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Hepatitis B virus infection is a leading cause of death worldwide. According to the World Health Organisation, two thousand million individuals have been diagnosed with this disease, and almost 350 million of them have been found to be permanently infected; of all that have been seriously infected with this infection, 65 million are expected to die from it. The challenge posed by this condition is very clear from the evidence, and this is because Chronic Hepatitis infection is linked to a variety of diseases, including the risk of cirrhosis and hepatocellular carcinoma. Age factor also plays a vital role in the determination of CHB virus, as this risk is low in adults and its severity reaches to maximum when it comes to neonates whose mothers are diagnosed with this virus. There are a number of drugs and medicines that are used in the treatment of this disease. One of the most used technique to prevent the growth of this virus in the human body is the method of vaccination. The vaccinations for this disease are available since the late 20th century. These vaccines play an important role in preventing the virus. The transmission of HBV in developing nations has been controlled by applying various techniques to stop the growth of this virus. However, in third world countries this virus us still a significant risk and due to the limited access to HBV vaccination, many people are still falling to this disease. This paper will discuss the history of this disease and an overview of the epidemiology along with its prevention, diagnosis, and treatment.
In general, Hepatitis refers to “inflammation of the liver”. The liver is the largest internal organ of the body and it has many vital roles in the body, this virus causes the inflammation of liver cells which results in the destruction if these cells. In 1885 a scientist named Lurman recorded the earliest epidemic that is caused by the viral cells of hepatitis B. It all started when in the year 1883, smallpox became an epidemic and an outbreak occurred in Bremen. In order to save all the infected people these people were vaccinated with the lymph of healthy people and their smallpox was cured. All those people who were vaccinated became healthy due to the vaccination but almost eight months later, approximately 200 workers who were vaccinated with the lymph were found to be suffering from serum hepatitis. It was proved in the later studies that the contaminated lymph was the source of this outbreak. It was in the year 1966 when this virus was discovered. Baruch Blumberg found antigen when he was working at National Institute of Health, later it was explained as the surface antigen of hepatitis B virus, in the blood stream of Australians. The first vaccine was tested in the year 1980.
The virus of hepatitis B has the capacity to stay alive outside the body for at least 7 days. If the body of a person is not immune to this virus and is not vaccinated the virus can enter the body and can cause infection. The time for incubation of this virus is seventy five days on average. Hepatitis B virus is commonly diagnosed after the period of 50 days in a body and after infection, this may develop into chronic hepatitis. It is very common in endemic areas that this virus is transmitted from mother to her children or through vertical transmission to healthy child during their young age which is up to first five years. In the first five years of a child life , the risk of introduction and development of severe infection in infants is common.
It is also spread through subjection of infected blood and different bodily fluids like saliva, blood that is drained out of the body during menstrual cycles and seminal fluids. Sexual transmission also occurs when an unvaccinated man has sex with more than one sex partner at any given condition the life of both the persons is at stake. Hepatitis B virus is also transmitted if the needles are reused and syringes are not wasted after use, these needles and syringes are dumped without precaution and are used by drug addicts which causes the transmission to grow at rapid rate. Tattooing, medical and dental procedures, razors used during shaving and dirty operating equipment can also transmit this virus from one person to another.
Signs and symptoms
Most of the people do not feel any symptoms in the acute infection phase. Some people, however, encounter symptoms which include vomiting and nausea, also as the liver is not functioning properly the color of urine changes to more dark and the patient loses all the appetite, aches in the body and then these symptoms develop jaundice. All types of hepatitis have a common symptom that is itchy skin and it is characterized as the most common symptom. This illness lasts for a few days but in some people, the virus gets more active and they face a severe liver disease that is known as the fulminant hepatic failure which can also lead to the death of the infected patient.
. Hepatocellular carcinoma is also caused due to this infection. Alcohol consumption is avoided in chronic carriers as it may increase the chance of getting cirrhosis and liver cancer. Hepatitis B also leaves symptoms outside of the liver, but they are very rare and are present in very few people which on average forms five percent of infected people, this also includes serum sickness-like syndrome, vasculitis, and glomerulonephritis. In acute hepatitis B, the serum sickness-like syndrome occurs which often precedes to the setting of jaundice. The symptoms of this are fever and skin rash, these symptoms may become dormant with the cure of jaundice but these symptoms also have the tendency to persist during the disease.
The virus of Hepatitis B interferes with the functioning of the liver by converting into a hepatocyte. NTCP is a functional receptor that is closely related to carboxypeptidase D. Extrahepatic cells also contains the cellular receptors that are present in HBV, this theory is suggested due to the presence of viral DNA proteins in the extrahepatic sites. When the infection take place the immune response of the host becomes a reason of hepatocellular damage and viral clearance. Immune system also plays a crucial role in incubation of this virus as the innate system is very dormant in this process but the adaptive system takes part in most of the injuries that are associated with the infection of Hepatitis B.
It is not applicable to differentiate between the virus of hepatitis B that is spread by other agents on clinical grounds. The basic steps to diagnose the virus is to get laboratory confirmation that if the sample provided is free of virus. The number and range of blood tests that These tests and laboratory reports are very necessary in order to differentiate between the stages of hepatitis may that be chronic or acute. .
Laboratory test emphasize on the presence of hepatitis B surface antigen HBsAg in the blood stream. It is recommended by doctors and physicians that the blood that is donated should be tested for hepatitis B to make sure that blood is of a healthy person, this is helpful to prevent and avoid accidental transmission of the virus in people who receive blood transfusions on a regular basis.
The two stages of this infection, chronic and acute are characterized by the presence of HBcAG and HBsAg. HBcAG is present in the acute stage and is found along the immunoglobulin and the accumulation of HBeAg in the blood stream shows that the blood of the person is highly infectious. Severe infection is differentiated from acute infection on the basis of the presence of HBsAg which is persistent in the blood for almost 6 months. This is a sign that the patient may develop liver disease or a carcinoma later in his/her life
It is very important to make sure that all the infants who are born receive the vaccination with in 24 hours of their birth in order to prevent the chance of getting this disease. The method of vaccination is very effective and as a result, the number of cases of infants has decreased. Following are the people who should receive the vaccine if not yet received.
•People who received a blood transfusion
•People who interned in prison
•Sexual contact with infected people
•People with multiple sex partners
•Health care workers
•Travelers before leaving endemic areas.
According to an estimate, approximately three hundred and fifty million people were infected with hepatitis B worldwide, this census was conducted in the 2004. Regional prevalence range from over ten percent in Asia and almost one percent in northern Europe. The root of this infection includes the transmission through vertical (childbirth) and horizontal (bites, sanitary habits) transmission. In the United States, the primary cause of transmission of this disease is unprotected sex. In East part of Europe, Russia and some regions of Japan, on average five percent of the total population gets infected with this disease and are found to be on the chronic stage. China is one of the high prevalence areas of this disease and transmission during birth is more common. China has approximately 12 million infected people. According to an estimate, almost six hundred thousand people die every year due to this disease.
Hepatitis B is one of the diseases that can be put to stop if the vaccination at the birth is received by everyone. This disease is a considerable cause of the mortality and morbidity worldwide. There are many new methods and techniques that are being developed in order to introduce a better and more effective cure. This is our responsibility to make sure that we clean all the equipment before any checkup, operation or procedure. Also, the blood of the donor should also be tested in order to avoid any problem. It is important to prevent the causes of this disease so that we may play our role in stopping this disease from spreading.
Blumberg, B. (2002). Hepatitis B. Princeton, NJ: Prentice University Press.
Bloom, M. (2002). Understanding Hepatitis. Jackson: University Press of Mississippi.
Chow, J., & Chow, C. (2006). The encyclopedia of hepatitis and other liver diseases. New York, NY: Facts On File.
Liaw, Y., & Zoulim, F. (2016). Hepatitis B Virus in Human Diseases. Cham: Springer International Publishing.
Tang, Z., & Ye, S. (1996). Recent progress in liver cancer and hepatitis. International Academic Publishers.
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