Viral hepatitis encompasses five known viruses, hepatitis A, B, C, D, and E. Hepatitis B virus (HBV) is a serious disease caused by a virus that affects the liver, which may cause lifelong infection, cirrhosis (scarring and dysfunction of the liver), liver cancer, liver failure, and death.
About 1.4 million Americans have chronic hepatitis B infection, and about 350 million individuals worldwide have this disease. In the US, the rate of new cases of hepatitis B has declined steeply, by about 80%, since the early 1990s when a national strategy to eliminate this infection was introduced in the US. However, since many HBV infections are asymptomatic or not reported, the numbers of those infected are estimated to be higher.
The risk for chronic hepatitis B is related largely to when the person becomes infected. About 90% of infants and 30% of children younger than 5 years old who become infected with hepatitis B will stay chronically infected. In contrast, about 95% of those infected as adults will completely recover and not become chronically ill.
About 30% of those infected with HBV have no symptoms; children and newly infected immunosuppressed adults generally do not have any symptoms. Symptoms in other individuals may include jaundice, fever, fatigue, nausea, vomiting, loss of appetite, abdominal pain, dark-colored urine, light-colored stools, and joint pain.
Those with chronic HBV may develop chronic hepatitis, cirrhosis, or liver cancer. Many patients with chronic HBV infection have no symptoms until they are diagnosed with cirrhosis or end-stage liver disease.
HBV is transmitted through punctures in the skin or by mucosal contact with infectious blood or body fluids, including:
HBV cannot be transmitted via water or food, sharing eating utensils, breastfeeding, kissing, coughing or sneezing.
At-risk individuals include:
There is a vaccination against HBV which is recommended for all infants and children, sexually active individuals not in a monogamous relationship, and all others with risk factors for the virus.
A blood test can determine whether patients are infected with HBV an average of 4 weeks after exposure. Blood tests detect certain antigens and antibodies to HBV present in a patient's blood. These antigens and antibodies can reveal if the virus is present and whether an individual is acutely or chronically infected.
There is no treatment for acute HBV infection. Chronic infection can be treated with antiviral drugs. Individuals with chronic HBV infection need to be assessed regularly to determine whether the disease is arrested or progressing, and to determine whether the liver is damaged.
Patients with viral hepatitis, and in particular, hepatitis B and C, benefit from research carried out by members of the NewYork-Presbyterian team. We are home to the Center for the Study of Hepatitis C, a collaborative research and treatment partnership comprised of physicians and researchers from Weill Cornell Medical College, Rockefeller University, and NewYork-Presbyterian Hospital. The Center has a serum and tissue repository, and a database with blood and liver samples of over 1,500 patients.
The Center for the Study of Hepatitis C also works closely with our Hospital's Center for Special Studies, which treats about 5,000 HIV-infected patients, and with the Methadone Clinic, which sees about 400 patients. Many of these patients are also infected with hepatitis.
Additionally, NewYork-Presbyterian has one of the nation's most extensive clinical trials programs. Our physicians have led and participated in several of the key clinical trials that have advanced the treatment and management of hepatitis C, including those trials that have defined the current standard of treatment of ribavirin and pegylated interferon.