Hepatitis B

This viral disease affects 1% of the population in France.

This virus is responsible for 10% of cases of chronic hepatitis and in 1% of cases of hepatitis fulminans (fatal in a few days).

In addition, it is responsible for 80% of primary liver cancer.

The virus is found in blood, semen and vaginal secretions, like AIDS, but hepatitis B is much more contagious.

The virus is also found in saliva in very small quantities.

The most at risk are drug addicts and homosexuals (as in AIDS).

Also currently, there is a very significant increase in hepatitis B among heterosexuals more than a quarter of hepatitis B are heterosexually transmitted.

B virus is not transmitted by way of the placenta from mother to child during pregnancy but is passed from mother to child during childbirth. This transmission induced in 80% of chronic hepatitis in children.

This is why we must vaccinate at birth of children born to HIV-positive mothers with hepatitis B, especially if they carry markers of replication (HBeAg and DNA).

The incubation period is longer than that of hepatitis A, it can go up to 4 months.

The symptoms are those of hepatitis:

- Jaundice (jaundice)

- ILI

5 to 10% of affected individuals will develop chronic hepatitis. These topics are contagious and will change often to cirrhosis or liver cancer in the following years.

Contamination, in addition to sex, may be by blood. This is why the medical and paramedical staff is a population at risk.

Saliva also contains small amounts of virus, and although no formal experimental evidence can be advanced, it is possible to explain the family repeated contamination by saliva contact. (A sick person to a non-vaccinated person)

Currently it is necessary to vaccinate all subjects at risk:

- People living with HIV HBV, that is to say, carrying the hepatitis B

- Medical staff,

- Subjects with multiple sexual partners,

- Homosexuals,

- Drug addicts,

- Newborns of mothers carrying the virus.

In reality, it is imperative vaccinate adolescents before their first sexual intercourse as the mode of transmission is common. Hepatitis B will become in the coming years a real public health problem if vaccination is not compulsory for all. It would even make mandatory vaccination against hepatitis B in infants, especially those born to mothers with the virus.

You can get effective protection by two injections one month apart and a booster at 6 months 12 months later.

The previous strategy, three injections and booster one year later can be preserved when immunity must be acquired quickly.

We currently have three vaccines:

- GENEVAC B

- Engerix B

- HB vax DNA.

We can consider hepatitis B as an STD, sexually transmitted disease.

TREATMENT

- Treatment of acute hepatitis is bed rest, if fatigue is very important.

There is no diet to follow, if not the elimination of alcohol in all its forms.

A new therapeutic hope is based on results VITRO (see this term).

A cellular protein, 3G Apobec seems capable of inhibiting the replication of HBV.

It will cause the inactivation of the DNA (see DNA (DEOXYRIBONUCLEIC ACID) by incorporating viral during reverse transcription.

This molecule could control viral replication chronically ill and perhaps eradicate the virus during the acute phase of infection.

Against chronic hepatitis B, we can use corticosteroids, interferon alpha and sometimes some antiviral drugs such as lamivudine or Vidarabine acting competitively inhibiting DNA polymerase and thus prevents viral replication.

Interferon alpha can be transient side effects. It can trigger a flu-like illness with fever, fatigue, joint pain, low white blood cells and blood platelets, hair loss, depression syndrome. Sometimes thyroid abnormalities may occur.

These side effects are very well explained because these are the symptoms of the flu. The organization achieved by the influenza virus produces large amounts of alpha interferon. This overproduction intended to kill the virus causes the same symptoms as when administering interferon alpha for therapeutic purposes.

The treatment seems more effective if the patient is young, he is a woman, if the infection is recent, if not the yellow race. The treatment is of course against-indicated if the subject is infected vis-à-vis AIDS.

The adénovir dipivoxil is a new antiviral drug appears to be effective and well tolerated.

It complements the two antivirals are known as alpha interferon and lamivudine.

It remains to wait to assess the preventive effect of cirrhosis and liver cancer.

View:

HEPATITIS A

HEPATITIS A VACCINE

HEPATITIS B VACCINE

HEPATITIS C

HEPATITIS D

HEPATITIS E

CHRONIC HEPATITIS

VIRAL HEPATITIS