of HBV which are elevated in disease.
The presence of a marker like HBsAg for more than 6 months after initial symptoms may indicate a chronic infection. This too will only require a simple blood test.
Ultrasound scan
An ultrasound is a painless method used by a doctor to detect abnormalities of the organs around the tummy area. Some people who have chronic HBV infection are recommended to have annual screening as they have a high risk of developing liver diseases. This is helpful to pick up any liver problems early on and attempt to treat it.
Henry understood and thank the doctor. He felt less anxious about his condition because of the information given to him by the doctor. He will be scheduling his follow-up visit to monitor his condition with the doctor.
In conclusion, HBV can cause severe liver problems in those who are infected by it. Therefore, those with HBV infection need to have regular follow-ups with medical professionals.
